• 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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• 제43권4호
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• pp.245-251
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• 2013

Purpose: This study was performed to evaluate the relationship between anterior disc displacement and effusion in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI). Materials and Methods: The study subjects included 253 TMD patients. MRI examinations were performed using a 1.5 T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the MRI findings, temporomandibular joint (TMJ) disc positions were divided into 3 subgroups: normal, anterior disc displacement with reduction (DWR), and anterior disc displacement without reduction (DWOR). The cases of effusion were divided into 4 groups: normal, mild (E1), moderate (E2), and marked effusion (E3). Statistical analysis was made by the Fisher's exact test using SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results: The subjects consisted of 62 males and 191 females with a mean age of 28.5 years. Of the 253 patients, T1- and T2-weighted images revealed 34 (13.4%) normal, DWR in 103 (40.7%), and DWOR in 116 (45.9%) on the right side and 37 (14.6%) normal, DWR in 94 (37.2%), and DWOR in 122 (48.2%) joints on the left side. Also, T2-images revealed 82 (32.4%) normal, 78 (30.8%) E1, 51 (20.2%) E2, and 42 (16.6%) E3 joints on the right side and 79 (31.2%) normal, 85 (33.6%) E1, 57 (22.5%) E2, and 32 (12.7%) E3 on the left side. There was no difference between the right and left side. Conclusion: Anterior disc displacement was not related to the MRI findings of effusion in TMD patients (P>0.05).

• Journal of Oral Medicine and Pain
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• 제42권1호
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• pp.16-19
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• 2017

Clinicians are familiar with limitation of opening mouth caused by temporomandibular disorders. Sometimes, patients also complain of difficulty in closing mouth. Difficulty in closing mouth can be caused by anterior, posterior disc displacement, and subluxation of temporomandibular joint (TMJ). In this report, we presented a patient who had a difficulty in both opening and closing mouth. The patient complained of TMJ noises and intermittent limitation of opening mouth, and inability to get teeth back into maximal intercuspal position. Magnetic resonance images revealed that the left TMJ had an anterior disc displacement with relative posterior disc displacement. We reviewed the possible causes, signs and symptoms, and treatment for difficulty in closing mouth with related literatures.

• Journal of Oral Medicine and Pain
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• 제23권1호
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• pp.45-55
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• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• Journal of Oral Medicine and Pain
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• 제23권3호
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• pp.277-280
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• 1998

The treatment of anterior disc displacement without reduction patients needs speicific treatment methods different from other Craniomandibular Disorders. Those are manual manipulation, anterior repositioning splint; ARS and step-back. It is well known that the use of Anterior Repositioning Splint is effective on relief of TMJ symptom. But the side effect of long- term ARS wearing, which is irreversible posterior open bite induction, has made many clinicians avoid ARS treatment. This report introduces a clinical case recently proven part- time wearing ARS method for treatment of Disc Displacement without reduction patient' that can reduce side effects with good efficacy. But now clinical statistical studies and basical histophysiological studies are more needed.

• The Korean Journal of Pain
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• 제22권1호
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• pp.99-103
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• 2009

We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.

• Journal of Oral Medicine and Pain
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• 제20권2호
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• pp.477-487
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• 1995

The purpose of this study was to assess the thermographic differences of craniomandibular area between normal individual and patients with craniomandibular disorders and to compare the differences between clinical and thermographical assessment. The author had used 50 subjects as materials for this study, which was divided into 2 groups (first group included 15 healthy subjects and second group included 35 patients) with craiomandibular disorders; 17 subjects had normal disc-condyle relationship, 13 subjects had disc displacement with reduction and 5 subjects had disc displacement without reduction. Agema 870 thermovision(D.I.T.I.) was used to take thermographs with $0.1^{\circ}C$ difference of gradual temperature shift. The results were as follows : 1. Of 34 patients with craniofacial pain, 15(44%) subjects showed hyperthermia on the pain site in the thermography, 8(23.5%)exhibited hyperthermia on the site opposed to the pain site, and 11(32.4%) did not show any significant thermal change. One patient without craniofacial pain showed hyperthermia on the site opposed to the site of disc displacement without reductin. 2. Of 35 patients with craniofacial pain or disc displacement, 24(68.6%) subjects showed a significant thermal difference between symptomatic and asymptomatic sides of the face, but 11(31.4%) did not show any difference. 3. Of 17 patients with pain but with normal disc-condyle relationship, 8(47.1 subjects showed hyperthermia on the pain site, 4(23.5%) showed on the site opposed to the pain site, and 5(29.4%) did not show any significant thermal change. 4. Or 13 patients with pain and disc displacement with reduction, 6(46.2%) subjects showed hyperthermia on the pain site, 3(23.1%) showed on the site opposed to the pain site, and 4(30.8%) did not show any significant thermal change. 5. 15 healthy subjects did not show any thermal differences between the both sides of the face.

• 한국임상수의학회지
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• 제20권4호
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• pp.519-522
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• 2003

An appearance of herniated intervertebral disc into thoracolumbar vertebral canal was evaluated in two patients using computed tomography (CT). Before CT scanning, plain radiography and myelography were performed in both cases. CT images were compared to those of myelography. Dogs were positioned in sternal recumbency under inhalation anesthesia and transverse slices with 2 mm thickness were obtained around thoracolumbar region. The transverse CT images were examined using both vertebral and spiral window mode. The most common findings on CT images were loss of vertebral canal epidural fat, bulging of vertebral canal disc margins, displacement of spinal cord and flatted vertebral canal. Whereas, narrowed intervertebral disc space and simple extradural pattern were the main findings on plain and contrast radiographs. CT imges showed the extent of the herniated disc lesion, type II intervertebral disc hernation, and the displacement of spinal cord in detail in both occations. It is considered that degree and precise localization of the intervertebral disc herniation and subtle lesion of spinal cord could be identified accurately using computed tomography.

• Journal of Oral Medicine and Pain
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• 제48권1호
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• pp.25-30
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• 2023

We present the case of a 60-year-old male with post-macrotrauma disc displacement and retrodiscitis, in which temporomandibular joint (TMJ) injection and manual therapy were used to alleviate his symptoms. He visited our clinic with complaints of pain and swelling in his right facial area and malocclusion of his right side teeth after being hit on the right side of his face five days earlier. During clinical and radiological examinations, the inflammatory state of the joint and disc displacement on the right side, which led to malocclusion, were noted. At the initial visit, we performed TMJ intracapsular injection and prescribed medications to control pain and inflammation. Simultaneously, manual manipulation was performed to relocate the disc. The same treatments were employed two days later. However, 10 days after the first visit, his symptoms did not mitigate substantially. We also performed magnetic resonance imaging (MRI), prescribed nortriptyline, and created a stabilization splint. MRI images depicted inflammatory disc displacement and joint effusion in the right TMJ. Based on the accurate diagnosis, we kept administering a stabilization splint, intra-articular injection, and medication. His signs and symptoms were alleviated 20 days after the initial visit and did not reoccur for the next 40 days.

• 치과방사선
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• 제21권2호
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• pp.327-336
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• 1991

The purpose of this study was to evaluate the validity among the clinical, transcraial radiographic and MRI diagnosis in internal derangement of the temporomandibular joint. Fourty two temporomandibular joints were assessed in twenty one patients who visited the dental department of Chonnam National University Hospital with the complaint of temporomandibular disorder from Oct. 1990 to Oct. 1991. The results were as follows: 1. In the clinically symptomatic 29 TMJs, 26 (89.7%) joints reveal disc displacement and 3 (10.3%) joints reveal normal disc position on MRI. The sensitivity of clinical diagnosis was 0.77, and the specificity was 0.63. 2. In the normal 22 TMJs on the trans cranial radiographic finding, 16 (72.7%) joints reveal disc displacement, and 6 (27.3%) joints reveal normal disc position on MRI. In the abnormal 20 TMJs on the transcranial radiographic finding, 18 (90%) joints reveal disc displacement, and 2 (10%) joints reveal normal disc position on MRI. The sensitivity of trans cranial radio- graph was 0.53, and the specificity was 0.75.