• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.275-289
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• 2013

본 연구는 측두하악장애에 대한 치과 내원환자의 인지도와 이해도를 조사, 분석하기 위해 시행되었다. 인제대학교 부산백병원 치과 혹은 울산광역시 소재 한빛치과병원을 방문한 총 243명의 환자에게 설문조사를 시행하였고, 설문지의 모든 문항에 대해 성실히 답한 195명을 대상으로 하여 다음과 같은 결과를 얻었다. 1. "측두하악장애"란 용어를 인지하고 있는 환자는 전체 대상자의17.4%였고, 총 12년 이상의 학력을 가진 군(82.4%, p<0.01)은 다른 군에서 보다 "측두하악장애"에 대한 인지도가 유의하게 높았다. "턱관절질환"이란 용어를 인지하고 있는 환자는 전체 대상자의 81.0%였고, 30-49세 연령군(45.6%, p<0.05)과 총 12년 이상의 학력을 가진 군(60.1%, p<0.01)에서 다른 군보다 "턱관절질환"이란 용어에 대한 인지도가 유의하게 높았다. 2. 전체의 과반수 이상인 50.6%가 턱관절질환의 개념으로 "턱을 무리하게 사용해서 생기는 병이다"를 선택했다. 3. 턱관절질환에 대해 들은 경로로TV, 라디오(41.4%)가 가장 많았고, 가족과 친구(20.2%), 병원 및 병원관계자(18.2%), 인터넷(15.7%) 및 신문과 잡지(4.5%)순이었다. TV, 라디오를 통해서 턱관절질환에 대해 들어본 응답자 중 30-49세 연령군이 다른 군보다 유의하게 높은 비율(52.4%, p<0.05)을 보였다. 인터넷을 통해서 턱관절질환에 대해 들어본 응답자 중 18-29세 연령군이 다른 군보다 유의하게 높은 비율(61.3%, p<0.01)을 보였다. 병원과 병원관계자를 통해서 턱관절질환에 대해 들어본 응답자 중 총 12년 이상의 학력을 가진 군(75%, p<0.05)이 다른 군보다 유의하게 높은 비율을 보였다. 4. 환자들은 입을 벌리고 다물 때 턱에서 나는 소리(26.9%), 입을 크게 벌리지 못한다(25.1%), 귀 앞쪽 부위의 통증(13.7%)을 턱관절질환의 증상과 징후로 골랐다. 턱관절질환의 원인으로는 딱딱하거나 질긴 음식을 즐겨먹기(19.5%), 아래, 윗니가 잘 안 맞물림(19.0%), 한쪽 어금니로 음식씹기(18.5%)를 많이 선택했다. 턱관절질환의 치료법으로 턱관절수술(28%)을 가장 많이 꼽았고, 구강내 장치치료(23.9%), 물리치료(14.6%)가 그 뒤를 따랐다. 턱관절질환의 예방법으로 딱딱한 음식의 섭취를 줄인다(21.1%), 입을 너무 크게 벌리지 않는다(17.0%), 양쪽 어금니로 음식을 씹는다(15.4%)를 많이 선택했다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.310-311
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• 2009

Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.38-51
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• 2022

Purpose: The purpose of this study was to analyze the extent of awareness and understanding of college students on temporomandibular disorder (TMD) and to search for avenues for raising public awareness and improving knowledge about TMD. Methods: One thousand and one hundred and twenty one college students in Gyeonggi-do completed a questionnaire related to awareness, experience and knowledge of TMD and collected data were analyzed by Pearson's chi-squared test. Results: Women were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than men. Third graders were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than any other graders. Third graders the most frequently chose to visit department of dentistry for the treatment of TMD among three graders (p<0.001). Women more frequently chose to visit department of dentistry for the treatment of TMD than men (p<0.001). Health field subjects were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than non health field subjects. Having more frequently visited department of dentistry for the treatment of TMD than non health field subjects (p<0.001), health field subjects more frequently chose to visit department of dentistry for the treatment of TMD in the future (p<0.001). Conclusions: The level of awareness and knowledge of TMD was higher in women college students, health field subjects and third graders than men college students, non health field subjects and the rest of two graders, respectively. The higher the level of experience and education of the subject, the more aware the subject was of TMD. Therefore publicity activities and education through various routes are required to raise public awareness and knowledge of TMD. In addition, it is necessary to inform general public of the dentistry specialized for the accurate diagnosis and standardized treatment of TMD.

• 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.

• 한국치위생학회지
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• 제17권4호
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• pp.589-600
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• 2017

Objectives: This study aims to prove that stress directly or indirectly affects the jaw joint disorders and provide basic data for developing oral health promotion program. Methods: The study was conducted by distributing a questionnaire survey to more than 350 people from December 30, 2016 to January 7, 2017. Among them, 336 copies were collected and 314 copies were utilized eventually, except Section 314, for the final analysis. Regression analysis was performed to investigate the factors affecting temporomandibular joint disorders. Results: As a result, academic achievement and stress were found to affect the temporomandibular joint disorders. The higher the level of education and stress, the higher the subjective symptoms of jaw joint disorder. Conclusions: Because stress affects temporomandibular joint disorders, it is necessary to find out the cause of stress not only for professional treatment but also for solution of temporomandibular disorder. Thus, stress level must be conisdred as influential factors in developing a jaw joint disease prevention program.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.39.1-39.6
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• 2015

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

• 대한치과의사협회지
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• 제38권6호통권373호
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• pp.549-557
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• 2000

ㆍPurpose: This study was performed to investigate the initial conservative treatment for TMD patients using careful counselling and medication prospectively. ㆍMaterials and Methods: Careful counselling and medication were performed in 51 TMD patients and 27 patients had follow-up check 2 months or more. Diagnosis of TMD was based on medical history and, physical and radiographic examination. TMD included masticatory disorder, internal derangement, degenerative joint disease, inflammatory joint disorder. and problems resulting from extrinsic trauma. All patients had chief complaints of TMJ pain, mouth-opening limitation. joint noise, and/or referred pain. We counselled and explained to the patient about the pathogenesis, etiologic factors, diagnosis and treatment plan for abut 10 minutes. We prescribed nonsteroidal anti-inflammatorv analgesic(Somalgen) and amitriptyline 10mg per day for 2 weeks. We informed the patient of the attention sheet and taught self-exercise of jaw. The patient were assessed by answering the questionnaire of subjective evaluation of TMD & maxillofacial pain. Questionnaire of an activity limitation. Questionnaire of a jaw function, and Questionnaire for the evaluation of TMD. ㆍResults: In questionnaire for the evaluation of TMD, 88.5% of 26 patients answered that the treatment was efficacious. 71.4% of 21 patients answered no problem in everyday life. There were significant differences between pretreatment and final follow-up in the evaluation of the subjective pain in the following sections: opening widely, chewing, resting, morning, masticatory muscle, and temporal portion(SAS program, paired T-test, P = 0.05). ㆍConclusions: Considerate counselling and proper medication could be significantly effectve in the initial treatment of TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.412-420
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• 2013

The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.

• 턱관절균형의학회지
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• 제7권1호
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• pp.11-16
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• 2017

In order to understand Changeologically on the meaning of FCST's TMJ (temporo-mandibular joint) treatment procedure, Yi, Shike, Bi, Gen trigrams concerning the jaw and change by treatment were analyzed from the viewpoint of semiotic context of hexagon and holistic interpretation on disease. Yi is meant by jaw but actually indicates mouth made by maxilla and mandible, and it's characters are related with nourishing by aliment and words. But when we eat and speak in the daily life, jaw does not nourish properly it's own body by bad habit or postures. For the treatment of this ill state, there needs punishment and correction symbolized with Shike. Shike has fourth nine meaning obstacles between the two strong lines in the upper and lower end, and so it has the function of mastication and get rid of the fourth nine metaphorically indicating subluxation of axis using CBA and auxiliary measures of four movement or laughing methods. Bi expresses the achievement and effects of consecutive mastication process implicating normalized manifestation of jaw and its linked spinal function. Gen symbolizes removing selfish motive or partiality in advance and reaches the best state of the saint righteously self-nourishable human being.