• PNF and Movement
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• v.21 no.3
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• pp.273-280
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• 2023

Objective: In patients with temporomandibular joint disorders, air insoles are used to investigate functionality and pain changes in the temporomandibular joint when walking in daily life. Intervention: Sixty-five patients with temporomandibular joint disorder were recruited: 34 as a control group who walked more than 7,000 steps a day in daily life, and 31 as an experimental group who were instructed to take at least 7,000 steps every day while wearing their air insoles. Measurements: To determine the effects of air insoles on temporomandibular joint pain, steady-state pain, maximum mouth opening, average pain, and the most severe pain were measured before and after the experiment. In addition, to evaluate functionality, the ability to open the mouth in a comfortable state, pain when opening the mouth, and the point of sound and maximum degree to which the mouth could be opened were evaluated before and after the experiment. Results: Pain, mouth openness, and sound points showed significant differences from the control group after the experiment, and the maximum mouth opening range showed no significant difference. Conclusion: When air insoles were used by patients with temporomandibular joint disorder, the functionality of the temporomandibular joint was improved and pain was decreased.

• PNF and Movement
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• v.22 no.2
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• pp.171-180
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• 2024

Purpose: This study aimed to investigate the use of insoles in patients with temporomandibular joint disorders to assess the function and changes in pain when walking in daily life. Methods: Sixty-five patients with temporomandibular joint disorder, were selected, with 34 assigned to the control group and 31 to the experimental group. The control group walked more than 7,000 steps per day in their daily life, while the experimental group wore insoles and was instructed to take at least 7,000 steps every day. To evaluate the effect on temporomandibular joint pain, steady-state pain, maximum mouth opening, average pain, and the most severe pain were measured before and after the experiment. In addition, to determine function, mouth opening in a comfortable state, mouth opening pain, and the point of sound and the maximum degree of mouth opening were evaluated before and after the experiment. Results: After the experiment, pain, mouth opening, and sound points showed significant differences compared to the control group. However, there was no significant difference in the maximum mouth opening range. Conclusion: The application of air insoles to patients with temporomandibular joint disorder confirmed the function of the temporomandibular joint and its positive effects on pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.392-396
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• 2003

Purpose : The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). Patients and Methods : Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. Results: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.2
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• pp.119-126
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• 2014

Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.

• Journal of TMJ Balancing Medicine
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• v.8 no.1
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• pp.6-10
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• 2018

In order to propose a fundamental and appliable theories for balancing therapy of temporomandibular joint (TMBT), evolutionary proofs and up-down theories in evolutionary biology and Korean medicine were investigated. Balancing therapy of temporomandibular joint treats disorder and diseases of the whole body through straightening of the abnormal linking between temporomandibular joint and axis. Although the mechanism of this therapy contains many merits like multicellular integrity and coadjustment, ease of balance and alert forward mobility by the bipedal stepping and evolution to Homo sapiens, increasing disadvantages of balancing pressure of right and left in the lengthened perpendicular axis and the balancing load of temporomandibular joint and axis following the reactional change of dental occlusion are deeply related and considered in this therapy. As for up-down theory, crossing of heavenly qi and earth qi centering on cervical joint is presented as the first mechanism for TMBT, and the other ones like in-out and up-down qi activity of tripple energizer, up-down of essence-qi-spirit in the three backbone barrier and three cinnabar field, up-down of yin-yang-water-fire of viscera and bowels can be related too.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.134-140
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• 2010

Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a characteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressive resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 18 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for this synovial chondromatosis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spaces and to remove the loose bodies without interruption of the whole synovial membranes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.155-159
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• 2014

Objectives: The purpose of this article is to evaluate factors influencing prognosis of arthrocentesis in patients with temporomandibular joint (TMJ) disorder. Materials and Methods: The subjects included 145 patients treated with arthrocentesis at the Dental Center of Ajou University Hospital from 2011 to 2013 for the purpose of recovering mouth opening limitation (MOL) and pain relief. Prognosis of arthrocentesis was evaluated 1 month after the operation. Improvement on MOL was defined as an increase from below 30 mm (MOL ${\leq}30mm$) to above 40 mm (MOL ${\geq}40mm$), and pain relief was defined as when a group with TMJ pain with a visual analog scale (VAS) score of 4 or more (VAS ${\geq}4$) decreased to a score of 3 or more. The success of arthrocentesis was determined when either mouth opening improved or pain relief was fulfilled. To determine the factors influencing the success of arthrocentesis, the patients were classified by age, gender, diagnosis group (the anterior disc displacement without reduction group, the anterior disc displacement with reduction group, or other TMJ disorders group), time of onset and oral habits (clenching, bruxism) to investigate the correlations between these factors and prognosis. Results: One hundred twenty out of 145 patients who underwent arthrocentesis (83.4%) were found to be successful. Among the influencing factors mentioned above, age, diagnosis and time of onset had no statistically significant correlation with the success of arthrocentesis. However, a group of patients in their fifties showed a lower success rate (ANOVA P=0.053) and the success rate of the group with oral habits was 71% (Pearson's chi-square test P=0.035). Conclusion: From this study, we find that factors influencing the success of arthrocentesis include age and oral habits. We also conclude that arthrocentesis is effective in treating mouth opening symptoms and for pain relief.

• Imaging Science in Dentistry
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• v.31 no.2
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• pp.73-84
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• 2001

Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• 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.