• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.238-242
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• 2000

Recurrent mandibular dislocation is frequent morbidity of temporomandibular joint relatively. There are many etiologic causes in TMJ disorders but, difficult to find obvious one. Various treatment methods have been utilized for a mandibular dislocation. It is categorized into two groups broadly - nonsurgical or surgical methods. The basic rationale of the surgical method is to allow free movement of the condyle by reducing height of articular eminence or to limit anterior excessive movement of the condyle by increasing height of articular eminence or soft tissue anchoring procedure. In this case, 69 year-old woman was treated by augmentation of the articular eminence with mandibular symphysial bone graft leading to osteosynthesis without difficulty. As a result, favorable postoperative outcome was obtained functionally without any complication or recurrence.

• 대한치과교정학회지
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• 제18권1호
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• pp.7-24
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• 1988

The stable occlusion in function is thought as important as the esthetics in form, in order to preserve the healthy oral condition. The stable occlusion requires the harmony between the condylar guidance factors and the anterior guidance factors. The aim of this study was to evaluate the quantitative relationship between the condylar guidance factors and the anterior guidance factors, estimating statistically the measurement of the condylar paths by Pantronic and those of the anterior guidance factors, craniofacial morphology by roentgenocephalometry in 46 relatively good functional occlusion. The results of this study were as follows. 1. The measurements of the protrusive condylar path inclinations were $36.41^{\circ}$ in the right, $35.63^{\circ}$ in the left, $36.28^{\circ}$ in the mean. The measurements of Fisher's angles were $8.17^{\circ}$ in the right, $6.43^{\circ}$ in the left, $6.87^{\circ}$ in the mean. 2. The anterior facial height and the lower anterior facial height made a negative correlation with the protrusive condylar path inclination. 3. The articular eminence angle relative to the artificial articulator plane showed a positive correlation with the maximum protrusive condylar path. 4. SNA and SNB made a negative correlation with the articular eminence angle, and AAP-GoMe, AAP-DcGn, the facial height ratio had a positive correlation with the articular eminence angle. 5. The angulation of maxillary incisor lingual slope, overbite and the ratio of overbite to overiet showed a positive correlation with the articular eminence angle. 6. The angulation of maxillary incisor lingual slope , overbite, and the ratio of overbite to overjet made a positive correlation with the inclination of occlusal plane, functional occlusal plane. 7. Overbite and the ratio of overbite to overjet had a positive correlation with the angulation of maxillary incisor lingual slope. 8. The anterior guidance factors were more influenced by the mean protrusive condylar path inclination and the maximum Fisher's angle, and the regression equations of those were made.

• 치과방사선
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• 제18권1호
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• pp.203-212
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• 1988

This study was designed to observe mandibular condyle shape and position in an asymptomatic popular ion. Using Accurad-200 head holder(Denar Corp.) for transcranial radiography of the temporo-mandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population(90.4%), the locally concave shape and wedge shape were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43nm superiorly, 2.17㎜ anteriorly, and 2.61㎜ posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below the top of the articular eminence.

• Imaging Science in Dentistry
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• 제48권2호
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• pp.147-152
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• 2018

Synovial chondromatosis is a rare metaplastic disease affecting the joints, including the temporomandibular joint (TMJ). Since its symptoms are similar to those of temporomandibular disorders, a careful differential diagnosis is essential. A 50-year-old male patient was referred with the chief complaint of pain and radiopaque masses around the left TMJ on panoramic radiography. Clinically, pre-auricular swelling and resting pain was found, without limitation of mouth opening. On cone-beam computed tomographic images, multiple calcified nodules adjacent to the TMJ and bone proliferation with sclerosis at the articular fossa and eminence were found. T2-weighted magnetic resonance images showed multiple signal-void nodules with high signal effusion in the superior joint space and thickened cortical bone at the articular fossa and eminence. The calcified nodules were removed by surgical excision, but the hypertrophic articular fossa and eminence remained. A histopathological examination confirmed the diagnosis. The patient was followed up few months later without recurrence.

• 대한치과교정학회지
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• 제16권1호
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• pp.85-106
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• 1986

The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.209-214
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• 1999

Chronic recurrent TMJ dislocation results in difficulty of mastication, speaking, and swallowing due to the limitation of the mandibular movement. Etiologic factors are considered as the looseness of the capsule and ligaments, the decrease of the articular eminence, condylar morphologic change, muscular disharmony near by TMJ, and the decrease of the vertical length of the mandibular ramus. Treatment approach has been suggested that surgical methods are selected for the correction of the etiologic factors when conservative treatments are not effective. Many surgical methods have been reported such as eminectomy, eminence augmentation, condylotomy, and zygomatic arch down fracture technique. We performed the eminence augmentation through interpositional bone graft in chronic recurrent TMJ dislocation. This method leads to favorable postoperative result without recurrence and complication, so we report the case with related references.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권5호
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• pp.305-309
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• 2012

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

• Imaging Science in Dentistry
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• 제32권4호
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• pp.221-225
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• 2002

Purpose: To evaluate the relationship between internal derangement and osteoarthrosis in the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). Materials and Methods: One hundred and six MR images of TMJs in 53 patients were evaluated. Disc displacements and osseous changes of the TMJs were assessed. Lateral and rotational disc displacements were also evaluated on coronal images. Results: No significant differences in the frequency of osseous changes of the TMJs between disc displacement with reduction and disc displacement without reduction groups were found. The erosion of the condylar head and the sclerosis of the articular eminence were more frequent in the internal derangement group than in the no disc displacement group. The flattening was the most frequently observed osseous change of both the condylar head and articular eminence. Conclusion : The relationship between internal derangement and osteoarthrosis is obscure, but it is thought that both disorders adversely affect each other.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.99-105
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• 2002

Purpose: To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. Materials and Methods: Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. Results: The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. Conclusion: There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.27-37
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• 2022

Purpose: This study aimed to broaden our understanding of the predisposing factor and treatment of dislocation by analyzing and evaluating the morphology of the articular eminence (AE) in subjects with temporomandibular joint (TMJ) dislocation using cone beam computed tomography (CBCT). Methods: The subjects were divided into two groups: dislocation (31 subjects) and control (32 subjects). CBCT was used to examine 126 TMJs in 63 subjects (26 males, 37 females). The height, width, and posterior slope of the AE were measured in the parasagittal plane. The posterior slope was measured using the "top-roof line angle (TR angle)" method and the "best-fit line angle (BF angle)" method. The AE on the left side (AEL) and the AE on the right side (AER) of the subjects in the dislocation group were separately analyzed and compared with the control group after taking measurements. The average value of both sides was used when comparing with subjects with bilateral dislocation. Results: Dislocations were more frequent in females (67.7%) than in males (32.3%). The dislocation group showed a gentler TR angle than the control group in the AER and in the average of AE on the both sides (AEB). The same group also showed a wider AE in the AEL and the AER (p<0.05). In subjects with unilateral dislocation, the width of the AE with dislocation was narrower and the TR angle and BF angle was steeper than the other side without dislocation (p<0.05). Conclusions: In subjects with unilateral TMJ dislocation, the posterior slope of the AE is steeper, and the width is narrower at the site of dislocation compared to the site without dislocation. However, in subjects with bilateral TMJ dislocation, AEB were wider, and the mean value of the posterior slope of AEB was gentler than that of the control group.