• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.9 no.1
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• pp.13-18
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• 1979

The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental mary of College of Dentistry, Seoul National University, Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54㎝) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normalrange was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41. 1 %. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71. 5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric occlusion and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.12 no.1
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• pp.69-80
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• 1982

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandi.bular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthorsis was eburnation of cortical bone (35. 64%) of total cases). Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed !tate, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relatioships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movenent in 332 cases (28.55%), bone on bone relation- ships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). bone on bone relationships in 243 cases (21.32%) and downward positioning of condyle in 217 cases (18.66%). 5. In the TMJ arthrosis patients with bone changes, 1249 cases of abnormal condylar position in the mouth closed state and 1163 cases of abnormal condylar position in the mouth open state could be interpreted. so, for the radiographic interpretation of TMJ arthrosis, the reading of condylar positional changes as well as that of bond changes should be performed and their interrelations should be profoundly considered.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.191-203
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• 2000

This study was performed to investigate the relationship between vertical dimension during swallowing and speech pattern in patients with temporomandibular disorders. For this study, 33 patients with temporomandibular disorders(TMDs), namely, 17 patients with disc displacement with reduction and 16 patients with disc displacement without reduction, and 30 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) was used for recording of electromyographic(EMG) activity(${\mu}V$) of the anterior temporalis, the superficial masseter, the sternocleidomastoideus and the trapezius insertion muscle during swallowing, and of mandibular positional change with function time(sec.) during swallowing and speech. A sentence of 'Sue is missing her house' was used for observing of speech pattern. Comparison between the two groups and relationship of the mandibular positional change and the function time between during swallowing and during speech were analysed by SPSS windows program. The results of this study were as follows : 1. Mean EMG activity of the trapezius insertion during swallowing was higher in the patient group, and the value was $3.4{\mu}V$ in patients and $2.1{\mu}V$ in normal subjects. 2. Vertica1 dimension(VD) at mandibular rest position before swallowing was slightly higher in the patient group, but VD at swallowing-late stage and at rest position after swallowing were not different between the two groups. 3. Swallowing time were 2.1 sec. in the patient group, and 1.5 sec. in the normal group, and the difference was significant. 4. VD during speech were generally higher in the normal group. In this case, speaking position showing the most difference between the two groups was 'her' position. The distance from habitual intercuspal position to 'her' position was 4.9mm in the patient group, and 6.6mm in the normal group. Speaking time was also longer in the patient group. 5. There were no difference in all observed items between the two categories of the patient group according to reduction of disc displacement. 6. Relationship between the positional changes during swallowing and speech were different between the patient group and the normal group. And in the normal group, VD at rest position before swallowing was negatively correlated with speaking time.

• Journal of Medicine and Life Science
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• v.16 no.3
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• pp.64-75
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• 2019

Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.324-335
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• 2020

Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

• The korean journal of orthodontics
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• v.25 no.6 s.53
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• pp.655-664
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• 1995

Sixty male patients with polysomnographically documented OSA were included in this study. A pair of cephalograms were obtained in the upright and supine positions. In the supine position, the ANB angle, lower facial height and the cross-sectional area of soft palate increased and there was a decrease in the vertical airway length and oropharynx cross-sectional area. Positional changes did not affect the cross-sectional area of tongue, but the cross-sectional area of the oropharynx decreased in the supine position. The obese group had higher AI and RDI. Maxillary unit length, C3-H, the cross-sectional areas of tongue, soft palate and oropharynx were significantly greater in the group Obese than in non-obese group. No correlation was noted between the mandibular unit length and OSA severity, The group of small mandibular unit length showed shorter lower facial height and maxillary unit length, and smaller cross-sectional area of tongue than the long mandibular unit length group. Hyold bone positioned more inferiorly and cross-sectional area of nasopharynx decreased as the OSA severity increased.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.223-232
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• 1987

The author obtained the transcranial-oblique lateral radiograms from 78 patients(26 male, 52 female) with temporomandibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54㎝ mouth opening with clicking, TMJ pain and mouth opening limitation repectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follows: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p<0.01) 2. In 2.54㎝ mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p<0.01) 3. Examined experimental group, the degree of condylar horizontal movement of affected ide was lesser than that of the normal side in 2.54㎝ mouth opening.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.2
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• pp.85-93
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• 2002

Simultaneous implant installation with bone graft was performed in 15 cases. Four cases were cleft alveolus patients. 56 implants were placed immediately with block bone grafts. 2 cases were cranial bone grafts and the others were iliac bone grafts. Three of 56 implants were lost(94.6% Survival rate). One of three was cleft alveolus case. The cleft alveolus patients with simultaneous implants installation showed functional and esthetic results without infraocclusion and positional changes. Bergland index was considered to be type I after 12 months later. Immediate implant installation with bone graft is one of choice of treatment in closing cleft alveolus hoping simultaneous implant installation could be related with function which might result in less resorption of graft. Functional and esthetic results are satisfaction ; there was no infraocclusion and positional changes.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.86-89
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• 2010

Purpose: Osteotome sinus floor elevation (OSFE) is an often-used technique of great utility in certain implant patients with resorbed posterior maxilla. Recently benign paroxysmal positional vertigo (BPPV) has been reported as an early postoperative complication following OSFE. Although OSFE-induced BPPV commonly resolves itself within a month without treatment, this complication can be a cause of trouble between the implant surgeon and patient. This report presents a case of BPPV following OSFE. Methods: A 27-year-old man without any significant medical problems and missing his maxillary right first molar, was scheduled for OSFE and simultaneous implant placement. Results: The patient suffered dizziness accompanied by nausea immediately after implant placement using OSFE. Following referral to the ear nose throat clinic, "right posterior canal BPPV" was diagnosed. Despite anti vertigo medication and a single episode of the Epley maneuver, the condition did not improve completely. The Epley maneuver was then applied 7 and 8 days later and the symptoms of BPPV disappeared. One year later, the patient remained symptom-free. Conclusions: Before sinus elevation with an osteotome, implant surgeons should screen out patients with a history of vertigo, to diminish the possibility of BPPV. Operators should be aware of BPPV symptoms. As the symptoms may be very incapacitating, immediate referral to an otorhinolaryngologist is recommended.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.28-32
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• 2016

Background Congenital muscular torticollis (CMT) is a benign condition. With early diagnosis and appropriate management, it can be cured completely, leaving no residual deformity. However, long-standing, untreated CMT can lead to permanent craniofacial deformities and asymmetry.Methods Nineteen patients presented to the author with congenital muscular torticollis. Three dimensional computed tomography (3-D CT) scans was obtained upon patient’s admission. Adjustment of skull’s position to Frankfort horizontal plan was done. Cervical vertebral segmentation was done which allowed a 3D module to be separately created for each vertebra to detect any anatomical or positional changes.Results The segmented vertebrae showed an apparent anatomical changes, which were most noticeable at the level of the atlas and axis vertebrae. These changes decreased gradually till reaching the seventh cervical vertebra, which appeared to be normal in all patients. The changes in the atlas vertebra were mostly due to its intimate relation with the skull base, while the changes of the axis were the most significantConclusion Cervical vertebral segmentation is a reliable tool for isolation and studying cervical vertebral pathological changes of each vertebra separately. The accuracy of the procedures in addition to the availability of many software that can be used for segmentation will allow many surgeons to use segmentation of the vertebrae for diagnosis and even for preoperative simulation planning.