• Physical Therapy Korea
• /
• v.23 no.3
• /
• pp.29-39
• /
• 2016

Background: In the treatment of temporomandibular joint (TMJ) disorder, the goals of traditional physical therapy are not only to reduce the inflammatory process leading to pain, but also to decrease joint overload and muscle hyperactivity. To achieve those goals, physical therapists generally use a photo-therapy, joint mobilization, and massage. Objects: To examine the impact of an unloading technique using non-elastic taping on the pain, opening mouth, functional level, and quality of life in patients with TMJ disorder. Method: Twenty patients with TMJ disorder were included in this study and randomly divided into the experimental ($n_1$=10), and control ($n_2$=10) groups. Traditional physical therapy including massage and stretching for 30 min was performed in both groups. Non-elastic taping was performed in the experimental group after traditional physical therapy, and they were recommended to keep the tape attached for 12 hours. Outcomes for pain, functional level, and quality of life were measured using a survey. The opening mouth was measured using a general ruler. Result: Significant differences were observed in the pain level, opening mouth, functional level, and quality of life after the intervention and on follow-up in both groups. However, we found that while the levels of all parameters were maintained throughout the follow-up period in the experimental group, the functional status level was not maintained throughout the follow-up period in the control group. Conclusion: Our unloading technique using non-elastic tape results comparable to those achieved by traditional physical therapy in the treatment of TMJ. However, the unloading taping method using non-elastic tape is more effective than traditional physical therapy in maintaining the impact of intervention.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.6
• /
• pp.545-551
• /
• 2005

Purpose: The effect of orthognathic surgery on the temporomandibular dysfunction has been controversial. The purpose of this study is to prove statistically that early removal of fixation plate at postoperative 2 weeks with active exercise of mouth opening could relieve preoperative temporomandibular dysfunction and reposition of temporomandibular joint. Patients and Methods: All 28 subject patients underwent mandibular setback with BSSRO in Kyunghee medical center by one surgeon. The fixation plates used for rigid fixation were removed at postoperative 2 weeks and we had the patients excercise active mouth opening with intermaxillary rubber rings for the guiding proper postoperative occlusion. Temporomandibular symptoms were checked and radiographs were taken before surgery, within a month after surgery, six to twelve months after surgery respectively. Results: The temporomandibular dysfunction symptoms were relieved after the surgery and the condyle was displaced inferior-posteriorly immediate after surgery and repositioned toward its original position during follow-up periods. Conculusion: Orthognathic surgery may benefit temporomandibular joint dysfunction by obtaining a postoperative stable occlusion and more physiologic neuromuscular function. The early removal of fixation plates after BSSRO could reposition the temporomandibular joint to physiologic position and relieve the symptoms of temporomandibular dysfunction by permitting movement of proximal segment.

• Physical Therapy Korea
• /
• v.26 no.1
• /
• pp.28-36
• /
• 2019

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

• Journal of TMJ Balancing Medicine
• /
• v.8 no.1
• /
• pp.24-29
• /
• 2018

Objectives: The purpose of this study was to report the effect of Postural Yinyang Correction of the Temporomandibular joint (Functional Cerebrospinal Therapy, FCST) for phantogeusia. Methods: A patient with phantogeusia was treated at the Department of Acupuncture & Moxibustion, Dong-Eui University Korean Medicine Hospital from Oct 10th, 2018 to Dec 4th, 2018. A patient received 24 times of FCST with Customized TMJ Balancing Intraoral Appliance, upper cervical manipulation. To estimate the efficacy, Visual Analogue Scale (VAS), Oral Health Impact Profile-14 (OHIP-14) and questionnaire. Results: The patient showed a certain degree of improvement in phantogeusia and other subject symtoms within 8 weeks. Adverse effects were not reported. Conclusions: These results showed that FCST using an Customized TMJ Balancing Intraoral Appliance, may be useful for reducing the symptoms of phantogeusia.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.35 no.1
• /
• pp.63-68
• /
• 2022

Objectives : To get to know the effects of placental extract and laser theraphy for Temporomandibular Joint Disorder, we have tried a injection of placental extract and laser theraphy into 聽宮(SI19), 聽會(GB02) for patient with Temporomandibular Joint Disorder. Methods : In this case clinical assessment of temporomandibular joint dysfunction is assessed by the VAS score and the Korean Version of Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD). Results : The VAS score was significantly decreased after Placental extract herbal acupuncture and laser theraphy Conclusion : Placental extract herbal acupuncture and laser theraphy effectively resolved pain for Temporomandibular Disorders.

• Physical Therapy Korea
• /
• v.27 no.2
• /
• pp.102-110
• /
• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• Journal of Oral Medicine and Pain
• /
• v.35 no.3
• /
• pp.213-219
• /
• 2010

Aim: The aims of this study were to survey the frequency of pain to palpation of the occipitofrontalis muscle in a TMD patient group, and to identify patients showing pain to palpation of the occipitofrontalis muscle that is also consistent with patients' headache symptom. Methods: A total of 218 TMD patients ($32.0{\pm}13.1$ years) participated in this study. Patients' symptoms, including headache, were surveyed by questionnaire. Temporomandibular joints, jaw muscles, and pericranial muscles including the occipitofrontalis muscle were examined with digital palpation. Pain to palpation (i.e. tenderness) was scored from 0 to 3 according to the patients' response, and frequencies were calculated of pain to palpation scores for each site of the pericranial muscles. Results: Twelve patients among 218 TMD patients (5.5%) showed pain to palpation (scores of 1, 2) on the occipitalis or frontalis sites, and seven patients (3.2%) had moderate pain (a score of 2) to palpation. Among 218 TMD patients, there was only one patient whose primary symptomatic site of headache corresponded with the result of pain to palpation of the occipitofrontalis muscle. Conclusion: It can be concluded that examination with palpation of the occipitofrontalis muscle could be considered in the evaluation of TMD patients' headache symptom when other factors have been ruled out.

• The Journal of the Korean dental association
• /
• v.46 no.4
• /
• pp.232-242
• /
• 2008

관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral>300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절 잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰 되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.

• Journal of TMJ Balancing Medicine
• /
• v.4 no.1
• /
• pp.21-26
• /
• 2014

Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in recurrent or habitual type temporomandibular joint (TMJ) dislocation. One Recurrent or habitual type TMJ dislocation case was managed with the Yinyang Balancing Appliance on TMJ, combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. Although it is not clear the effect is sustaining or temporary in its nature, a positive effect was observed and further clinical and biological research on FCST is expected.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.6 no.2
• /
• pp.45-52
• /
• 2011

Objective : We had good effects on two patients who had problem with temporomandibular joint by using upper cervical manipulation combined with acupuncture therapy. Methods : Two temporomandibular disorder cases were managed by using upper cervical manipulation, combined with acupuncture therapy. We used Toggle-recoil technique for the purpose of upper cervical manipulation. Results :Even though symptoms of two patients were not same, each cases showed clinical changes by using upper cervical manipulation. Two cases had effects on decreasing pain of temporomandibular joint, and at the first case, the range of motion of temporomandibular joint was increased. Conclusion : We could treat temporomandibular disorder patients by using upper cervical manipulation combined with acupuncture therapy.