• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1255-1259
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• 2016

Background: Oral physiotherapy or mouth exercise is considered to be an adjunct but mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. Materials and Methods: A total of 231 OSMF patients were selected and treated with basic regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IID<20mm were managed surgically. IID was measured at baseline and at 6 months recall. The change in IID measurements was calculated and statistically analyzed using 2-way ANOVA and Tukeys multiple post hoc analysis. Results: Average improvement in IID after six months of recall visits was observed to be 8.4 mm in subgroup-A1 (n-53) compared to 5.5 mm in B1(n-50) (p<0.01). The IID improvement in subgroup-A2 was found to be 9.3mm (n-46) compared to 5.1 mm in B2 (n-48) (p<0.01). In the surgery group, mouth opening improvement was observed to be 9.6 mm in subgroup A3 (n-18) compared to 4.8 mm for B3 (n-16) (p<0.01). Conclusions: Use of the MED appears to be effective for increasing oral opening in OMSF patients in conjunction with local, injection and/or surgical treatment.

• Imaging Science in Dentistry
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• v.35 no.4
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• pp.231-234
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• 2005

Coronoid impingement can cause limitation of mouth opening. In many cases, it appears to be related to the coronoid hyperplasia. We present a case of mouth opening limitation caused by coronoid impingement on the posterior surface of the zygomatic bone without coronoid hyperplasia. The bony changes in coronoid and zygoma including surface irregularity and discontinuity of the cortex and sclerotic change of inner medullary space were noted on computed tomography (CT) scans in different level of axial planes. Through another CT scans in open mouth position could demonstrate that those bony changes were caused by the contact of both surfaces against each other. In case coronoid impingement is suspected of the many possible causes, the open mouth CT scans will be needed to reveal the direct impingement of coronoid on zygoma even without coronoid hyperplasia.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.291-306
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• 1995

Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.367-374
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• 2007

Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.29-34
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• 2013

Objective: All patients who have the disc displacement with reduction (DDwR) are always not progressive but some of them with significant catching or locking progress to disc displacement without reduction (DDw/oR). In this study, we suggest opening exercise therapy using Locking-free Appliance (LA) to be helpful to prevent progressive derangement. Methods: Retrospectively, a total 37 patients who received exercise treatment using LA was analyzed from January 2010 to December 2011. Patients had been instructed in proper exercise technique to practise for opening and closing of mouth wearing the appliance 30 times a day in locking-free position. Results: None of the patients took a turn for worse to DDw/oR (37 patients). The 16 patients (43.2%, locking-free group) of them could open their mouth without intermittent condylar locking. Measurement of data was analyzed using and Mann-Whitney test. There was no statistically significant difference for age, gender, presence of palpational pain, locking period, VAS quantitative pain score between locking-free group and locking group. Conclusions: In this study, some patients could open their mouth without intermittent locking and did not take a turn for worse to DDw/oR after opening exercise therapy with LA. Furthermore, LA had advantages which were short wearing time, low costs and minimizing patients' uncomfortable compared to conventional treatment method. This therapy can be more appropriate new treatment to prevent progress to DDw/oR.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.3
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• pp.182-188
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• 1993

A technical refinement for oral commissure reconstruction is presented. The oral commissure has an important role in oral sphincteric function. Once lost, the oral commissure is very difficult to restore and therefore, reconstruction of the oral commissure requires prevention of this function as well as prevention of microstomia. Trauma and tumor excisions are the most frequent reasons that will necessitate reconstruction of the oral commissure. Direct approximation of the wound margins after resection of the corner of the mouth could easily induce microstomia and difficulty in opening. Thus case presented here deals with distortion of noraml mouth angle and acquired microstomia due to burn and tissue deface following shotgun and explosive wounds. The a mucosal flap approach was used to rehabilitate a natural looking mouth angle showing satisfactory results function and esthetic wise.

• Proceedings of the Korea Concrete Institute Conference
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• 2001.05a
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• pp.215-220
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• 2001

The objective of this study is to examine the fracture characteristics of concrete at early ages such as critical stress intensity factor, critical crack-tip opening displacement, fracture energy based on the concepts of the effective-elastic crack model and the cohesive crack model. A wedge splitting test for Mode I was performed on cubic wedge specimens with a notch at the edge. By varying strength and age, load-crack mouth opening displacement curves were obtained and the results were analyzed by linear elastic fracture mechanics. The results from the test and analysis showed that critical stress intensity factor and fracture energy increased, and critical crack-tip opening displacement decreased with concrete age from 1 day to 28 days. The obtained fracture parameters at early ages may be used as a fracture criterion and an input data for finite element analysis of concrete at early ages.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.157-166
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• 1997

Treatment of condylar fracture is still controversial, but the indication of surgical mangement is increased due to improved fixation methods and surgical techniques. In this article, we report our clinical and radiological results with the use of lag screw osteosynthesis for fixation of fractured mandibular condyle. 12 case of condyle fracture treated by open reduction and fixation with lag screw were monitored for an average of 10 months (range from 6 months to 19 months) postoperatively. The obtained results are as follows : 1. Postoperative maximum mouth opening is achieved over 40mm except one patient. 2. Although slight crepitus and deviation of mandible during mouth opening were found, Temporomandibular joint problem is satisfactory in all but one patient. 3. Distal migration of screw and resorption of fractured fragment were found in each 2 patients, but good functional recovery was achieved in all. According to the above results, we think that lag screw osteosynthesis is relatively indicated in level III or IV condylar fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.79-87
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• 1994

The authors investigated the 17 patients with the condylar fractures of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Chosun University, Dental hospital from 1990 to 1993 and could be taken follow-up above 6 months. Helkimo's clinical dysfunction index and mandibular mobility index were applied to the evaluation of the patients and the obtained results were as follows. 1. Mean maximal mouth opening was 38.4 mm in the conservative group, 41.3 mm in the surgical group and that showed no statistically significant difference.(P>0.05) 2. Clinical dysfunction index was higher in the surgical group than in the conservative group but .that showed no statistically difference.(P>0.05) 3. The extent of maximal mouth opening was increased gradually throughout the follow-up period. 4. Both groups didn't show severe clinically dysfunction.

• Journal of Korean Dental Science
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• v.12 no.2
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• pp.66-72
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• 2019

Osteochondroma is a bone tumor with cartilaginous growth potential that generally appears near the growth plate of long bones in areas such as hip, knee, and shoulder joints, related to the nature of endochondral ossification and it is known a common benign bone tumor. However, it has been very rare in craniofacial region possibly because craniofacial bone is largely formed by intramembranous ossification. Moreover, reports on the solitary type of osteochondroma in mandibular condyle has been extremely rare. Osteochondroma in mandibular condylar may show various symptoms similar to general temporomandibular joint disorders (TMDs), such as pain in the condylar area during mouth opening, internal derangement, facial asymmetry or posterior open bite. Therefore, it can be disregarded for a long time period without any adequate treatment. Surgical excision has been the treatment option for the solitary osteochondroma with very low recurrence rate reportedly. In this case report, a rare case of solitary osteochondroma developed in unilateral mandibular condyle is presented with emphasis on differential diagnosis with general TMDs.