• 제목/요약/키워드: DJD

검색결과 12건 처리시간 0.019초

측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포 및 임상적 특징 (Distribution and clinical features of patients with degenerative change of the mandibular condyle)

  • 임용규;김민지;김연중;송윤헌;이동렬
    • 대한치과교정학회지
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    • 제36권6호
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    • pp.402-411
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    • 2006
  • 측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포와 임상적 특징을 규명하고자 측두하악장애로 진단받은 6,070명의 환자들을 대상으로 연구를 시행하였다. 환자들의 초진 시 파노라마와 TMJ 파노라마 사진을 관찰하여 하악과두의 퇴행성 골 변화 유무를 기준으로 환자들을 퇴행성 골 변화를 보이는 군(DJD군)과 골 변화를 보이지 않는 군(non-DJD군)으로 나누고, 환자들의 초진 의무기록을 바탕으로 두 군 간의 특징을 비교, 분석하였으며, 각종 변수들이 DJD 발병에 미치는 상대적 위험성을 측정하기 위하여 로지스틱 회귀분석을 시행하였다. 연구결과 전체 환자 중 DJD군에 속한 환자는 31.7%였고, non-DJD군에 속하는 환자는 68.3%였다. DJD군은 성별에 따라 다른 분포를 보여 남자보다 여자의 이환율이 높았고, 10대와 20대에서 가장 높은 분포를 보였다. 환자의 내원 주소 중에서는 전치부 개방교합, 턱의 후퇴감, 안모 비대칭, 개구장애를 주소로 내원한 환자가 다른 주소로 내원한 환자들에 비해 DJD를 보일 위험성이 높았으며, 교정치료 경력이나 중심 위-중심교합위 변위 그리고 염발음을 보이는 환자도 DJD군에 속할 위험성이 큰 것으로 나타났다. 따라서 측두하악장애를 가진 환자 중 30세 이하의 여성이 위와 같은 임상적 특징을 보이는 경우, 교정치료를 계획할 때 DJD에 이환 되었을 가능성에 대하여 충분히 주의를 기울여야 할 것으로 생각된다.

측두하악관절 퇴행성관절질환을 동반한 전치부개교환자의 측모두부방사선계측학적 연구 (CEPHALOMETRIC APPRAISAL OF THE OPEN-BITE CASES WITH THE DEGENERATIVE JOINT DISEASE OF THE TEMPOROMANDIBULAR JOINT)

  • 김태우
    • 대한치과교정학회지
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    • 제23권4호
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    • pp.455-474
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    • 1993
  • Degenerative joint disease(DJD) has hun known as one of the diseases which affect the middleor old-aged people. But as orthodontists are getting interested in the adult orthodontics, it is not rare for them to meet the open-bite patients with the TMJ DJD in their clinics. The purpose of this article is to investigate the cephalometric characteristics of the open-bite cases with TMJ DJD. Twelve TMJ DJD patients($15.1\~39.5$ years old) were selected from the patients who visited Department of Orthodontics, Seoul National University Hospital. Cephalograms were taken and means from 60 measurements were compared by t-test with those of the fifty four healthy adults($20.0\~26.7$ years old) who have normal occlusion and TMJ. In this study male and female are compared respectively, for in the normal samples 26 measurements showed significant differences between the male and the female. The results and conclusions axe as follows: 1 In DJD group, ANB and Angle of convexity decreased, which means the retruding of the mandible. The interincisal angle was smaller than that of the normal group. The means of the overbite were -2.1mm in male and -3.0mm in female, and the means of the overjet were 5.6mm in male and 6.7mm in female. The profile was similar to that of Angle's Class II div.1 open-bite. 2. SN-GoMe and FMA increased in DJD but SN-PP and FH-PP did not show any significant difference. In TMJ DJD open-bite cases, the bony structure lower than the palatal plane seemed to play an important role in developing open-bite. 3. In DJD group, PH-ArGo, SArGo and Y-sxis angle increased significantly, but genial angle showed no significant difference. The means of hか were 50.1mm in male and 40.2mm in female, which were significantly smaller than those of the normal(56.5mm in male, 50.9mm in female). These findings seemed to indicate the posterior rotation of mandible resulted from the shortening of the ramus height. 4. Anterior faical height(AFH), upper anterior facial height(UAFH) and lower anterior facial height (LAEH) of DJD showed no significant increase as compared with those of the noraml group. There was no significant difference in the ratio of upper anterior facial height to lower anterior facial height(UAFH/LAFH). But, lower posterior facial height(LPFH) was significantly smaller than that of the normal group. 5. It was thought that the peculiar profile of the TMJ DJD open-bite was resulted from the posterior rotation of mandible as the ramus became short following the degerative destruction of of the condylar head and neck.

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Evaluation for canine hip dysplasia in Golden and Labrador retrievers using PennHIP method in Korea

  • Choi, Jihye;Kim, Hyunwook;Kim, Hyejin;Jang, Jaeyoung;Kim, Mieun;Yoon, Junghee
    • 대한수의학회지
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    • 제48권3호
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    • pp.375-379
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    • 2008
  • Hips of the Golden and Labrador retrievers in Korea were evaluated with the University of Pennsylvania Hip Improvement Program (PennHIP) and the severity of joint laxity and degenerative joint disease (DJD) were compared to the PennHIP database. The distraction index (DI) of domestic Golden and Labrador retrievers was significantly higher than the DI of the PennHIP database. In the two breeds, the prevalence of DJD increased according to the DI. However, the severity of DJD did not show a positive correlation with the DI. Overweight dogs and dogs kept indoors showed more severe DJD and more prevalence of clinical signs. This report is thought to be the first case presentation of a large population of Golden and Labrador retrievers in Korea and the findings are representing the overall level of canine hip dysplasia (CHD) of domestic Retrievers, as the PennHIP method was not available in Korea until 2001. We can respect that the stock of retrievers can have a tighter hip joint through control of CHD using an accurate diagnostic method keyed to a phenotype especially concern for joint laxity using PennHIP method and an organized screening program. The clinical manifestation of dysplastic dog can be reduced through control of bodyweight and the environment with regular monitoring the hips with concern for joint laxity using PennHIP method.

CEPHALOMETRIC CHARACTERISTICS OF OPEN-BITE CASES WITH DEGENERATIVE JOINT DISEASE(DJD) OF TMJ

  • Kim, Tae-Woo
    • 대한치과교정학회지
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    • 제25권6호
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    • pp.665-674
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    • 1995
  • The purpose of this study is to investigate the cephalometric characteristics of the open-bite patients with DJD of TMJ. The DJD open-bite cases were compared with normal samples and Class II open-bite cases with normal TMJ respectively. Twenty three open-bite patients with bilateral DJD of TMJ($13.9\~35.3$ yens old, Group I) were selected from the Department of Orthodontics, SNUDH. Group ll consisted of thirteen Class II open-bite cases($13.2\~27.4$ years old) with no TMD signs/symtoms and good condylar shapes. Group III samples were the forty eight healthy dental students who have Class I molar relationships with no history of orthodontic treatment, good facial balance and no TMD symptoms($20.0\~26.8$ years old). First, sixty measurements in the lateral cephalometric radiographs and analysis of variance(P<0.05, Scheffe) were used to compare these three groups. The seven measurements showed significant difference(p<0.05) between Group I and Group II. After analysis of variance, six of them were used for the discriminant analysis(Wilks' stepwise analysis) and the discrminant function for Group I/Group II was obtained. The results and conclusions were as follows : In most of the measurments, Group I and Group II showed the same skeletal and dental characteristics. But seven of the sixty measurements(FH-PP angle, SNB, FH-ArGo angle, articulare angle, genial angle, upper gonial angle and Ar-Go length) were significantly different(p<0.05) between Group I and Group II. These differences may be explained by the fact that in DJD cases the mandible rotated backward due to the shortening of the ramus following the degenerative destruction of condylar head and its surrounding structures. The resulting discriminant function was : $D={-0.120X}_1+{0.066X}_2+{0.144X}_3-{0.058X}_4+2000,\;where\;X_1=ArGo\;length(mm),\;X_2=SArGo\;angle(degree),\;X_3=FH-PP\;angle(degree),\;X_4=Gonial\;angle(degree)$. Mean of the group centroids was -0.555 and percent of the 'grouped' cases correctly classified was $88.89\%$.

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외이전기자극이 슬관절질환 노인의 통증과 보행 및 균형에 미치는 영향 (Effects of Auricle Electric Stimulation on Pain, Gait and Balance in the Old Aged with Knee Joint Disease)

  • 서삼기;조운수;이정우;김용남;정진규;황태연
    • The Journal of Korean Physical Therapy
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    • 제20권2호
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    • pp.11-17
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    • 2008
  • Purpose: This study examined the application of electric stimulation to the auricle acupoint (frequency 2 Hz, stimulation level: noxious) with 30 elderly people over 65 years that received treatment in a rural hospital to determine the influence of pain, gait and balance in the aged with knee joint disease. Methods: The subjects were divided into three groups; the degenerative joint diseases (DJD) group (1 male, 9 females), the total knee replacement (TKR) group (1 male, 9 females) and the control group (1 male, 9 females). Auricualr electrical stimulation (AES) was applied with low frequency, high intensity transcutaneous electrical nerve stimulation for 10 seconds per each point. Results: 1. For the change of pain according to AES, there was interaction in the resting period (p<0.001) and gait (p<0.001) and pain of the DJD group and TKR group was decreased. 2. The range of motion (ROM) of the knee joint showed a significant difference in interaction for each group of elderly people (p<0.001) and the ROM for the DJD group and TKR group of elderly people was increased. 3. In the analysis of gait speed changes, there was a significant difference in interaction for each group of elderly people (p<0.001) and for gait speed in the DJD group and TKR group of elderly people. 4. It was found in the change of static balance that there was a significant difference in interaction for each group of elderly people (p<0.01) and balance capacity in the DJD group and TKR group of elderly people was increased. Conclusion: The aged with knee joint disease have pain, and a decreased function of gait and balance. AES was an excellent treatment for control of pain, and an excellent treatment to enhanced joint functions. AES was useful for improving gait and balance due to decreased pain.

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Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints

  • Bae, SunMee;Park, Moon-Soo;Han, Jin-Woo;Kim, Young-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.19.1-19.6
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    • 2017
  • Background: The aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs). Methods: Two hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse). Results: Degenerative bony changes were the most frequent in the age groups of 10~19, 20-29, and 50~59 years. The most frequent pain intensity was "none" (NRS 0, 34.6%) followed by "annoying" (NRS 3-5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). "Ero + Fla" was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age. Conclusions: Osp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. "Six months to 2 years" may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.

측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성 (The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis)

  • 노창세;정연화;태일호;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제34권1호
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    • pp.81-90
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    • 2009
  • 2005년부터 2007년까지 진주 OOO치과의원 턱관절/구강안면통증클리닉에 내원한 측두하악장애환자 95명, 190개의 관절을 대상으로 한 명의 검사자가 측두하악관절장애 분석검사와 파노라마영상검사를 엄격히 시행하고, CBCT영상을 촬영하여 구강내과 전문의와 치과방사선과 전문의가 각각 영상진단 하였으며, 임상적 진단과 CBCT영상의 결과를 비교하여 다음과 같은 결과를 얻었다. 1. 구강내과 전문의와 치과방사선과 전문의에 의한 CBCT의 영상진단의 일치도(Kappa: 0.681)가 높았다. 2. 파노라마영상과 CBCT의 영상진단과의 일치도(Kappa: 0.169)가 낮으며, 파노라마영상에서 골변화의 위음성이 높았다. 3. 임상적으로 비퇴행성골관절염으로 진단된 관절 중 CBCT의재진단시 54.2%에서 골변화가 관찰되었으며, 퇴행성골관절염으로 진단된 관절 중 CBCT의 재진단시 15.3%에서 골변화가 없는 것으로 관찰되었다. 4. 관절통은 침식성 골변화에서 높게 나타났으며, 골증식체의 골변화에서 염발음이 가장 많이 나타났으며 병력기간도 가장 길었다.

개의 고관절 변성관절질환의 방사선학적 진단 (Radiographic Diagnosis of Degenerative Joint Disease in Canine Hip Joint)

  • 엄기동;장동우;서민호;정주현;장진화;원성준;정우조;최호정;이기창
    • 한국임상수의학회지
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    • 제18권3호
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    • pp.243-248
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    • 2001
  • Radiographic findings of degenerative joint disease (DJD) in the coxofemoral joints were studied in 108 dogs referred to Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Seoul National University. Radiographic findings were identified with a extended ventrodorsal projection. Clinical signs such as pain in the affected joint, exercise intolerance, lameness, crepitation on flexion and extension of the joint and decreased range of motion, were shown in 40% and radiographic changes of bilateral coxofemoral joints were identified in 69% of a group of dogs. There are no sex predilections. Thirty-seven dogs were diagnosed as canine hip dysplasia (CHD; 10 cases), avascular necrosis of the femoral head (Legg-Calves-Perthes disease [LCPD]; 12 cases), fracture of the acetabulum (1 case), luxation(10 cases) and subluxation (15 cases), however, luxation and subluxation were identified in 11 dogs affected with CHD and LCPD. Causes of DJD in others (71case) were not identified. Radio-graphic findings identified included osteophyte formation at the attachment of the joint capsule (70%), sclerosis of the subchondral bone of the cranial acetabular edge (47%), remodeling of the femoral head (34%), thickening of the femoral neck(31%), perichondral osteophyte formation (31%), joint laxity (30%) and so on. All of the dogs diagnosed as CHD were large breed such as Retriever, Germain Shepherd, and Weimaraner and their age was under 1 year. This condition occurred bilaterally in 70% of affected animals. Dogs diagnosed as LCPD were young (under 1 year), small breed dogs. The incidence of LCPD is greater in Yorkshire Terrier, Miniature Pinscher and Poodle. This condition occurred unilaterally in 67% of affected animals. Clinical signs of dogs with unknown cause were shown in 15% and this condition occurred bilaterally in 75% of affected animals. Radiographic findings varied with patient's age and breed, however, the most common finding was osteophyte formation at the attachment of the joint capsule.

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퇴행성 악관절장애환자의 임상양태에 관한 연구 (Clinical Features of the TMD Patients with Degenerative Joint Disease)

  • Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • 제20권2호
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    • pp.257-267
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    • 1995
  • An Epidemiologic study was carried out on 77 TMD patients with degenerative joint disease who had visited the Orofacial Pain Clinic in Pusan National University Hospital. Al subjects were interviewed and examined clinically and radiologically using a standardized examination form. As related to gender and duration, subjective and objective sysmptoms in DJD patients were studied. The obtained results were as follows : 1. There were much more patients in the twenties or thirties, women and histories such as chronic duration and microtrauma. 2. Most patients responded positively more often to the questions of jaw function, unilateral chewing in habits, poot appetite and depression in behavioral response and shoulder pain in worsening prognosis 3. While the most common reasons for treatment were pain, noise, and limitation of opening, the associated symptoms such as headache, neckache, earache, jaw dysfunction, neck dysfunction, acute bite change and dizziness, ringing or fullness in the ears as secondary CNS excitatory effects were complained. 4. Opening the mouth in 25 to 40mm, soft end feel and deflective incisal pathway were seen and more tenderness to lateral or dorsal capsule of joint than intra or extra oral muscles were complained. 5. While there appeared no click, crepitus and single click in acute group, in chronic group, crepitus, single click and no click appeared in order of sequence. 6. Tomogram or bone scan revealed more bony changes than panorama and transcranial view.

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