• Title/Summary/Keyword: Chronic orofacial pain

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Coronoid Process Hyperplasia: A Rare Case of Restricted Mouth Opening Masquerading as Temporomandibular Disorder

  • Juhyun Cha;Jin Woo Chung
    • Journal of Oral Medicine and Pain
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    • v.48 no.3
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    • pp.112-117
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    • 2023
  • Coronoid process hyperplasia (CPH) of the mandible is a rare condition in which abnormal elongation of the coronoid process leads to chronic mandibular hypomobility. CPH causes impingement or impedance of the coronoid process on the inner surface of the frontal part of the zygomatic bone during mouth opening. The lack of significant symptoms makes the diagnosis difficult. Its etiology remains inconclusive despite several theories being suggested. In this report, three reviewed cases are presented. All three patients visited our clinic with limited mouth opening as the chief complaint. Standard clinical and radiographic examinations were conducted under the initial impression of temporomandibular disorders (TMDs), and restricted jaw movements were confirmed in all cases. The absence of improved signs and symptoms following conservative treatment for TMDs or the indeterminate plain radiographs required the attending clinicians to consider three-dimensional imagery. Computed tomography revealed bilateral coronoid hyperplasia in all cases and impingement on the zygomatic bone in two of the three cases. After concluding that this condition caused the patients' limited mouth opening, the patients were referred to the Department of Oral and Maxillofacial Surgery for possible bilateral coronoidectomy or coronoidotomy. CPH usually presents no symptoms apart from a progressive reduction of mouth opening over time. Diagnosis is often delayed, and patients may undergo unnecessary treatment procedures. Clinicians should be aware of this condition and exercise caution in the differential diagnosis of patients with chronic mandibular hypomobility.

Intraoral Manifestation of Leukemia (백혈병의 구강병변에 관한 연구)

  • Byul-Hee Lee;Yun-Woong Ko;Chong-Yeol Kim
    • Journal of Oral Medicine and Pain
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    • v.14 no.1
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    • pp.105-111
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    • 1989
  • For the purpose of oral hygiene care and oral diagnosis of patients in leukemia, the author have got following conclusion after the oral examination and chart review of 56 patients with leukemia : 1. The frequency of specific oral lesions was 57.1% in total. 2. The specific oral lesions were more often in acute leukemia than chronic leukemia. 3. The most frequent period of specific oral lesions was one week after chemotherapy. 4. The oral findings in leukemia were oral ulcer, oral petechia or / & ecchymosis, gingival swelling & redness, gingival bleeding.

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A Case Report of Sjogren Syndrome (쉐그렌증후군의 임상 증례)

  • JK Choi;SC Yoon;HK Park
    • Journal of Oral Medicine and Pain
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    • v.20 no.1
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    • pp.29-37
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    • 1995
  • We diagnosed a patient with chronic dry mouth for 3 years as definite Sjogren's syndrome by the criteria for diagnosis of Sjogren's syndorne proposed by the 1st international seminar on Sjogren's syndrome. The clinical immunologic , hematologic, scintigraphic, and histologic examinations were performed. The patient showed severe xeorstomia, keratoconjunctiva sicca, severe infiltration of lymphocytes in minor salivary glands, and evidences of autoantibodies. The patient's history and clinical findings excluded preexisting lymphoma, graft-versus-host disease, acquired immunodeficiency disease, and sarcoidosis.

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Reactive Hyperplasia of Intraoral Soft Tissue by Mechanical Irritation (기계적 자극에 의한 구강내 반응성 증식)

  • Kim, Ji-Hyun;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.115-120
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    • 2001
  • Intraoral soft tissue can easily be injured by weak mechanical irritation. Each symptom by irritation is various, but most of patients show chronic inflammatory lesion. The fibroma is the most frequent disease found in intraoral area followed by pyogenic granuloma, epulis fissuratum, palatal papillomatosis, and epulis granulomatosum. The inflammatory hyperplasia by mechnical irritation is easily different from other disease, but this shows similar to several benign and malignant tumors required differential diagnosis. By microscopic feature, the lesions is divided by granulatory stage, mixed stage, and fibrotic tissue stage. The inflammatory hyperplasia is differently treated by each clinical features.: only removal of cause or, and excisional biopsy is/are required. This is the cases report of reactive hyperplasia of intraoral soft tissue by mechanical irritation that suggests various treatments of each cases.

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Diagnostic Considerations in TMD patients (전악수복 후 발생한 TMD에 대한 검사법의 유용성)

  • Shin, Su-Yun
    • The Journal of the Korean dental association
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    • v.49 no.2
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    • pp.72-76
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    • 2011
  • Temporomandibular disorders refer to a large group musculoskeletal disorders that originate from the masticatory structures. The AADR recognize that temporomandibular (TMDs) encompass a group of musculoskeletal and neuromuscular conditions that involve the temporomandibular joints (TMJs), the masticatory muscles, and all associated tissues. The signs and symptoms associated with these disorders are diverse, and may include difficulties with chewing, speaking, and other orofacial functions. They also are frequently associated with acute or persistent pain, and the patients often suffer from other painful disorders. The chronic forms of TMD pain may lead to absence from or impairment of work or social interactions, resulting in an overall reduction in the quality of life. However, the consensus of recent scientific literature about currently available technological diagnostic devices for TMDs is that, except for various imaging modalities, none of them shows the sensitivity and specificity required to separate normal subjects from TMD patients or to distinguish among TMD subgroups. This article reviews the various instruments to aid in the diagnosis of TMDs, and the overall validity and practical use of the Electromyography.

Quantitative and Qualitative Gradient of Pain Experience, Sleep Quality and Psychological Distress in Patients with Different Phenotypes of Temporomandibular Disorders

  • Choi, Hee Hun;Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.45 no.3
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    • pp.56-64
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    • 2020
  • Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

Diagnosis and Treatment of Temporomandibular Disorders (측두하악장애의 진단 및 치료)

  • Choi, Young-Chan;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.319-328
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    • 2009
  • Temporomandibular disorders(TMD) have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory muscles, and associated structures. Since Dr. Costen, an otolaryngologist, published his article in 1934 claiming that pain in and around the jaw and "related ear symptoms" improved with alteration of the bite, diagnosis and treatment of temporomandibular disorders(TMD) have been within the concept of occlusion. However most of the modern descriptions for TMD no longer include occlusal disorders within their domain. Despite this trend toward the exclusion of occlusal disorders from TMD domain, the historical linkages between TMD and occlusal therapy are still strong. Currently the most popular theories regarding TMD etiology are based on the biopsychosocial model. In the future, treatment modalities should be directed at the pathophysiological processes of joint and muscle pain as well as the psychosocial aspects of chronic pain.

Sleep Quality Evaluation Using Self-Reported Questionnaires in Patients with Burning Mouth Syndrome

  • Jin, Jung-Yong;Lee, Kyung-Eun;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.188-194
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    • 2016
  • Purpose: Burning mouth syndrome (BMS) is ambiguous and enigmatic oral condition. Sleep disturbance is one of the most prevalent complaints of patients with chronic pain. The aim of this study was to estimate general sleep characteristics and propensity in patients with BMS. Methods: A total of thirty BMS patients and thirty healthy control subjects were investigated. Self-reported measures of sleep quality were conducted using two widely used methods; the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Data were analyzed with one-way ANOVA, chi-square, Fisher's exact test, Kruskal-Wallis test, Holm method with 95% confidence interval and p<0.05 significant level. Results: BMS patients showed more poor sleepers than those in control subjects in both ESS and PSQI test. BMS patients also showed statistically significant poorer sleep quality compared with control subjects in both test. When BMS group were divided into three groups on the basis of numeric rating scale, the higher score subjects had, the more mean rank they had in the PSQI. Conclusions: BMS patients showed up poor sleep characteristics and propensity than control group, and they also showed the more severe the pain was, the worse the sleep quality was.

Herpes Zoster Accompanying Odontogenic Inflammation: A Case Report with Literature Review

  • Lee, Soyeon;Kim, Minsik;Huh, Jong-Ki;Kim, Jae-Young
    • Journal of Oral Medicine and Pain
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    • v.46 no.1
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    • pp.9-13
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    • 2021
  • Herpes zoster is caused by reactivation and multiplication of a latent varicella-zoster virus infection. Reactivation can frequently occur in older adults and immunosuppressed individuals. It is hypothesized that this is related to an aging society and a corresponding increase in the number of people with underlying chronic diseases, such as cancer and diabetes, that lower immunity. Clinically, the patient complains of pain, and a vesicular rash presents on one side of the face up to the midline in the dermatomes associated with the affected ganglion. Herpes zoster of the oral mucosa is rare. When oral lesions do occur, they are most often concurrent with pathognomonic unilateral linear vesicular skin lesions, facilitating both clinical diagnosis and management of the condition. Cases limited to the oral mucous membrane alone are most unusual. Treatment includes antiviral agents and analgesics for pain control. Antivirals should be administered within 72 hours of onset. Early diagnosis and treatment are important to avoid complications, such as postherpetic neuralgia. The present case report describes the adequate management of a patient diagnosed with shingles which affected the right side of the face and oral cavity. In addition, a literature review is presented.

Psychological Analysis of BMS Patients through the SCL-90-R (간이정신진단검사를 이용한 구강작열감 환자의 심리학적 분석)

  • Jang, Yong-Seok;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.49-57
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    • 2008
  • Personality characteristics of BMS patients were alalyzed psychologically by using the SCL-90-R. 59 BMS patient were subjected at Orofacial pain clinic, Department Of Oral Medicine, Pusan National University Hospital during the period from 2006 to 2007. The control group were subjected at dental clinic during the same period. 1. BMS patients group, Dental new patient group, Adult citizen groups were within normal range. 2. The T-scores of HOS, PHOB,PAR, PSY in BMS patient groups was significantly low. 3. The mean T-scores of male in BMS patients group shows the lowest HOS scale, the mean T-scores of female in BMS patient group shows the lowest PHOB scale. 4. The mean T-scores of female in BMS patients group show higher SOM, O-C, DEP, ANX, PSY scales. 5. As compared with the mean T-scores of acute and chronic group in BMS patients, there was no significant difference of the scales.