• Journal of TMJ Balancing Medicine
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• v.11 no.1
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• pp.1-11
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• 2021

Dystonia is a neurological disorder characterized by involuntary and uncontrollable muscle tonus abnormalities. It is a huge burden not only to the patients and their families, but also to the field of medicine, in that there has hardly been any substantial change in the concept of and approach to this intractable disorder and therefore no breakthrough to its diagnosis, evaluation and treatment. As an effort to solve the current impasse, this review briefly summarizes the current concept, etiology, diagnosis, treatment and management, and then suggests a rather new therapeutic approach to this disorder, based on the concept of neurological balance and TMJ integrative approach. These new approaches will provide a platform for the clinicians and researchers to have a leap in the concept, diagnosis and therapeutics.

• Journal of Oral Medicine and Pain
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• v.11 no.1
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• pp.19-27
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• 1986

Registration of the mandibular movement in patients with temporomandibular joint noise (clicking and/or crepitus) was performed using one of mandibular tracking devices(SAPHON VISI-TRAINER CII,Tokyo Shizai-sha Inc.,Japan). The obtained results were follows : 1. In many cases, the movement pattern of light emitting diode(LED) attached on the mandibular midline showed lateral deviation from a vertical reference line which was pronounced in association with TMJ noise during opening and closing. 2. In patients with unilateral TMJ noise the mandibular midline usually towards the side demonstrating TMJ noise during opening. 3. A distinct V-shaped discontinuity in the trace of velocity of mandibular movement was found at the point of the TMJ noise. 4. In patients with TMJ noise the velocity of mandibular movement at the point of the TMJ noise was decreased rapidly. 5. In several cases, TMJ noise could be eliminated by traning of Rocabado`s control of TMJ rotations.

• Journal of Oral Medicine and Pain
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• v.17 no.1
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• pp.9-17
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• 1992

The purpose of this study was to investigate the characteristics of TMJ sounds by computerized sound power-spectrum analyser(SONOPAK, Bioresearch Inc., U.S.A.). TMJ sounds were recorded and anaylsed in the 87 patients wit TMJ noises by SONOPAK. The followings are the criteria of TMJ sound analysis. 1. It is possible to record the location of the TMJ sound in relation to the opening/closing cycle of mouth. 2. It is possible to record amplitude of sound(loudness) and frequency of sound (Hz) 3. Clicks display a narrow band of sound within the 0-300 Hz range. The peak frequency generally occurs between 50-150 Hz. And crepitus appear as a wide band of sound, occuring from 0-1300Hz. The data obtained from quantitative TMJ sound analysis give lots of information, but further researches are needed.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.133-139
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• 1995

The aim of this study was to investigate the state of anterior tooth contacts in patient with internal derangement of TMJ. We have investigated the change of the number of tooth contacts after conservative treatment including stabilization spint in 83 patients with TMJ internal derangemnet who visited the Orofacial Pain Clinic, Dept of Oral Diagnosis, Seoul National University Dental Hospital. The obtained results were as follows : 1. The gender ratio of patients was 1:3.7(M:F) 2. The number of patients with bony changes in TMJ was 17(20.5%) 3. The number of patients with absence of incisor tooth contacts was 73(88%) 4. The number of Tooth contacts after treatment was decreased compared with that before treatment in both groups. However there was no significant difference between groups 5. There was the decrease in the number of tooth contacts in 12(76%) of 17 patients with bony changes in TMJ and in 23(34.8%) of 66 patients without bony changes in TMJ. 6. The ratio of patients who showed the decrease of the number of tooth contacts was higher in patients with bony changes in TMJ than patients without bony changes in TMJ. 7. After conservative treatments with stabilization splints in patients with TMJ internal derangement, the possibility of the decrease in the number of tooth contacts had no relationship with the presence of incisor tooth contacts. However, the incidence was higher in patients with bony changes in TMJ.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.137-143
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• 2016

Posterior disk displacement (PDD) of the temporomandibular joint (TMJ) is a rare condition and most descriptions of TMJ PDD are about the adhesion of superior TMJ in which the position of disk is relatively posterior to anteriorly translated condyle in open mouth position. However, there have been reports about truly posteriorly positioned disk to the condyle in closed mouth position. This type of PDD has been classified into three subtypes-thin flat disk type, grossly posterior displaced disk type, and perforated disk type. Here, we report two rare cases of TMJ PDD, one with thin flat disk and one with perforated disk. Its possible etiology, pathogenetic mechanisms, related signs and symptoms, differential diagnoses, and treatments were reviewed and discussed.

• The Journal of the Korean dental association
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• v.51 no.2
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• pp.74-83
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• 2013

In the management of temporomandibular joint(TMJ) disorders, dental practioner should conduct the reversible, conservative, and inexpensive treatment modalities prior to the irreversible and invasive treatment. That is to say, behavioral, pharmacologic, and physical therapy should be conducted firstly, and then the occlusal appliance therapy could be considered. If patients do not react to these conservative treatments, we have to consider surgical treatments. If the accurate diagnosis is confirmed by intimate history taking, clinical and imaging examinations, we can rehabilitate the normal TMJ function and relieve the clinical symptoms with only conservative treatments in most TMJ disorder cases.

• The Journal of the Korean dental association
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• v.58 no.6
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• pp.364-376
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• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.175-185
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• 2013

Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.455-466
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• 1999

The purpose of this study was to investigate the magnitude of mandibular rotational torque movements in subjects with TMJ sounds, and to analyse correlation between quantitative characteristics of TMJ sounds and mandibular rotational torque movement. Twenty dental college students with TMJ clicking and twenty students without any TMD signs and symptoms were examined by mean of SonoPak and Rotate program of BioPAK system(Bioresearch Inc. MilWaukee, wisconsin, USA) in this study. Mandibular rotational torque movements were recorded and analysed during maximum mouth opening, protrusion, and lateral excursion in frontal and horizontal planes. The obtained results were as follows: 1. On maximum mouth opening, mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.05). 2. During maximum mouth opening closing, maximum mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.01). 3. On protrusion, mandibular rotational angle and distance of clickin group were significantly greater than those of control group in horizontal plane. (P<0.05). 4. On lateral excursion, there was no significant difference in mandibular rotational angle and distance between clicking group and control group in frontal and horizontal planes. 5. There were significant correlations between peak amplitude of TMJ sounds and maximum mandibular rotational distance during maximum mouth opening (r=-.481) and mandibular rotational distance on maximum mouth opening (r=-.455) in horizontal plane. 6. There were significant correlations between Above 300/(0-300)Hz ratio of TMJ sounds and mandibular rotational angle (r=-.499) and distance (r=-.457) on maximum mouth opening in frontal plane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.