• Journal of Oral Medicine and Pain
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• v.25 no.1
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• pp.63-71
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• 2000

The authors assessed if there is a relationship between joint effusion and the presence of pain, and between joint effusion and disc displacement in 446 temporomandibular joints of 223 subjects who visited the Department of Oral Medicine, Kyungpook National University Hospital with the complaints of temporomandibular joint problem. The amount of joint effusion and the position of disc were determined from magnetic resonance images of the temporomandibular joints. The position of disc was classified into normal disc position, disc displacement with reduction (DDWR), and disc displacement without reduction (DDWOR). The amount of joint effusion was graded according to the extent of joint area of high signal intensity on T2-weighted MR images. These findings were correlated with one another and statistically analyzed. The results were as follows; 1. The incidence of temporomandibular joint pain Was higher in the joints with higher amount of joint effusion (P<0.001). 2. The proportion of temporomandibular joints with higher amount of effusion increased in the joints with more advanced articular disc displacement (P<0.001).

• Journal of Oral Medicine and Pain
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• v.23 no.3
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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.

• Imaging Science in Dentistry
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• v.31 no.1
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• pp.9-16
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• 2001

Purpose: To investigate bone and disc configuration on MR images in internal derangement related to age. Materials and methods: MR images of 150 TMJs in 107 patients were analyzed to determine the morphologic changes. Two groups were distinguished to be correlated with age. Group I consisted of TMJs that were diagnosed as having anterior disc displacement with reduction (ADDwR), and Group 2 consisted of TMJs that were diagnosed as having anterior disc displacement without reduction (ADDwoR). We assessed the configuration of the articular disc, degree of anterior disc displacement, and osseous changes of TMJs. Results: The third decade (83 of 150 joints) was most frequent in this study. In the ADDwR group biconcave discs was most frequent at all ages except fifth decade, but in the ADDwoR group deformed discs was most frequent at third and forth decades. In the ADDwR group slightly displaced discs was most frequent at all ages, but in the ADDwoR group severely displaced discs was most frequent at second decade, and the degree of disc displacement was increased with aging over 30 years of age. TM joints showed osseous changes in 17% of the ADDwR group, and in 30% of the ADDwoR group. MR findings of osseous changes of the TMJ were not found to be significantly correlated with age. Conclusion: The prevalence of deformation of disc, displacement of disc, and osseous changes of TMJ was higher in the ADDwoR group than in the ADDwR group. MR findings of disc configuration and degree of disc displacement were found to be correlated with age.

• Imaging Science in Dentistry
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• v.43 no.4
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.373-382
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• 2000

Temporomandibular disorders arised from joint itself was caused by inflammation or mechanical irritation of the retrodiskal tissues. Histologic changes of the retrodiskal tissues of temporomandibular joint(TMJ) internal derangement, such as inflammatory cell infiltration, hyalinization, myxoid change, fatty change, arterial obliteration, and so on, were reported, but relationships between magnetic resonance imaging(MRI) findings and histologic findings of the retrodiskal tissue were few reported. The purpose of this study was to find histologic changes of the retrodiskal tissues for status of joint and joint effusion in MRI of the temporomandibular joint which had surgical treatment. Materials were surgically treated 52 temporomandibular joints with internal derangement or osteoarthritis in TMJ clinic, Yongdong Severance Hospital. All joints were confirmed by magnetic resonance T1- and T2-weighted imagings bofere surgery. Status of joint was categorized by normal position, disc displacement with reduction, disc displacement without reduction, disc displacement without reduction associated with osteoarthrosis using preoperative MR T1-weighted images. Magnetic resonance evidence of joint effusion was observed in T2-weighted images and classified by its amount; degree 0(not observed), degree 1(small amount), degree 2(moderate amount), degree 3(large amount). Histologic features were observed whether the retrodiskal tissue has inflammatory cell infiltration, myxoid change, hyalinization, chondroid metaplasia and arterial obliteration. The distribution of elastic fibers were also observed. The results were as follows; 1. Inflammatory cell infiltration was not observed in any retrodiskal tissues. 2. MRI findings such as status of joint and evidence of joint effusion did not have significant relationship with myxoid change, hyalinization, chondroid metaplasia, arterial obliteration of the retrodiskal tissues. 3. Hyalinization and chondroid metaplasia were found in 8 joints(15.4%) and 5 joints(9.6%). All of them were found in disc displacement without reduction and disc displacement without reduction associated with osteoarthrosis. 4. Arterial obliteration was observed more frequently in disc displacement without reduction(55.6%) than disc displacement without reduction associated with osteoarthrosis(28.6%). Further studies with proper controls and more materials will be necessary.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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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.

• Imaging Science in Dentistry
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• v.31 no.3
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• pp.145-151
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• 2001

Purpose : To investigate the hypothesis that the morphology of the articular eminence of the temporomandibular joint is a predisposing factor for disc displacement. Materials and Methods: MR images of 126 temporomandibular joints in 94 patients were analyzed to assess for morphology of the articular eminence and disc displacement. The displaced disc was further categorized as disc displacement with reduction (DDWR) and disc displacement without reduction (DDWOR). The morphology of the articular eminence was classified into four types; box, sigmoid, flattened, and deformed. The relationship between the four types of shape of the articular eminence and the two types of disc position was assessed. Results: In the DDWR and DDWOR groups, the morphology of articular eminence were a box type in 40.5%, a sigmoid type in 30.2%, a flattened type in 24.6%, and a deformed type in 4.7%. The box type of the articular eminence were 34.3% in the DDWR group and 42.9% in the DDWOR group. The sigmoid type of the articular eminence were 34.3% in the DDWR group and 28.6% in the DDWOR group. The flattened type of the articular eminence were 28.6% in the DDWR group and 23.1 % in the DDWOR group. The deformed type of articular eminence were 2.9% in the DDWR group and 5.5% in the DDWOR group. Conclusion: Disc displacement is more likely to be found in the temporomandibular joints with a box-shaped articular eminence. It can be considered that shape of the articular eminence is related to the development of disc displacement.

• Imaging Science in Dentistry
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• v.32 no.4
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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.

• Journal of Oral Medicine and Pain
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• v.23 no.1
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.337-343
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• 2001

Objective. Disc displacement may affect the joint space narrowing between condyle head and glenoid fossa. This study was designed to evaluate the correlation between the joint space change and the directions of disc displacement. Study Design. Two hundreds temporomandibular joints MR images of TMD patients (170 joints) and asymptomatic volunteers (30 joints) were evaluated for this purpose. Anterior disc displacement was divided into 3 stages (normal, little to mild, and moderate to severe displacement) based on sagittal images. And sideways displacement was classified as 3 categories (center, medial and lateral displacement) based on coronal images, then joint spaces were measured at medial, central and lateral parts of condyle head on coronal MR images, respectively. The joint spaces of 7 groups divided according to the severity and the direction of disc displacement were compared. Results. The reduction of the joint space was affected by sideways disc displacement at the opposite side of the condyle head, except the cases accompanied with severe anteriorly and laterally displaced disc. Conclusion. The sideways disc displacement affected on the opposite side temporomandibular joint space width.