• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.19.1-19.6
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• 2017

Background: The aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs). Methods: Two hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse). Results: Degenerative bony changes were the most frequent in the age groups of 10~19, 20-29, and 50~59 years. The most frequent pain intensity was "none" (NRS 0, 34.6%) followed by "annoying" (NRS 3-5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). "Ero + Fla" was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age. Conclusions: Osp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. "Six months to 2 years" may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.

• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.267-274
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• 2013

본 연구는 측두하악관절의 개구성 과두걸림과 골격적 특성 사이의 연관성을 분석하고자 개구성 과두걸림 환자를 대상으로 측두두부방사선 사진과 횡두개촬영 방사선 사진을 이용하여 두개골의 골격적 특성 및 관절 융기의 기울기를 비교 분석하였다. 개구성 과두걸림 환자를 환자군으로 하고 개구성 과두걸림은 없지만 측두하악장애 연구진단 기준(Research Diagnostic Criteria for Temporomandibular Disorder; RDC/TMD) Axis I에 따라 측두하악장애으로 진단된 환자를 측두하악장애 환자군, 개구성 과두걸림과 측두하악장애가 모두 없는 정상 환자를 정상군으로 설정하고 순차적으로 수집된 환자군 50명과 성별 및 연령이 일치하도록 무작위로 측두하악장애 환자군과 정상군, 각각 50명의 임상기록을 선별하였다. 측두하악장애에 영향을 줄 수 있는 관절염이나 외상의 병력, 악안면 기형, 악안면 수술 병력이 있는 환자는 모두 제외하였다. 세 군의 측두두부규격방사선 사진과 횡두개촬영 방사선 사진을 분석하여 골격적 특성과 관절 융기의 기울기를 측정하였다. 두개골과 하악과의 골격적 특성을 나타내는 측두두부방사선 사진을 분석한 결과 개구성 과두걸림이 있는 환자군에서 하악의 전후방적 위치를 나타내어주는 saddle angle이 더 작은 것으로 나타났으며 이는 두개골에 대해 하악이 더 전방으로 위치하고 있음을 나타낸다. 또한 횡두개촬영 방사선 사진상에서는 개구성 과두걸림 환자군이 측두하악장애 환자군과 정상군보다 관절융기의 기울기가 더 크게 관찰되었다. 이러한 결과는 두개골에 대해 측두하악관절이 더 전방으로 위치하고 관절 융기가 더 급한 경사를 가질 경우 개구성 과두걸림이 발생할 가능성이 더 크다는 것을 의미한다.

• 대한소아치과학회지
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• 제30권3호
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• pp.477-482
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• 2003

하악과두부는 하악골에서 자주 발생하는 골절부위 중의 하나로 특히, 하악골의 성장이 완성되지 않은 소아의 경우 하악과두골절이 적절히 치료되지 않으면 안면 기형, 악관절 강직종, 부정교합, 그리고 하악골 발육이상 등을 초래할 수 있다. 소아에서의 하악과두골절의 치료목적은 동통없이 악기능을 정상적으로 회복시켜 악안면골의 성장발육을 정상적으로 유도하는 것이다. 치료방법의 선택은 환자의 나이, 골절된 위치, 골절부위의 이물질의 유무 등에 의해 이루어지나 소아의 경우 가능한 한 비수술적, 기능적 치료가 선호된다. 본 증례에서는 activator를 이용한 하악과두골절의 기능적 요법을 시행하고 골절부위의 기능적 재형성을 유도하면서 10개월간 관찰해 본 결과, 골절 부위의 동통 감소, 정상적 교합관계의 회복, 최대개구량의 증가, 하악의 편위 감소 등의 기능적 회복을 보였고 특이한 자각증상을 보이지 않았다. 소아에서 하악과두골절의 처치법으로 activtor를 이용한 기능적 치료는 동통없이 악기능을 회복시키고, 정상적인 교합관계로 유도할 수 있을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제19권1호
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• pp.137-149
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• 1994

This study was performed to investigate the relationship between Forward Head Posture(FHP) and Craniomandlbular Disorders(CMDs). Many studies reported that there was some relationship between them, however, there is still controversy. So It Is necessary to observe and compare many more patients with CMDs wirh normal controls. For the study 85 patients with CMDs and 37 dental students were selected as experimentals and controls, respectively. And the experimentals were classified Into two groups, that is, TMJ internal derangement group and muscle disorders group according to clinical diagnosis. For measuring the FHP, CROM(Cervical-Range-of-Notion)was used. This goniometer is composed of three part. First, gravity goniometer for flexion and extension. Second, magnetic compass and yoke for rotational movement. And last, forward head arm and vertebra locator for forward head posture. Next T-Scan, electronic occlusal analyzer, was used for recording of occlusal contact state. Other items such as maximum opening, lateral excursion, Helkimo's anamnestic index, and muscle palpation point from Friction's craniomandibular index were checked clinically by one examiner. The result of this study were as follows : 1. In male, control group showed much more measurement in resting forward head posture than did experimental group. But there were not significant differences between groups in female subject. From this results, the author contended that CROM is new measuring system and differ from other goniometers in some aspect, so that results should be re-evaluated 2. Mean value of maximum mouth opening in nearly all groups were greater than 40mm. and mouth opening had a significant correlation with occlusal force and with anamnestic index both sex. 3. Mean value of palpation point had not any correlationship with forward head posture in both sex, but there was significant difference between upper and lower group by rounded shouldes. 4. In summary, there was no significant relationship between forward head posture and sign and symptom of Craniomandibular Disorders.

• Journal of Oral Medicine and Pain
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• 제8권1호
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• pp.43-60
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• 1983

In order to obtain the basic data for diagnosis of occlusion the author investigated the occlusal sounds produced by mandibular closing movement from rest position to centric occlusion by using the Korotkoff sounds microphone electrodes and physiograph for Korean 20S without TMJ problems. And the author analyzed the correlation of the occlusal sounds with height, body weight, mandibular closing movement distance, maxillary sinus size and masseter muscle activities relating to the production of occlusal sounds. The obtained results were as follows : 1. The occlusal sounds prouduced by mandibular closing movements from rest position to centric occlusion were ranged from 3.08mV to 52.00mV, their maen value 19.07mV in right side, and ranged from 2.41mV to 18.33mV, their mean value 9.19mV in left side in group of Angel's class I occlusion subjects having right habitual side of mastication. 2. In general the occlusal sounds in the habitual side of mastication were greater than those in the opposite side. 3. The correlations of the occlusal sounds with height and maxillary sinus size were not significant. 4. The correaltions of the occlusal sounds with body weight, mandibular closing movement distance and masster muscle activities were significant.

• 대한소아치과학회지
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• 제21권2호
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• pp.540-546
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• 1994

The authors treated three patients who chiefly complained functional anterior crossbite due to premature loss of primary molars by using removable space maintainer and functional appliances. In orthodontic practice, the mandibular rest position and the possibility of taking construction bite have been as the criteria for evaluation of functional factors involved in anterior crossbite. Functional anterior crossbites, if left untreated, may have deleterious effects on the development and function of craniofacial complex and TMJ. Objectives of the treatment were as follows: 1) to recover vertical dimension 2) to eliminate functional disharmony 3) to correct anterior reversed occlusion 4) to attain good facial esthetics 5) to prevent unfavorable growth of jaw & dentition Characterized craniofacial morphology resulting from the premature loss of deciduous molars could be recovered following the correction of crossbite. Therefore, it is recommended that in orthodontic diagnosis of functional anterior crossbite due to premature loss of deciduous molars, the craniofacial abnormality affected by that should be considered.

• Imaging Science in Dentistry
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• 제30권3호
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• pp.217-222
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• 2000

A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

• 구강회복응용과학지
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• 제22권1호
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• pp.29-36
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• 2006

As migraine pain represents a substantial personal and social burden worldwide, there has been a great deal of effort in developing a screening instrument for migraine. Lipton et al(2003) developed and validated the ID Migraine questionnaire, which is a self-administered screener for migraine in primary care, and it is brief and easy to use for a primary care provider. The aim of this study was to determine if the ID Migraine questionnaire could be applied successfully to assess the headache patients with temporomandibular disorders(TMD) and orofacial pain. This study found that nausea, photophobia and headache-related disability had the highest individual sensitivities and specificities, and the performance of the three-item screener was equivalent to that reported in a previous study. Although the sensitivity of the three-item screener in this study (0.58) was lower than in a previous study (0.81), the specificity (0.98) was higher and the positive predictive value was 93.9%. This suggest that the ID Migraine questionnaire is very efficient in this setting. In conclusion, the ID Migraine questionnaire, which is a three-item screener consisting of nausea, photophobia and headache-related disability, is effective as a self-administered report for detecting migraine headaches in patients with temporomandibular disorders(TMD) and orofacial pain.

• Journal of Oral Medicine and Pain
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• 제23권3호
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• pp.281-288
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• 1998

The authors treated a 30-years old female patient who visited the Department of Oral Medicine, PNUH due to the chief complaint of limitation of mouth opening. The magnetic resonance imaging following clinical examination was used for establishing an accurate and reliable diagnosis and the patient was diagnosed as having anterior disc displacement without reduction in the right joint and anterior disc displacement with reduction in the left joint. For managing acute anterior disc displacement without reduction, mandible manipulation was applied first focusing on pain control and then stabilization appliance was used for maintenance of joint stabilization. With time, the sign and symptom was remarkably reduced and an active exercise program was recommended to maintain of normal muscle length, increase joint range of motion and develop normal coordination arthrokinematics. As a result of treatment, the patient did not complain discomfort of normal daily activities and it was difficult to consider that the displace disc was not reduced completely, but the improvement in range of motion and joint mobility were remarkably found. Therefore, an exercise program should be considered to maintain joint mobility and be effective as a self-care.

• Journal of Oral Medicine and Pain
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• 제49권1호
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• pp.22-27
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• 2024

A 74-year-old female presented with a complaint of dry mouth, continuous spontaneous burning sensation in the tongue, and asymptomatic submucosal soft tissue mass on both sides of the lower labial mucosa. She refused to undergo total excision of the mass due to concern about the possibility of complications such as nerve damage because of the large size of the mass. As her clinical features and magnetic resonance imaging indicated the possibility of Sjögren's syndrome, a biopsy of the minor salivary gland of the right lower lip was performed. Consequently, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Although the patient had typical signs and symptoms of Sjögren's syndrome, the histopathological result of MALT lymphoma made it impossible to determine whether the patient had a history of Sjögren's syndrome. For patients with risk factors for MALT lymphoma, such as Sjögren's syndrome, a biopsy of the labial minor salivary gland with immunohistochemical staining can be helpful in the diagnosis of not only Sjögren's syndrome but also MALT lymphoma.