• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.140-145
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• 2014

Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.289-294
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• 2019

Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

• 한국치위생학회지
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• 제21권6호
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• pp.731-740
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• 2021

Objectives: The purpose of this study was to examine the effects of oral and mental health status on temporomandibular joint disorders (TMDs) and the effects of TMD symptoms on quality of life using data from the 5th 2012 National Health and Nutrition Examination Survey. Methods: A total of 1,154 people were selected as subjects for the study. Temporomandibular joint (TMJ) sounds (672 persons), TMJ pain (227 persons), and TMJ dislocation (255 persons) were the factors studied. The complex sample chi-square test was performed to compare demographic characteristics according to the three groups of TMD symptoms. Complex sample logistic regression analysis was performed to confirm the effect of oral and mental health status on TMDs, and complex sample linear regression analysis was performed to check the effect of TMDs on the quality of life (EQ-5D). Results: After adjusting for demographic characteristics, those without TMJ sound symptoms had lower pain/discomfort (OR: 0.055, CI: -0.095 to -0.016) and anxiety/depression (OR: 0.053, CI: -0.092 to -0.014). Those without TMJ pain had lower pain/discomfort (OR: 0.119, CI: -0.192 to -0.046) and anxiety/depression (OR: 0.071, CI: -0.137 to -0.004). Pain/discomfort (OR: 0.063, CI: -0.125 to -0.001) was lower in those without TMJ dislocation symptoms. After adjusting for mental health status, pain/discomfort (OR: 0.088, CI: -0.161 to -0.014) was found to be lower in those without TMJ pain symptoms (p<0.05). Conclusions: Based on the results of this study, the treatment of TMDs, oral health, and also mental health, is needed to improve the quality of life.

• 한국치위생학회지
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• 제11권6호
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• pp.853-862
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• 2011

Objectives : The aim of this study was to investigate the number of self-report symptoms for temporomandibular disorders(TMD) and related factors in the third grade students of high school. Methods : A total of 1,043 high school the 3rd students age 16 20 completed a questionnaire from 11 high schools in Andong city from April to June 2010. Student's t-test was used to analyze the difference of TMD number. Multiple regression analysis was performed to determine the effects of independent variables on TMD number. Results : 1. Students who have one TMD were 71.3%, two 41.7% and over three 25.7%, respectively. 2. The number of TMD symptom of students who have no good habits such as clenching, bite lip and cheeks, resting on hand, chewing gum, hard foods, and unilateral chewing was a statistically significant higher than those who doesn't have ones(p=0.00). 3. TMD number of students who have been under more stress was a significantly higher than those who didn't have been(p=0.00). 4. Bite lip and cheek(${\beta}$=0.03, p=0.037), chewing gum(${\beta}$=0.03, p=0.029), resting on hand(${\beta}$=0.04, p=0.006), hard foods(${\beta}$=0.07, p=0.000), and stress out(${\beta}$=-0.03, p=0.018) were significantly associated with TMD number by multiple regression analysis. Conclusions : Variables associated with TMD were bite lip and cheek, chewing gum, resting on hand, hard foods, and stress out factor. According to our findings, it is so important to teach good habits on oral health to the 3rd grade students in high school. Further prospective study should explore cause of TDM from those variables.

• Nuclear Medicine and Molecular Imaging
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• 제43권2호
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• pp.143-149
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• 2009

목적: 골스캔이 측두하악관절장애의 예후 예측에 유용한지 알려져 있지 않다. 이 연구의 목적은 편측성 측두하악관절장애 환자에서 예후 예측 인자로서 유용한 골스캔 소견은 무엇인지 알아보는 것이었다. 대상 및 방법 : 2005년 1월부터 2007년 7월에 걸쳐서 편측성 측두하악관절장애로 진단받고 치료 전 골스캔을 시행한 55명의 환자(남:여=9:46; 나이, $34.7{\pm}14.1$세)들을 대상으로 하였다. 양측의 측두하악관절과 두정골 영역에서 $13{\times}13$ 픽셀 크기의 정사각형 관심영역을 그려서 Tc-99m HDP섭취를 정량화하였다. 측두하악관절 섭취비는(측두하악관절 카운트 - 배후영역 카운트) / 배후영역 카운트로 계산하였고 이환된 측두하악관절에 대한 비대칭지표는 이환된 관절과 비이환된 관절 섭취비의 비로 정의하였다. 교합안정장치 시행 6개월 후 임상적 평가를 통해 호전군과 비호전군으로 나누고 골스캔 소견이 이러한 예후에 따라 어떻게 다른지 평가하였다. 결과: 46명의 환자가 호전되었고 9명의 환자는 증상의 호전이 관찰되지 않았다. 호전군과 비호전군간에 이환관절의 측두하악관절 섭취비, 반대편 정상관절의 측두하악관절 섭취비,그리고 비 대칭지표의 유의한 차이는 관찰되지 않았다(p>0.05). 그러나 소그룹 분석에서 이환 측두하악관절에 Tc-99m HDP의 섭취가 증가한 환자들에서는 비대칭지표에 의해 환자군이 구분되었다. 즉, 호전군의 비대칭지표가 비호전군에 비하여 유의하게 증가되어 있었다($1.32{\pm}0.35$ vs. $1.08{\pm}0.04$, p=0.023). 결론: 편측성 측두하악관절장애 환자에서 Tc-99m HDP 골스캔은 시각 분석에서 이환 관절의 섭취가 증가되어 있는 경우 교합안정장치 치료에 대한 예후를 예측할 수 있는 것으로 보인다.

• 한방재활의학과학회지
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• 제27권4호
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• pp.67-74
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• 2017

Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.27.1-27.8
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• 2018

Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

• 구강회복응용과학지
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• 제37권4호
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• pp.225-231
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• 2021

목적: 측두하악장애 환자에게 주로 사용되는 장치 치료의 적응증 및 효과에 대한 연구는 다수 존재하나, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 방법에 대한 연구는 부족하다. 따라서 본 후향적 연구는 측두하악장애 환자를 대상으로, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 과정을 고찰하고자 한다. 연구 재료 및 방법: 턱관절 질환, 근막 통증, 이갈이 및 이악물기 등을 주소로 연세대학교 치과대학병원 구강내과를 내원하여 장치 치료(교합안정장치, 전방위치교합장치)를 시행한 130명의 환자의 차트 리뷰를 통해 장치 치료를 테이퍼링하여 종료하는 과정을 알아보았다. 결과: 평균 장치 장착 기간은 29개월로, 매일 장치를 장착한 기간은 8.4개월, 일주일에 3 - 4일간 장치를 장착한 기간은 9.5개월, 일주일에 1 - 2일간 장치를 장착한 기간은 11.1개월이었다. 결론: 측두하악장애 환자에서 장치 장착 시 처음 6개월 간은 매일 장착, 이후 6개월에서 18개월 동안은 일주일에 3 - 4일간 장착, 18개월 이후부터는 일주일에 1 - 2일간 장착하는 방식으로 테이퍼링하여 장치 치료를 종료할 시 측두하악장애 환자의 증상은 완화시키면서 교합 변화 등의 부작용은 최소화시킬 수 있을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제38권1호
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• pp.77-86
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• 2013

2012년 7월부터 2012년 9월까지 부산대학교치과병원 구강내과에 내원하여 측두하악장애로 진단받은 후 행동치료, 약물치료, 물리치료, 교합안정장치 등 보존적 치료를 시행한 환자 137명을 대상으로 초진 시와 치료 3개월 후의 증상 및 임상소견을 비교, 평가하여 다음과 같은 결과를 얻었다. 1. 측두하악장애는 행동치료, 물리치료, 약물치료, 교합안정장치 등의 보존적 치료에 의해 통증, 관절잡음, 개구제한 및 최대편이개구량이 현저히 개선되었다. 2. 보존적 치료에 따른 결과는 성별 및 급, 만성별로 유의한 차이 없이 개선되었다. 3. 측두하악장애의 치료에서 물리치료와 약물치료만 시행한 경우보다 교합안정장치를 병행한 경우에서 임상 증상들의 개선이 현저하였다. 4. 치료 3개월 후 근육장애군은 통증과 개구제한이 유의하게 개선되었고, 관절원판변위군은 통증, 개구제한 및 관절잡음이 유의하게 개선되었다. 골관절염군에서는 통증, 관절잡음, 개구제한 및 최대편이개구량이 모두 개선되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.211-216
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• 2007

Temporomandibular joint disorders (TMD) often show muscular disorder, internal derangement and degenerative change of articular surface of the condyle. It is important to choose adequate diagnostic method for obtaining data for the diagnosis and treatment. Magnetic Resonance Imaging (MRI) has some advantages, because it shows good resolution image for the soft tissue and it is not invasive to the human body. We have performed serial research about the retrodiscal tissue of the TMJ according to the progress of the disease, using T2 weighted image, since 2002. In this study, we applicated resized observation area to compare signal intensity between the retrodiscal tissue of the TMJ and cerebral gray matter, using T2 weighted image.