• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.308-323
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• 1996

This study tried to find the prevalence and distribution of temporo-mandibulr disorders(TMD) for workers (employee) in Seoul area to investigate the correlation between TMD and possible etiological factors such as general muscle and joint symptoms, headache, unilateral chewing and parafunction. This study was an epidemiological investigation of answers obtained from 282 persons by questionaire from Aug. 1995 to Nov. 1995. The major findings from the questionaire were as follows. (1) 43.26% of the subjects(282 persons) has TMD. (41.88% of man and 43.26% of women) (2) The more often people have general muscle and joint symptoms and headache, the more susceptible they are to TMD. Their correlation was very significant(p<0.001). (3) The more people have bad oral habits such as bruxism, clenching and biting habit, the more likely they have TMD. The more sensitive people are to stress, the more frequently they have bad oral habits such as bruxism, clenching and biting habit. (4) Unilateral chewing has higher TMD index than bilateral chewing. There is no relationship between ache areas and TMD index.

• Journal of Oral Medicine and Pain
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• v.26 no.3
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• pp.291-300
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• 2001

본 연구는 측두하악관절장애의 증상이 있는 악관절의 통상적인 방사선 단층촬영술에 대한 해석과 관절강 측정에 대한 조사자내, 조사자간 신뢰도를 조사하였다. 신뢰도 검사는 조사자들 간에 판독의 일관성이 있는지와 일정 시간이 지난 후 반복 측정 시 판독의 정확성이 있는지를 알아보기 위하여 시행하였다. 조사자내 상관계수는 과두 형태에 대해서는 각각 0.812와 0.619, 골변화 형태에 대해서는 모두1.00, 골변화에 대해서는 0.846과 0.991, 전방관절강에 대해서는 0.919와 0.966, 상방관절강에 대해서는 0.864와 0.955, 그리고 후방관절강에 대해서는 0.718과 0.672였다. 통상적인 방사선 단층촬영술이 신뢰도가 있음을 보여주는 이 연구의 결과로 보아, 측두하악 관절을 평가하는데 있어서 통상적인 방사선 단층촬영술은 높은 진단학적 정확성과 조사자간 일치성을 가진다고 할 수 있다.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.364-372
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• 2010

Objective: This study was designed to assess the diagnostic validity of digital panoramic radiographs compared to cone beam computed tomography (CBCT) in patients with temporomandibular joint disorders. Methods: Panoramic radiograph and CBCT were taken from a total of 212 joints from 106 subjects. The joints were examined by two dentists and divided into the following six groups: normal, flattening, osteophyte formation, erosion, sclerosis, and unclassified. The sensitivity and specificity of each observer and inter-observer reliability were statistically analyzed. Results: The results showed relatively high intra-observer reliability in the diagnosis of both panoramic and CBCT images and the weighted Kappa indices of panoramic and CBCT images were 0.714 and 0.727, respectively. The sensitivities of panoramic images of observer A and B to CBCT images was 82.35% and 84.30%, respectively, while the specificity of observer A and B was 58.06% and 61.54%, respectively. However, guided diagnosis from panoramic and CBCT images were statistically different (p < 0.05). Conclusions: The present study suggests that the panoramic radiograph could be used as a primary diagnostic device to detect bony changes of temporomandibular joints in clinical orthodontics, because panoramic images showed relatively high sensitivity compared to CBCT images. However, CBCT images may be one of the best choices when a more accurate diagnosis is necessary.

• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.155-165
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• 2006

The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.91-104
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• 2007

An epidemiologic investigation was carried out to determine the prevalence of symptoms of temporomandibular disorders in college students that aged 19-31 years. 460 students were investigated with a questionnaire from September to December 2006. The obtained results were as follows : 1. The prevalence of symptoms of temporomandibular disorders was 80.6%. 2. The most frequently complained symptom was headache and joint sound was the next one without distinct difference between men and women. 3. While the rate of occurrence of symptom of acute malocclusion decreased with age in men, that of TMJ pain during chewing or speech increased with age in women. 4. Symptoms including TMJ pain during mouth opening, chewing or speech, TMJ fatigue and acute malocclusion occurred significantly more frequently in women than in men. Contributing factors including resting cheeks on hands, stressful state, gum chewing, insomnia and clenching occurred significantly more frequently in women than in men. 5. There was a highly significant relationship between symptoms and contributing factors including resting cheeks on hands, stressful state, unilateral chewing, insomnia and clenching. 6. There was a highly significant relationship between symptoms and general personality.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.292-295
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• 2008

Temporomandibular joint cysts usually occur between the second and fourth decade of life. There is a female predominance to male of approximately 3 to 1. The patients complain of swelling, pain and sometimes decreased mouth opening. Synovial cysts of the temporomandibular joint seem to develop by an increase of intraarticular pressure due to trauma or inflammation which causes capsular herniation. However, if inflammatory synovial cysts develop by an increase of synovial fluid into inflammation tissue in the capsule without capsular herniation, a differential diagnosis should include synovial chondromatosis and synovitis. This is a case report of a synovial cyst developed in a capsule of the temporomandibular joint.

• The Journal of the Korean dental association
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• v.44 no.11 s.450
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• pp.719-727
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• 2006

• The Journal of the Korean dental association
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• v.38 no.5 s.372
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• pp.410-414
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• 2000

• The Journal of the Korean dental association
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• v.34 no.4 s.323
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• pp.271-275
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• 1996

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.205-218
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• 2008

Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.