• Imaging Science in Dentistry
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• v.37 no.3
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• pp.139-147
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• 2007

Purpose: To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) patients. Materials and Methods: 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra- and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Results: Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78-0.84), but interobserver agreement was fair (k=0.45). Conclusion: CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.112-117
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• 2019

Purpose: The aim of this study was to assess the thickness of the roof of the glenoid fossa (RGF) in Korean adult population without symptoms of temporomandibular disorder (TMD) using cone-beam computed tomography (CBCT). Methods: CBCT Data from 111 Korean adult patients aged ${\geq}25years$ (55 males and 56 females) without signs and symptoms of TMD were analyzed retrospectively in this study. The thickness of the RGF was determined as the perpendicular distance between the 'glenoid fossa line' and 'middle cranial fossa line' on parasagittal and paracoronal reconstructions, respectively. The thickness of the RGF according to sex and age was analyzed using t-tests (p<0.05). Differences were also examined between the right and left sides, and between the paracoronal and parasagittal sides. Results: The mean thickness of the RGF in all subjects was $0.75{\pm}0.39mm$; there was no significant difference in thickness between male ($0.78{\pm}0.36mm$) and female ($0.72{\pm}0.30mm$). We found no correlation between age and the mean thickness of the RGF, when age was grouped by decade. However, when subjects were divided into >40 years and ${\leq}40years$ age groups, the thickness of the RGF was significantly different between the groups. Conclusions: We found that the thickness of the RGF did not differ by sex, but might be affected by aging. Further studies with larger numbers of subjects are needed to confirm the results of this study.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.355-364
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• 2006

Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.211-218
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• 2007

The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.388-394
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• 1999

To compare the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis the author investigated 22 temporomandibular joint disorder(TMD) patients with pain and limitation of mouth opening who visited at the Department of Oral and Maxillofacial Surgery. Chosun Dental Hospital and were made a diagnosis as Wilkes stage III or IV of TMJ internal derangement clinically and radiographically. The two groups consisted of 10 patients with injection of sodium hyaluronate 10mg$(Artz^{(R)})$(hyaluronate group) on the upper joint space of the affected temporomandibular joint 5 times at intervals of a week after arthrocentesis, and 12 patients with injection of dexamethasone$(Oradexon^{(R)})$ at a time(dexamethasone group). Maximum mouth opening, pain value and satisfaction value during mastication were assessed on a visual analog scale before arthrocentesis and after 6 months. Then the within-group and between-group differences were evaluated in the obtained data and the clinical success rate of each group was calculated according to our success criteria. The results were as follows. 1. the mean of maximum mouth opening before arthrocentesis and after 6 months in the hyaluronate group were 24.9mm and 39.0mm respectively, and those before arthrocentesis and after 6 months in the dexamethasone group were 25.7mm and 41.3mm respectively. 2. The mean of pain value on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 6.7 and 1.8 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 7.0 and 1.8 respectively. 3. The mean of satisfaction value during mastication on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 2.8 and 7.7 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 3.1 and 7.8 respectively. 4. There were statistically significant differences between all measurements before arthrocentesis and after 6 months(P<0.001), but no difference between all measurements in the hyaluronate group and those in the dexamethasone group. 5. The over all success rate of the hyaluronate group and the dexamethasone group were 60.0% and 63.6% respectively. In summary, there was significant difference between the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis but hyaluronate is better than corticosteroid as the injection drug in consideration of the side effect related with repeated injection.

• The korean journal of orthodontics
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• v.26 no.1 s.54
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• pp.53-63
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• 1996

In order In analyze the occlusion of TMD patient, 73 casts and post eroanterior cephalometric X-rays of patients showing TMD symptoms at first interview were measured and compared that of 30 non-patients . Horizental overjet, vertical overbite, openbite, crossbite, depth of curve of Spee, midline deviation, facial asymmetry, attrition, and TPI were measured and processed statistically The results could be summarized as follows, 1. TMD group showed the highest prevalence in twenties, teens, and before 9 years old group in order, and more prevalent in female than male. 2. There were no statistically significance between two groups of overjet and overbite measurements, but showed significance of 6 classification of anterior tooth relationship between two groups TMD groups. 3. n group had more anterior openbite than normal group but there were no statistically significance between two groups. 4. Anterior crossbite was more prevalent in normal group brit posterior crossbite was more prevalent in TMD group. 5. TMD group showed deeper curve of Spee and there were statistically significance between two groups. 6. TMD group had more attrition than normal group and there were statistically significance beween two groups. 7 TMD group showed more facial asymmetry than normal group. 8. TPI did not showed statistical significance beween two groups. According to the above results, TMD group showed severe and complex mode of malocclusion and this should be carefully regarded when treatment planning and during the treatment of malocclusion.

• Journal of Oral Medicine and Pain
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• v.40 no.2
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• pp.72-78
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• 2015

Purpose: The purpose of this research was twofold: to compare the short-term efficacy of once-off education versus repetitive education (RE) of patients suffering from temporomandibular disorders (TMDs) and to determine whether there was any correlation amongst patient demographics, recommendation adherence degree and pain levels. Methods: A total of 848 patients with TMDs were enrolled. The control group consisted of patients who received a standard conservative treatment (STD) over at least 6 visits with education provided only during the first visit. The experimental group consisted of patients who received STD but had also been given RE (STD+RE). The RE was delivered through a standardized self-assessment questionnaire (SAQ) that was completed by the patient during each visit. Pain, which included maximum comfortable opening (MCO) of the mouth and limitation of mouth opening (LOM), was compared between the two groups. Behavior pattern and reported pain level changes in the group who used the SAQ were also analyzed. Results: The LOM was significantly improved in all of the experimental group patients (especially in females under 30 years of age, p<0.05). The MCO was significantly higher in females (p=0.029). All of the patients displayed improvements in their habits following RE, which resulted in a strong correlation with pain reduction. Adhering to the recommendations regarding questions 14 and 15 of the SAQ appeared to have the greatest effect on pain reduction. Conclusions: These results clearly demonstrate that RE is more effective than once-off education for TMD patients who are female or under 30 years of age.

• Journal of Oral Medicine and Pain
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• v.35 no.1
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• pp.83-91
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• 2010

Objectives: This study aimed to assess the characteristics of temporomandibular disorder (TMD) symptoms and to determine the correspondence between TMD symptoms and clinical examination findings. Material and methods: A total of 218 patients (143 females and 75 males; age=$31.3{\pm}14.0$) were enrolled in this study who completed a questionnaire and underwent a clinical examination and radiographic assessment. Patients were asked about all the symptoms and complaints, including onset or duration, and locations of the symptoms. Clinical examination included amounts of mouth opening, palpable temporomandibular joint (TMJ) sounds, and tenderness to palpation of the TMJ and all masticatory muscles. Tenderness scores obtained from palpation of the masticatory system were summated to define the variables for further analysis. Results: Pain was the most frequently reported symptom (78.9%), followed by joint sounds (45.4%), and limitation in mouth opening (17.0%). Jaw pain comprised 91.9% of pain complaints. The subjective intensity of jaw pain was low to medium in most patients (93.7%), but it was poorly correlated with the sum of tenderness scores of the TMJ and masticatory muscles (Kendall tau = 0.084). In contrast, the side in which pain was reported by patients was well associated with the clinical examination results (pain of the right side, p < 0.001, and left side, p < 0.001). There was moderate agreement in TMJ sounds between the side identified by patients as symptomatic and clinical examination findings (kappa = 0.482). Finally, patients who complained of restricted mouth opening showed about a 10 mm less opening in all three measurements, compared to other patients (p < 0.001). Conclusion: The most frequent symptoms reported by TMD patients were jaw pain, TMJ sounds, and mouth opening limitation. The side of jaw pain, the side of TMJ sounds, and the presence of opening limitation were highly concordant between symptom reports and examination findings.

• Journal of Oral Medicine and Pain
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• v.37 no.1
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• pp.47-59
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• 2012

A retrospective study was conducted to determine the patterns of Temporomandibular Disorder(TMD) among adolescents (12-19 years) over last ten years. 174 patients who had visited the Oral medicine of Pusan National University Dental Hospital in 2000 and 491 patients in 2008 were found on chart review. The results obtained were as follows : 1. The number of adolescent patients was significantly increased in 2008 than in 2000, especially in male. 2. Bruxing, clenching, holding habits and bad sleep hygiene were highly increased more in 2008 than in 2000. 3. Osteoarthritis was significantly increased in 2008 than in 2000 and anterior disc dislocation without reduction was slightly increased. 4. The ratio of male to female adolescent patients with osteoarthritis was remarkably increased. Among the patients who had holding, bruxing, clenching habits, significantly increased osteoarthritis found to be common. This could imply holding, bruxing, clenching habits are prominently associated with increasing risk of developing osteoarthritis.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.81-90
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• 2009

This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.