• Title/Summary/Keyword: 측두하악관절 장애

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A proposal of injection points of botulinum toxin into temporal region for chronic migraine (만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시)

  • Kim, Young Gun;Bae, Jung Hee;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.1-6
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    • 2017
  • Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

Cephalometric Characteristics of the Patients with Developed Anterior Open Bite Following Anterior Disc Dislocation without Reductions (비정복성 관절원판 전위와 연관되어 발생된 전치부 개교합 환자의 측방 두부방사선 계측)

  • Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.255-263
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    • 2006
  • Objectives: This article reported three patients developed anterior open bite seemed to be related to TMJ anterior disc dislocation without reduction(ADD WO R), but no evidence of condylar destructive or collapse and analyzed the craniofacial skeletal structure by means of cephalometric analysis. Results: All patients suddenly developed a centric relation/centric occlusion discrepancy, an increased overjet and an anterior open bite following ADD WO R. All patients had Angle's Class I occlusion and shallow bite, but they had skeletally Class III and Class II pattern and all were vertically significant hyperdivergent type. Conclusions: These 3 patients had characteristics of common facial morphology including:(1)Angle classification Class I and shallow bite,(2)high mandibular plane angle,(3)high gonial angle. Developed anterior open bite resulted from clockwise rotation of the mandible related TMJ ADD WO R, rather than a result from the eruption of posterior teeth. We hypothesize rotation may relate to attached direction of masticatory muscle.

Magnetic resonance evidence of joint effusion in patients with temporomandibular joint disorders (측두하악관절장애 환자의 자기공명영상에서 관찰되는 악관절 삼출)

  • Ko Jee-Young;Kim Kee-Deog;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.31 no.2
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    • pp.73-84
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    • 2001
  • Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

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Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report (악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례)

  • Sang-Myeong Tak;Chang-Mo Jeong;Jung-Bo Huh;So-Hyoun Lee;Mi-Jung Yun
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.33-43
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    • 2023
  • Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

Dentofacial changes of non-orthodontically treated female patients with TMJ disk displacement: a longitudinal cephalometric study (교정 치료를 받지 않은 측두하악관절원반변위가 있는 여성 환자의 두부계측방사선사진을 이용한 안모 및 치열 변화 연구)

  • Han, Jung-Woo;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.40 no.6
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    • pp.398-410
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    • 2010
  • Objective: The purpose of this study was to investigate the changes in dentofacial morphology of non-orthodontically treated female patients with TMJ disk displacement. Methods: The sample consisted of 25 Korean female patients with bilateral TMJ disk displacement who visited the Department of Orthodontics, Seoul National University Dental Hospital from 1996 to 2006. Disk displacements were diagnosed using the magnetic resonance imaging (MRI) of both TMJs. Baseline (T1) and follow-up (T2) lateral cephalograms were analyzed. The mean age of samples at T1 was $18.1{\pm}3.5$ years (range 14.2 - 25.8 years) and at T2, $21.1{\pm}3.5$ years (range 16.2 - 28.0 years). The mean observation period was $3.0{\pm}1.9$ years. Descriptive statistics for each variable were calculated at baseline (T1) and follow-up (T2) stages, and during the observation period (T2-T1). Results: Skeletal changes were found in 64% of the non-orthodontically treated female patients with TMJ disk displacement during the observation period. The L1 to Mandibular plane distance (mm) increased significantly by 0.8 mm (p < 0.01). But there were no significant differences in the other dental relationship variables (overjet, overbite, U1 to palatal plane) during the observation period. Most patients with skeletal changes showed a backward rotation of the mandible. The ratio of the rotation was a decrease of SNB by $0.43^{\circ}$ for every $1^{\circ}$ increase of FMA (Spearman rho = -0.660, P < 0.01). A few patients showed a distal shift of the mandible without rotation or significant changes in the vertical dimension. Conclusions: During observation periods without orthodontic treatment, non-growing patients with TMJ disk displacement showed dentoskeletal changes, mainly backward rotation of the mandible.

Epidemiologic Study on the Elderly Patients Visited Oral Medicine (고령환자의 구강내과 진료실태)

  • Hong, Seong-Ju;Kang, Seung-Woo;Ryu, Ji-Won;Yoon, Chang-Lyuk;Cho, Young-Gon;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.133-141
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    • 2009
  • We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

Full mouth rehabilitation through re-establishment of occlusal plane in partially edentulous patient with reduced vertical dimension accompanied by loss of posterior occlusal support (구치부 교합지지 상실과 수직고경 감소를 동반한 부분 무치악 환자에서 교합평면 회복을 통한 완전구강회복 증례)

  • Cho, Young Eun;Leesungbok, Richard;Lee, Suk Won;Choi, Joseph June Sirk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.263-275
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    • 2022
  • The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

Comparison of Cold Pack and Capsaicin Application in Temporomandibular Disorder Treatment (측두하악장애 치료에 있어 냉찜질과 capsaicin적용에 관한 비교)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.219-225
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    • 2007
  • This investigation was carried out to evaluate the effect of pain control temporomandibular disorders with clinical application of capsaicin cream. 20 healthy subjects without systemic diseases were measured in current perception threshold and pain tolerance threshold with $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) after cold pack, 0.025% capsaicin and 0.075% capsaicin cream application. The obtained results were as follows : 1. The current perception threshold of C-fiber was significantly higher to the baseline on. There were significantly increased in C- fiber current perception threshold of 0.025% capsaicin cream and 0.075% capsaicin cream application comparison to cold pack. 2. There was significantly increased in pain tolerance threshold of cold pack and 0.075% capsaicin application comparison to one of baseline as $A{\beta}$-fiber, There was significantly higher after cold pack and 0.025% capsaicin cream application than baseline as $A{\delta}$-fiber. In C-fiber case, 0.025% capsaicin application's was significantly increased than baseline one. 3.There were significantly higher C-fiber of 0.075% capsaicin application than baseline in visual analogue scale marking pain level of pain tolerance threshold.

The Clinical Report on 3 cases of the patient of Tempormandibular Disorder Treated with Motion Style Treatment (동작침법(M.S.T.)을 시행한 측두하악관절장애환자 치험 3례)

  • Moon, Ja-Young;Cho, Jae-Hee;Lee, Hyo-Eun;Lim, Myung-Jang;Kang, In;Wang, Wu-Hao;Park, Cheol-Jin;Lim, Jin-Kang
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.29-36
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    • 2008
  • Object : The purpose of this study is to report the improvement of Tempormandibular Disorder patients who were treated by M.S.T(Motion Style Treatment). Methods : The clinical study was done on 3 cases of patients with tempormandibular disorder we checked the diameter between the maxilla and mandible with jaws fully opened, and also checked NRS score after the treatment of M.S.T(Motion Style Treatment) each day. Results & Conclusion : The diameter of the open mouth increased after the treatment of M.S.T(Motion Style Treatment), whereas NRS score decreased after the treatment of M.S.T(Motion Style Treatment). It is concluded that the M.S.T might be effective to the patient with tempormandibular disorder.

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Full mouth rehabilitation using removable partial denture in patient with loss of vertical dimension due to worn dentition (심한 치아 마모로 인해 수직 고경이 상실된 환자에서 국소 의치를 이용한 전악 수복 증례)

  • Shim, Eun-Young;Lee, Na-Young;Kang, Jeong-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.347-353
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    • 2018
  • Gradual attrition is a normal process of aging, but severe attrition causes occlusal disharmony, functional disorder and esthetic problems. The collapse of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). And it induces the pathologic change of the TMJ, unaesthetic facial appearance and decreased masticatory function. In this case, 70 year-old male presented with decreased vertical dimension and esthetic problems due to worn dentition. Based on assessment of intraoral findings, diagnostic cast and radiographic examination, full-mouth rehabilitation with increase of OVD was planned. After 10 month follow-up, occlusal stability is maintained and through this procedure, satisfactory outcomes were achieved in esthetic and functional aspects.