• Journal of Oral Medicine and Pain
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• 제49권2호
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• pp.29-34
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• 2024

Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

• Journal of Oral Medicine and Pain
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• 제25권1호
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• pp.73-85
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• 2000

The purposes of the study were (1) to see if there are various types of disc configuration in normal temporomandibular joint and, if so, (2) to examine whether a specific type of disc configuration is susceptible to disc displacement, and (3) to see if a specific type of disc configuration and position is related to early relief of clinical symptoms from the anterior disc displacement without reduction to conservative treatment. From the magnetic resonance (MR) images taken for the patients with symptoms of temporomandibular disorders, 235 images as normal joint group, 255 images as anterior disc displacement with reduction group, and 249 images as anterior disc displacement without reduction group were selected, After the TMJ image was scanned and processed with Photoshop program, the disc configuration was determined, The incidence of various types of disc configuration was analyzed according to age, sex, diagnostic group, and the promptness of symptom relief. The disc position was also examined in relation to the promptness of symptom relief. The results were as follows : 1. In the normal joint group, biconcave type appeared most frequently and reversed, biplanar type in order, Posterior band enlarged and folded type didn't appear at all. On the other hand, in the anterior disc displacement without reduction group, folded type appeared most frequently and also posterior band enlarged type were found often. 2. There were statistically significant differences between sex and configuration of disc in the normal joint group and no statistically significant differences in the anterior disc displacement with reduction group and anterior disc displacement without reduction group, 3. There were no statistically significant differences between age and configuration of disc in the normal, anterior disc displacement with reduction group and anterior disc displacement without reduction group. 4. In anterior disc displacement without reduction group, rapid response was observed in biconcave and reversed type and delayed response was observed in folded type.

• 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.

• Imaging Science in Dentistry
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• 제31권4호
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• pp.221-225
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• 2001

Purpose: To observe the relationship of bilaminar zone of temporomandibular joint retrodiscal tissues to the disc condition. Materials and Methods : The upper and lower stratum of bilaminar zone were identified on magnetic resonance open mouth images of 148 joints from 74 patients with disc displacements. Results: Both strata were identifiable in 105 joints which had disc displacement with reduction. Lower stratum was not identifiable in 35 joints which had disc displacement without reduction but 12 of 35 had hyalinized posterior attachment where the disc was. The 8 joints which had partial disc displacement without reduction showed identifiable lower stratum at the reducing site which was medial. Conclusion: Disruption or no identification of lower stratum which corresponds to the condylar portion of posterior attachment may be the sign of disc displacement without reduction.

• 대한치과교정학회지
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• 제23권4호
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• pp.503-527
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• 1993

This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

• 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 Korean Neurosurgical Society
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• 제61권1호
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• pp.89-96
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• 2018

Objective : Morphometric data for the lumbar posterior longitudinal ligament (PLL) was investigated to identify whether there is a difference in the morphometry of the PLL of the lumbar spine at each level with respect to the pattern of intervertebral disc displacement. Methods : In 14 formalin-fixed adult cadavers (12 males and 2 females), from L1 to L5, the authors measured the width and height of the PLL and compared them with other landmarks such as the disc and the pedicle. Results : Horizontally, at the upper margin of the disc, the central portion of the superficial PLL covered 17.8-36.9% of the disc width and the fan-like portion of the PLL covered 63.9-76.7% of the disc width. At the level of the median portion of the disc, the PLL covered 69.1-74.5% of the disc width. Vertically, at the level of the medial margin of the pedicle, the fan-like portion of the PLL covered 23.5-29.9% of the disc height. In general, a significant difference in length was not found in the right-left and male-female comparisons. Conclusion : This study presents the morphometric data on the pattern of intervertebral disc displacement and helps to improve the knowledge of the surgical anatomy of the lumbar PLL.

• 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.

• Imaging Science in Dentistry
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• 제33권2호
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• pp.63-70
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• 2003

Purpose: To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. Materials and Methods: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. Tl-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. Results: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment(TPA) were correlated neither with clinical, nor with other MRI findings. Conclusion: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.142-146
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• 2018

Patients with temporomandibular disorder often present with acute occlusal change and properly managed with conservative treatment. If such change is caused by unusual etiology, differential diagnosis may be challenged. This article describes the diagnosis of a patient exhibiting pain and acute posterior open bite on the ipsilateral side after chewing hard food. After initial conservative treatment failed to resolve the complaint, magnetic resonance imaging was ordered and confirmed partial perforation of articular disc. Disc perforation itself is usually chronic in nature, but sudden macrotrauma may also cause the disorder. However, occlusal discrepancy caused by disc perforation is rare and seldom reported. We present a case of acute malocclusion caused by disc perforation with a review of related literature.