• Journal of Oral Medicine and Pain
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• v.43 no.2
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• pp.41-51
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• 2018

Purpose: The aim of this study was to evaluate the possibility of utilizing blood tests for the diagnosis of temporomandibular disorders (TMDs) by investigating the hematologic characteristics of TMD patients according to the main source and level of TMD pain and analyzing their interrelationship. Methods: Clinical examination following the research diagnostic criteria for TMD and hematological and psychological evaluations were conducted in 357 TMD patients. Patients were divided into groups according to the main source of pain (myogenous, arthrogenous, and combined pain) and the degree of pain according to the graded chronic pain scale (GCPS). Hematological differences among the groups were statistically analyzed. Results: The C-reactive protein (CRP) level was significantly higher in the arthrogenous pain group compared to the combined pain group (p=0.032). There was no significant difference according to the GCPS classification. There were significant correlations between some of the TMD pain indices and the hematologic indices, and also between the psychological indices and the hematologic indices. Conclusions: This study suggests the possibility of applying blood tests to the diagnosis, treatment and prevention of TMD. Further research should be conducted focusing on the role of CRP in TMD pain with more refined methodology and a longitudinal study design.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.161-171
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• 2001

In order to determine how oral mucosal change relates to inducing factors of burning mouth syndrome, the difference in pain perception scale and keratinization rate between burning mouth syndrome patients and normal subjects were investigated. Twenty patients (13 female, 7 male, mean age: 59 years), presenting in the Department of Oral Medicine, Chonnam National University Hospital were participated in this study. All subjects had been complaining of constant oral burning pain for more than a year, none took any strong analgesics, and none had oral mucosal lesions. Twenty volunteers (11 females, 9 males, mean age: 25 years) were also participated in this study as a control group. The control subjects had never had any symptoms of oral burning pain. A thermal stimulation using a Nd-YAG laser and cytological smear were carried out to anterodorsal part of tongue, tip of tongue, the left buccal mucosa, the lower lip mucosa and the chief complaint site. Stimulation of the dorsum of left hand was also carried out to contrast the mucosal area of burning mouth syndrome subjects and the control subjects. The laser output power could be adjusted from 0.75W to 4W. The pain perception scale of the burning mouth syndrome subjects were lower than in control subjects in the chief complaint area, the anterodorsal part of tongue and the buccal mucosa(p<0.01). The keratinization rate of burning mouth syndrome subjects, however, was higher keratinization rate than in normal subjects in the same area and lower lip mucosa(p<0.001). From above results, the anterodorsal part of tongue is the most appropriate site to use diagnostic laser stimulation. The higher level of keratinization and the lower level of thermal pain perception of the burning mouth syndrome subjects are explained as a protective mechanism against xerostomia and burning sensations. The application of Nd-YAG laser stimuli and cytological smear to oral mucosal surface could therefore be usefully employed as appropriate and standardized diagnostic tools for chronic orofacial pain subjects.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.335-345
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• 1995

Emotional state of dental outpatients was studied by means of symptom checklist-90- revision, 229 male and 290 female dental outpatients were subjected at the private local clinic in Pusna, during the period from 1994 to 1995. T-scores from SCL-90-R were analyzed psychologically by means of 90 questionnaires through Korean manual of SCL-90-R. The obntained results were as follows : 1. Mean value of T-scores on 9 basic scales of SCL-90-R in all the dental outpatients was within normal range. 2. T-scores in male were significantly higher than that in female, and there was a significant difference by age group in female. 3. There were higher levels of T-scores in groups of high academic carrier, salaryman, public servant, and unmarried person. 4. T-score of patients with periodontal pain was the highest in all subject groups. 5. While T-score of patients with K01(embedded and impated teeth) was the highest, that of K02(dental caries) was the lowest. 6. T-score in acute group was higher than that in chronic group. 7. T-score of patients treated in field of oral surgery or oral medicine was higher than those of other fields of dental treatments.

• Journal of Oral Medicine and Pain
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• v.7 no.1
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• pp.47-58
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• 1982

The author has studied on the clinical features and symptomatology of 97 MPDS patients, who visited the Dept. of Dentistry, Kyungpook National University, from January to September in 1982. The results were as follow : In age and sex distribution of patients in this population, the third decades appeared to have the highest prevalence and the male to female ratio was almost 1 to 2.23. As to occupation, students and housewives were revealed to have the highest incidence of MPDS. The chief complaints of patients were pains, TMJ noises, and limitation of mouth opening in order of frequency, and the most prevalent site of symptom was that of preauricular area. In symptom sequence, the majority of initial symptoms were TMJ noise and pain but limitation of mandibular movement was progressively developed, regardless of nature of early symptoms. Chronic unfavorable oral habits were found to be the most possible predisposing factors in this study. The average maximum interincisal distance was $38.13\pm10.00mm$ in males and $30.73\pm8.75mm$ in females, and a deviation of mandible during mouth opening was observed in 60.8% of patients. In TMJ signs, tenderness of the TMJ to palpation was found in 60.8% of patients and TMJ noise was audible in 50.5% of patients with a stethoscope. The muscles of masticatory system were palpated according to usual methods, and a significant indidence of muscular tenderness was present, with the lateral pteygoid muscles being most frequently involved, followed by masseter, medical pterygoid and temporalis muscles.

• Journal of Oral Medicine and Pain
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• v.24 no.1
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• pp.9-24
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• 1999

Pumping into the upper joint cavity of the TMJ was done on patients who had reducible disc displacement with pain. This article discusses the change in TMJ sounds before and after the Pumping treatment. 20subjects(mean age of $32.1{\pm}10.2yr$)were selected among those who visited the department of Oral Medicine of Yonsei University for the treatment of craniomandibular dysfunctions. Through a thorough history taking, clinical exam and X-ray taking these subjects were diagnosed as reducible disc displacement patients, and they were subdivided into two groups as acute and chronic according to the time the TMJ sound was made. Sonopak was used to measure the TMJ sound before, right after and one-week after the Pumping treatment. VAS was used to measure the degree of subjective TMJ complaints(sounds and pain) before and one-week after the Pumping treatment. Vibration related items included total integral, high integral, low integral, ratio of high integral to low integral, peak amplitude, peak frequency and median frquency. 1. It was not statistically significant between the acute and chronic groups before the treatment. However, total integral, high integral, low integral, peak amplitude, peak frequency, median frequency showed to be greater in the chronic group. 2. In all the subjects, just after the Pumping treatment was done, total integral, high and low integral, peak amplitude and peak frequency significantly decreased (p<0.05). Even after one week, low integral, peak frequency and median frequency significantly decreased (p<0,05), and the TMJ sound diminished accordingly. 3. Comparing the two groups(before and right after the Pumping treatment), there was the following difference ; in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05). In the chronic group, total integral, high integral, low integral, ratio, peak amplitude and peak frequency significantly decreased(p<0,05). It was not statistically significant between the acute and chronic group. 4. Comparing the two groups(right after and one week after the Pumping treatment), there was the following difference : in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05), In the chronic group, low integral significantly decreased(p<0.05). However, although it was not statistically significant, after one week, there was an increase in total integral, ratio, peak amplitude and peak frequency compared to right after the treatment group. 5. In the VAS of before and one week after the Pumping treatment of the TMJ pain and sound, the TMJ pain significantly decreased(p<0.05) in both the acute and chronic group. However, it was not statistically significant between the two groups. There was a statistically significant decrease(p<0.05) in the TMJ sound in the acute group after one week of Pumping treatment, but no change was notable in the chronic group and it was not statistically significant between the two groups. From the above results, we can conclude that Pumping into the upper joint cavity of patients having reducible disc displacement is effective in reducing clicking and pain. Therefore, it can be applied in diverse clinical fields.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.55-69
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• 1993

The purpose of this study is investigation on prevalence and clinical characteristics of headache among 10-39 years men and women. Information could be obtained with the questionnaire, and 1952 respondents completed the questionnaire. All participants were asked if they had experienced headache. Those responding positively were further questioned regarding the frequency, severity, character, location and duration of headache and were questioned regarding the experience of medical cunsultation and taking analgesics. The obtained results were as follows : 1. The life time prevalence of headache was 49.6% among men, 70.8% among women and 61.5% in all. 2. The prevalence of episodic tension type headache, chronic tension type headache, migraine, mixed type headache in this population was 27.1%, 5.0%, 2.8%, 23.1% respectively. 3. Headache duration was classified as less than 1 hour, 1-6 hours, 6012 hours, more than 12 hours for 1 day. The percentage of each other case is 41.8%, 46.2%, 7.4% and 4.4% of headache suffers respectively. 4. As regards the severity of headache, 4.2% of headache suffers had a very mild pain intensity, 17.9% a mild pain, 57.7% a moderate pain, 18.1% a severe pain and 2.2% a quite severe pain. 5. Headache occured at morning in 8.2% of headache suffers, at afternoon in 9.4%, at evening in 18.1%, at night in 4.3% and at anytime in 59.9%. 6. 11.7% of headache suffers among men consulted doctor, 13.9% among women and 13.1% in all. 7. 66.2% of headache suffers didnt have any analgesics because of their pain, 33.8% of headache suffers had analgesics because of their pain.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.27-33
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• 2008

Candidiasis, an opportunistic infectious condition caused by the genus Candida, is the most common oral fungal infection in humans. The diagnosis of oral candidiasis can often be made based on recognition of its clinical pattern, but at times there is difficulty in making a clinical diagnosis because of its various manifestations. Several antifungal medications have been developed for managing fungal infections. Despite the availability of several effective antimycotics for the treatment of oral candidiasis, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleaning action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. In this case report, we present two patients diagnosed with chronic hyperplastic candidiasis and median rhomboid glossitis, which are known as rare forms of candidiasis. In both cases, there was a significant reduction of clinical signs and symptoms when fluconazole was prescribed after the failure of initial nystatin therapy.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.317-324
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• 2009

This study aimed to assess stiffness and elasticity of the masticatory muscle in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether the masticatory muscle pain affects the facial expression muscles. From those who visited Department of Oral Medicine in Dankook University Dental Hospital, 27 patients presenting with unilateral muscle pain and tenderness in the masseter muscle (Ms) were selected (mean age: $36.4{\pm}13.8$ years). Exclusion criterion was those who also had temporomandibular joint (TMJ) disorders or any neurological pain. Muscle stiffness and elasticity for the muscles of mastication and facial expression was investigated with the tactile sensor (Venustron, Axiom Co., JAPAN) and the muscles measured were the Ms, anterior temporal muscle (Ta), frontalis (Fr), inferior orbicularis oculi (Ooci), zygomaticus major (Zm), superior and inferior orbicularis oris (Oors, Oori) and mentalis (Mn). t-tests was used to compare side difference in muscle stiffness and elasticity. Side differences were also compared between diagnostic groups (local muscle soreness (LMS) vs myofascial pain syndrome (MPS) and between acute (< 6M) and chronic ($\geq$ 6M) groups. This study showed that Ms and Zm at affected side exhibited significantly increased stiffness and decreased elasticity as compared to the unaffected side.(p<0.05) There was no significant difference between local muscle soreness and myofascial pain syndrome groups and between acute and chronic groups. The results of this study suggests that masticatory muscle pain in Ms can affect muscle stiffness and elasticity not only for Ms but also for Zm, the facial expression muscle.

• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.141-146
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• 2006

Personality characteristics of recurred TMD patients were analyzed psychologically by using the SCL-90-R. 27 recurred TMD patients, 45 new TMD patients, control I were subjected at Orofacial pain clinic, Department Of Oral Medicine and Health Promotion Center, Pusan National University Hospital during the period from 2005 to 2006. 50 general dental patients, control II were subjected at a local dental office in Pusan during the same period. The obtained results were as follows. 1. Mean values of T-scores on 9 basic scales in all the groups were within normal range. 2. The T-scores of IS, Dep, Phob, Psy in general Dental patient group were significantly higher than those in recurred TMD patient group. 3. As compared with recurred TMD patient Group & control I group by sexual subclass, there was no significant difference of the scales. 4. As compared with acute and chronic groups, there was no significant difference of the scales in recurred TMD patient group. However, the T-scores of Som, Par, Phob, Psy in chronic new TMD patient group were significantly higher than those in acute new TMD patient group, control I group.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.45-63
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• 1997

A Study was conducted to examine the nature and extent of psychological differences among diagnostic subgroups of temporomandibular disorders(TMD) patients and to whether psychological distress acts as a precipitator for TMD or is only an incidental consequence of the discomfort and frustrations presented by the disorder. Ninty six TMD patients and ninty seven non-TMD dental patients were included for the study as an experimental group and control group. TMD patients were classified into subgroups according to their primary pain sites and labeled as: 1) Myogenous TMD group; 2) Arthrogenous TMD group; 3) Mixed TMD group. After Hilkimo indices were rated from patient history and clinical examination, levels of psychological distress were measured using SRRS (Social Readjustment Rating Scale) and MMPI (Minnesota Multiphasic Personality Inventory). Outcomes from Helkimo indices, SRRS, and MMPI were assessed in terms of diagnostic subgroups and pain chronicity. The relationship between SRRS and MMPI scores were also assessed. The results were as follows : 1. The TMD patients showed higher frequencies of AiII, DiII, and DiIII of Helkimo indices than those in the control subjects. 2. The chronic TMD patients showed lower frequencies of DiII and DiIII of Helkimo indices than those in the acute group. 3. The arthrogenous TMD group showed higher frequencies of DiII and DiIII of Helkimo indices than those in the myogenous TMD group. 4. The TMD patients showed higher SRRS mean score than that in the non-TMD patients. 5. The SRRS mean score was highest in the myogenous TMD group and lowest in the arthrogenous TMD group. 6. The chronic TMD patients showed higher SRRS mean score than the acute TMD group. 7. The TMD patients showed higher MMPI mean scores on the Hs, D, Hy, and Pt scales than those in the non-TMD patients. 8. The MMPI mean scores on th Hs, D, and Hy scales were higher than of other MMPI scales in the TMD patients as well as in the myogenous and the mixed TMD group and they showed 1-3-2(Hs, -Hy, -D.) profile pattern, conversion "V". 9. The MMPI mean scores on the Hs and Hy scales were higher in all subgroups of TMD patients than non-TMD patients. 10. Although there were no significant differences in the MMPI mean scores on all the scales between the acute and the chronic groups of all TMD patients, the chronic myogenous TMD group showed higher MMPI mean scores on the Hs, Hy, Pa, and Pt scales than the acute myogenous TMD group. 11. There were positive correlationships between SRRS score and each MMPI scores on the Hs and Hy scales.Hy scales.