• Journal of Oral Medicine and Pain
• /
• v.34 no.1
• /
• pp.91-102
• /
• 2009

Condylar resorption, or condylysis can be defined as progressive alteration of condylar shape and decrease in mass. Condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. The aim of this study was to investigate clinical assessment and cephalometric characteristics in 224 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients who visited with chief complaints of TMD were 2419 and 224 (9.3%) among them revealed the condylar resorption, Among patients group with condylar resorption, female was 183 and male was 41, females were predominant. 2) Patient's age ranged from 12 to 70 and mean age was 30.6 years old with a strong predominance for 10s and 20s. Distribution of a showed as follows; 10s was 26.3%, 20s was 34,8%, 30s was 13.8%, 40s was 11.2%, 50s was 7.1%, 60s was 6.3% and 70s was 0.4%. 3) Most of the patients had parafunctional habit. 4) The case of showing the pain in condylar resorption was 145, the case of not showing the pain was 79. 5) Treatment duration of the patients was relatively short. 2. Cephalometric Characteristics 1) ANB which means the retruding of the mandible increased significantly than normal group. The ANB of female was lager than male group as the means of ANB were 5.05 in female and 3.57 in male, 2) SN-GoMe and FMA increased in resorption patients, but FH-PP did not show any significant difference. The FMA of female was lager than male group as the means were 31.69 in female and 30.44 in male. 3) Total posterior facial height was significantly smaller and total anterior facial height showed no significant increase as compared with those of the normal group. Condylar resorption was predominant in young female which was caused by more vertical facial pattern in female than male and increase of parafunctional habit in young age. It was thought that the patients who have a risk factor increasing the compressive stress at condyle caused by obliquely inclined masseter and medial pterygoid show high prevalence of condylar resorption.

• Journal of Oral Medicine and Pain
• /
• v.32 no.4
• /
• pp.441-447
• /
• 2007

Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

• Journal of Acupuncture Research
• /
• v.26 no.4
• /
• pp.39-47
• /
• 2009

Objectives : These studies are designed to make a survey of the effectiveness of oriental medicine treatment on temporomandibular disorder. Methods : The clinical study was done on 194 cases of patients with temporomandibular disorder who was treated in Ja-Seng Oriental Medicine Hospital from January 2008 to June 2008. After treatment we checked VNRS(verbal numerical rating scale) score and five-point linkert scale. Also we observed the change of symptom of click sound and trismus. Results : After the last treatment, The mean VNRS(verbal numerical rating scale) score changed 4.63 to 2.25. The click sound was disappeared of 53% patients, and the trismus was disappeared of 57% patients. And The five-point linkert scale were checked 3.78. Conclusions : It is concluded that oriental medicine treatment has on useful effect on temporomandibular disorder.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.32-36
• /
• 2010

The purpose of this study was to evaluate the clinical outcomes of patients with temporomandibular joint disorder before and after performance of arthrocentesis and stabilization splint therapy. The subjects of this study were 33 patients with limited mouth opening or pain or joint effusion who visited the Department of Oral and Maxillofacial Surgery, St Mary's Hospital, Catholic University of Korea. The arthrocentesis was performed and the stabilization splint was worn immediately after the arthrocentesis. Comparing the clinical outcomes of treatment at the times of first medical examination, 3 months and 6 months later on treatment. The results are as follows; 1. Statistically significant increase in the amount of maximum mouth opening occurred 3 months and 6 months later on treatment. 2. Statistically significant decrease in the average value of pain on test measured by VAS during maximum mouth opening, protrusive movement, right lateral movement, left lateral movement occured 3 months and 6 months later on treatment. The results suggested that arthrocentesis and stabilization splint therapy provide a improvement on patients with temporomandibular joint disorder when the exact diagnosis were provided.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.17 no.4
• /
• pp.217-224
• /
• 2001

A prevalence of temporomandibular disorders(TMD) based on the clinical sign and symptom in 155 patients were investigated. History taking with interview chart and clinical examination were performed. Age and gender of the patients, duration of TMD, location of pain, joint sound, limitation of mouth opening and more detailed diagnostic name were identified. The results of this study were as follows: 1. TMD was more prevalent in female than in male. TMD was the most prevalent at the age of 20s and decreased with age. 2. Acute TMD was more prevalent than chronic one. 3. About ninety percent of TMD patients had pain. Pain had mainly a unilateral origin. Muscle pain was mainly related with the masseter muscle. 4. Joint sound was identified in about fifty-six percent of the TMD patients and unilateral joint sound was more prevalent than bilateral one. 5. Limitation of mouth opening was observed in about forty percent of the TMD patients. 6. In TMD patients, muscle dysfunction was the most prevalent one. In muscle disorders local muscle soreness was the most prevalent one. In joint disorders, capsulitis was the most prevalent one. In muscle-joint disorders, trigger point pain with retrodiscitis was the most prevalent one.

• Imaging Science in Dentistry
• /
• v.34 no.2
• /
• pp.91-97
• /
• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• Journal of Korean Physical Therapy Science
• /
• v.5 no.4
• /
• pp.717-728
• /
• 1998

The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.2
• /
• pp.171-178
• /
• 2012

Botulinum toxin type A (BoNT-A) has been applied successfully to treat chronic migraine, dystonia, spasticity and temporomandubular disorders(TMDs) as well as frontal wrinkle and glabella wrinkle. Recently it has been reported that BoNT-A, reversibly blocks presynaptic acetylcholine release, also inhibits the release of substance P, CGRP(calcitonin gene related peptide) and glutamate related to peripheral sensitization and neurogenic inflammation in sensory nerve, In this study we reviewed animal nerve injury model such as rat and rabbit and identify the analgesic effect and mechanism of nerve injury pain after dental treatment.

• The Journal of the Korean dental association
• /
• v.48 no.6
• /
• pp.459-468
• /
• 2010

International Classification of Disease (ICD-10) is widely used as a crucial reference not only in the medical diagnosis of diseases but also within the health insurance system. It makes possible for medical personnel to make decisions systematically and for the people working in the health insurance or public health industries to better understand medical issues. However, this classification is often not enough or acceptable in a clinical setting. Many countries amend in their own way to make it more appropriate for their people. Korean Classification of Disease (KCD-5) was made by adding a 5 digit code for some diseases to clarify the conditions of the patients. The authors found problems of KCD-5 in temporomandibular disorders and several related medical problems. Medical treatment for these problems had not been covered even by public health insurance until 2000 in Korea. For the last decade, private insurance companies have introduced new items for reimbursement of the treatment fees the patients actually pay. The authors assumed that many patients with these medical problems encountered difficulties in the reimbursement from private insurance companies because KCD-5 did not classify these medical conditions appropriately. An overview of KCD-5 and suggestions for improvement are introduced in this study.

• Journal of Acupuncture Research
• /
• v.19 no.1
• /
• pp.76-83
• /
• 2002

Forteen cases were observed among the Temporomandibular Disorder who were outpatients at the Department of Acupuncture & Moxibustion Oriental Medical Hospital, Dae Jeon University. Objective : To improve the therapeutic rate of Temporomandibular Disorder by treatment of acupuncture, chiropractic therapy and exercise therapy. Methods : Forteen outpatients suffering from Temporomandibular Disorder were treated by acupuncture, chiropractic therapy and exercise therapy. Acupuncture therapy was taken on Waiguan(TE5,外關), Zulingi(G41, 足臨泣), Sidu(TE9, 四瀆), Yanglingquan(G34, 陽陸泉), Qiuxu(G40, 丘墟), Xiaguan(S7, 下關). Chiropractic therapy was taken, when the subluxation of outpatients's Cervical spine was observed. Results : The syndrome of TMD, that is the Pain, the movement disorder and the click sound, was disappeared by 2~3 times acupuncture, chiropractic and exercise therapy.