• Title/Summary/Keyword: Chronic orofacial pain

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Long-Term Evaluation of Conservative Treatment for Craniomandibular Disorders (두개하악장애환자의 보존적 치료에 관한 장기평가)

  • June-Sang Park;Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.18 no.2
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    • pp.81-96
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    • 1993
  • In order to evaluate the prognosis of conservative treatment for Craniomandibular Disorders, 127 patients were subjected at the Dept. of Oral Medicine, Pusan National University Hospital from 1983 through 1991. All the changes of patients' symptoms and related factors were analyzed before treatment, after treatment and at follow-up examination by means of subjective and objective symptom indicies (Ai, AAI, SDS, Di, CDS, MCO). 1. All the indices were reduced and MCO became increased at follow-up examination (p<0.01). 2. As the duration after treatment became longer, all the indices became reduced and MCO became increased. 3. There were no significant differences in index scores according to sex and age. 4. Long-term patients showed higher index scores and lower MCO than short-term patients(p<0.01). 5. Chronic group showed higher index scores and lower MCO than acute group (p<0.05). 6. Macrotrauma group showed higher index scores and lower MCO than microtrauma group (p<0.05) 7. While muscle group showed the lowest MCO, muscle and joint group showed the highest index scores (p<0.01). 8. The long-term success rate of conservative treatment was more than 80% (p<0.01)

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A Study on the Clinical Feature and Treatment Outcome of Patients with Trigeminal Neuralgia (삼차신경통의 임상양태와 보존적 치료결과에 관한 연구)

  • Nam, Chang-Ok;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.24 no.3
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    • pp.315-323
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    • 1999
  • The 63 patients(20 males, 43 females) were treated for their trigeminal neuralgia at the Department. of Oral Medicine, Pusan National University Hospital from 1993 to 1998. All the patients were treated for their trigeminal neuralgia by conservative methods such as medication, and Electric Acupuncture Stimulation Therapy The obtained results were as follows: 1. Trigeminal neuralgia was mainly involved in the patients of past forties, women and acute group. 2. 50.8% of patients were related to maxillary branches of trigeminal nerves. The trigger points were on gingivae, cheeks, teeth, lips in order. 3. 55.6% of patients with trigeminal neuralgia had systemic diseases and 39.7% were related to dental practices. 4. Success rate of the treatments was 71.4% and the recurrence rate was 26.3%. 5. The refractory factors in improving symptoms were chronic history, involvement of complex branches, and experience of prosthodontic treatments.

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Treatments of the Acute and Chronic Oral Ulcerative Lesions : Case Report (구강에 발생한 급성 및 만성 궤양성 병소의 치료 : 증례보고)

  • Hong, Seong-Ju;Kang, Seung-Woo;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.55-62
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    • 2009
  • In most cases, it is difficult to diagnose ulcerative diseases of the mouth, because they have many similar clinical appearance. For the diagnosis of oral ulcerative lesions, the clinician should check a detailed history of the patient and consider the relation with systemic diseases. In this case report, we introduced two patients with erythematous multiforme, phemphigus, lichenoid reaction and aphthous stomatitis as clinical diagnosis. The lesions were improved by medication.

An Epidemiologic Study on the Anxiety Level of Dental Ouppatients in Response to Dental Procedure (치과치료에 따른 외래환자의 불안도 수준에 관한 역학적 연구)

  • Hyun-Koo Kang;Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.17 no.1
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    • pp.19-29
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    • 1992
  • Fear at the dental treatment is a problem not only for patient but for dentist as well, because the anxious patient often require more item, even for simple procedures. The anxiety level in response to dental procedures was evaluated through a simple questionnaire, Corahs, DAS. 783 female and 790 male outpatients were studied at the Dept. of Oral Diagnosis, PNUH from 1988 to 1989. The obtained results were as follows : 1. The anxiety level in female was significantly higher than that in male, and patients in 10s and 30s showed more anxious than those in other groups. 2. Housewives and pupils revealed higher level of anxiety. 3. The anxiety level in 524 (ICD) was the highest in all diseases, inspite of no difference among various diseases. 4. There was significantly higher level of anxiety in the patient of Orthodontics and Pedodontics than those of other departments. 5. There was no difference in anxiety level between acute and chronic group. 6. Dental phobes were more in female than in male.

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Actinomycotic Osteomyelitis of the Mandible: A Case Report

  • Lee, Young-Cheol;Lim, Lee-Rang;Lee, Kyu-Hoon;Seo, Dong-Jun;Yun, Na-Ra;Oh, Ji-Su;You, Jae-Seek;Choi, Hae-In
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.140-144
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    • 2019
  • Actinomycosis is rare, chronic, slowly progressive disease caused by gram-positive anaerobic organisms from the Actinomycosis family that normally colonizes the oral cavity. Actinomycotic osteomyelitis is even more rare and refractory disease because diagnosis by bacterial culture is not easy. In our case, 80-year-old man visited our clinic with a complaint of swelling and severe sinus tracts without teeth evolvement on anterior mandible. Computed tomography (CT) scan demonstrated erosive bone destruction on anterior mandible, clinically suspected actinomycotic osteomyelitis. The patient also had thoracic actinomycosis on Lt. lower lung. We could diagnosis actinomycosis by histopathologic examination. He treated by conservative surgery and long term antibiotics. After 2 year, no recurrence was seen in CT scan.

Relations between Clinical Findings and Treatment Results in Patients with Temporomandibular Disorders (측두하악장애환자의 임상양태와 치료결과와의 관계)

  • Hee-Young Oh;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.407-420
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    • 1995
  • This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

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Conservative management of dislocated temporomandibular joints: A case report (턱관절 탈구의 보존적 치료법에 대한 증례보고)

  • Park, Jo-Eun;Kim, Hye-Kyoung;Choi, Hee-Hoon;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.319-324
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    • 2013
  • Dislocation of the temporomandibular joint (TMJ) occurs when the mandibular condylar head is displaced completely out of the glenoid fossa and cannot be reduced by the patient. The occurrence of bilateral anterior dislocation is the most common. Dislocations can be classified into three types in terms of duration and frequency of dislocation, i.e., acute, chronic and recurrent. There are various treatment modalities for dislocation from conservative try to surgical intervention. The selection for the appropriate modality mainly depends on the types of dislocation as previously stated. The authors report three cases of dislocation with different treatment modalities according to the duration of dislocation. In particular, we tried prosthetic approach instead of surgical intervention in the patient with chronic dislocation.

Evaluation of Craniocervical Posture in the Patients with Chronic Tensional Headache (만성 긴장성 두통환자에 있어서 두경부 자세의 평가)

  • Seon-Ju Koo;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • v.18 no.1
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    • pp.9-19
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    • 1993
  • The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

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Reliability of the Korean Version of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (한국어판 측두하악장애 연구진단기준 (RDC/TMD) 설문지의 신뢰도에 관한 연구)

  • Sohn, Byung-Jin;Park, Min-Woo;Park, Ji-Woon;Chung, Sung-Chang;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.323-338
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    • 2008
  • Objectives: The aim of this study was to analyze the reliability of the Korean language version of the Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD) axis II questionnaire among TMD patients. Methods: The Korean version of the RDC/TMD questionnaire was distributed to 154 TMD patients(31 men, 123 women) who visited Seoul National University Dental Hospital. The test-retest reliability was also assessed among the same subjects with a one- or two-week time interval. The subjects did not receive any form of therapy until the retest administration was completed. Results: The internal consistency reliability of pain intensity, disability score, jaw disability, and psychosocial status were 0.92, 0.94, 0.68, and 0.94, respectively using the Cronbach's alpha coefficient of the 1st test. Test-retest reliability coefficients of each items of the questionnaire ranged from 0.40 to 0.94 assessed with kappa value, and the intra-class correlation coefficient(ICC) for each subscale ranged from 0.81 to 0.93. Test-retest reliability coefficient of the graded chronic pain(GCP) scale was 0.63. Conclusions: The Korean language version of RDC/TMD axis II questionnaire demonstrated good reliability. It can be used as a valuable instrument for the analyses of the psychosocial aspects of the TMD patients in Korea.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.