• 제목/요약/키워드: TMJ disorder

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임상가를 위한 특집 1 - 측두 하악 장애의 진단과 치료 (Diagnosis and Treatment of the Temporomandibular Disorder)

  • 김철훈
    • 대한치과의사협회지
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    • 제50권5호
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    • pp.244-255
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    • 2012
  • Temporomandibular disorder(TMD) is described as a cluster of disorders characterized by pain in the preauricular area and/or the muscles of mastication; limitations or deviations in mandibular range of motion; and noises in the TMJ during mandibular function. The most common symptom in TMD patients is pain that is aggravated by chewing or other jaw function. These symptoms are appeared when the stimuli loaded in TMJ are over the physiologic tolerance. The primary goal in treatment of TMD is to alleviate pain and lor mandibular dysfunction. TMD treatment can be divided into 2 categories: reversible and irreversible methods. Reversible methods include medication, thermal therapy, habit modification, physical therapy, appliance therpy and arthrocentesis and lavage and irreversible methods include arthroscopic lysis, surgery, occlusal adjustment et al. It is widely accepted that reversible methods are ther first choice of treatments. However if reversible ones are not effective, irreversible methods are considered.

임상가를 위한 특집 1 - 턱관절장애의 보존적 치료 (Conservative treatment modalities for patients with temporomandibular joint(TMJ) disorders)

  • 김철
    • 대한치과의사협회지
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    • 제51권2호
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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.

측두하악장애의 예후에 관한 임상 연구 (A CLINICAL STUDY IN THE PROGNOSIS OF THE TEMPOROMANDIBULAR DISORDER)

  • 최진호;김일규;오남식;김의성;오성섭;이성호;양동환
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권5호
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    • pp.497-506
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    • 2000
  • This study is comprised of data obtained from the files of 346 patients with temporomandibular disorders. All patients were diagnosed, treated and followed in the Department of Dentistry at the Inha university hospital, Incheon, Korea. The patients had treated with medications, physical therapy, occlusal splint and arthrocentesis. The study data were obtained from the medical records and telephone interviews that were conducted by research assistants. The results were as follows 1. The patient's main complaint was pain(77%), and mouth opening limitation was 17%. 2. An analysis of the medical records of the 346 patients disclosed that 82% were improved and 17% had no improvement when they were dismissed. 1% of the patients had become worse during therapy. 3. A success rate of 82% was achieved when medication assisted physical therapy was included. In the current status at the telephone interview, 270 patients(89%) reported that they were doing well with 56% describing themselves as asymtomatic and 32% experiencing only minor residual or recurrent symptoms. 11% regarded themselves as unimproved and worse. 4. In the current status of the unsuccessfully treated patients by medications and physical therapy, 64% of patients were doing well(3% as asymptomatic and 56% as only minor residual or recurrent symptom). But 36% of patients was reported as unimproved and worse. 5. TMJ has a remarkable adaptive potential and TMJ disorder has a natural history of spontaneous fluctuations and favorable prognosis during the subsequent natural course. 6. In the treatment of the temporomandibular disorders, there is a treatment ladder, starting with the simplest and least expensive treatment, that is ascended until resolution of the patient's symptoms occur. These findings suggest that conservative reversible therapies are both sufficient and appropriate for management of temporomandibular disorder in most patients. Major alterations of mandibular position or dentoalveolar relationships do not appear to be necessary for obtaining either short term or long term success and therefore they can be generally regards as inappropriate treatment for this disorder. The fact that physical therapy is non-invasive and does not appear to be fraught with irreversible changes, makes it a very applicable vehicle in the area of clinical TMJ disorder management.

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파노라마 X-선사진을 이용한 측두하악관절 장애환자의 수직적 하악비대칭에 관한 연구 (THE PANORAMIC RADIOGRAPHIC STUDY OF THE VERTICAL MANDIBULAR ASYMMETRY OF IN THE TMJ DISORDER PATIENTS)

  • 윤귀현;최순철
    • 치과방사선
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    • 제23권2호
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    • pp.315-322
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    • 1993
  • To evaluate of the relationship between the TMJ disorder and the vertical mandibular asymmetry, the author analyzed the differences between condylar heights, ramus heights and mandibular heights of both sides. All measurements were performed with a digital micrometer on the panoramic radiographs of 36 TMJ disorder patients and 30 normal control group. The differences were expressed in millimeters and percentage using the following formula; |(R-L)/(R+L)|×100% The results were as follows : 1. The condylar height difference was greater of in patient group (1.86±1.66㎜) than that of in control group (1.22±0.85㎜)(p<0.05). But there was no significant difference in the condylar height ratio difference between patient group (11.67㎜11.44%) and control group (7.64±621%) (p>0.05). 2. The ramus height difference and ramus height ratio difference of patient group (4.52±3.70㎜, 4.39±3.49%) were greater than those of control group (2.64±2.13㎜, 2.46±2.02%)(p<0.05, p<0.01). 3. The mandibular height difference and mandibular height ratio difference of patient group (4.32±3.52㎜, 3.59±2.81%) were greater than those of control group (2.57±2.46㎜, 2.01±1.95%) (p<0.05). 4. The ratio difference in condylar height to ramus height and condylar height to mandibular height of patient group (5.01±4.13%, 3.36±2.88%) were greater than those of control group (2.33±1.78%, 1.90±1.40%) (p<0.01).

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두경부 위치에 따른 하악운동 및 측두하악관절음의 변화 (Changes of Mandibular Movement and TMJ Sound on Head and Neck Posture)

  • 나홍찬;최종훈;김종열
    • Journal of Oral Medicine and Pain
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    • 제22권1호
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    • pp.95-109
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    • 1997
  • The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.

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Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

  • Ku, Jeong-Kui;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Korean Dental Science
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    • 제8권1호
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    • pp.1-9
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    • 2015
  • Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

Treatment of Temporomandibular Joint Disorder by Alloplastic Total Temporomandibular Joint Replacement

  • Roh, Young-Chea;Lee, Sung-Tak;Geum, Dong-Ho;Chung, In-Kyo;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제35권6호
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    • pp.412-420
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    • 2013
  • The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.

Organized hematoma of temporomandibular joint

  • Lee, Chena;Yook, Jong In;Han, Sang-Sun
    • Imaging Science in Dentistry
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    • 제48권1호
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    • pp.73-77
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    • 2018
  • Organized hematoma is a pseudo-tumorous lesion mostly occurs at sinonasal cavity and often confused with malignant neoplasm. The initiation of this lesion is blood accumulation, probably due to trauma, and this hematoma develops into organized hematoma as it encapsulated with fibrous band and neo-vascularized. Since it is uninformed at temporomandibular joint (TMJ) region, imaging diagnosis might be challenging. Also, delayed detection of mass involving TMJ is not uncommon due to confusion with joint disorder. Thus, this report introduced the rare pathology, organized hematoma on TMJ with advanced imaging features. Also, diagnostic point for early detection was described for the TMJ tumors and pseudo-tumors considering complexity of surgical intervention in this region.

Temporomandibular Joint False Ankylosis in a Cat: A Case Report

  • Sanghyeon Yoon;Jung-Ha Lee;Seo-Eui Lee;Hakyoung Yoon
    • 한국임상수의학회지
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    • 제40권5호
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    • pp.365-369
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    • 2023
  • Temporomandibular joint (TMJ) ankylosis is a rare disease impairing mandible movement and can either be intra-articular (true) or extra-articular (false). A cat presented with an inability to open its mouth, drooling, and facial asymmetry. Computed tomography (CT) confirmed an extracapsular abnormal TMJ fusion, and a surgical plan was devised based on the CT imaging. Post-surgery, the cat regained mouth mobility (indicating false ankylosis) and showed an improved prognosis. This case of CT-diagnosed and treated feline TMJ false ankylosis underscores the indispensable role of CT in diagnosing and devising surgical strategies for feline TMJ false ankylosis.

FCST의 음양균형장치를 이용한 연축성 사경증 증례보고 (Cervical Dystonia Cases Managed by Yinyang Balancing Appliance for FCST, Functional Cerebro Spinal Therapy of TMJ)

  • 최근욱;이영준
    • 턱관절균형의학회지
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    • 제2권1호
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    • pp.20-25
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    • 2012
  • 본 증례에서는 원인불명의 전신 연축성 사경증과 강박장애를 동반한 경부 연축성 사경증의 두 증례에 대해 음양균형장치를 포함한 표준형 구강내 균형장치, 침구치료, 한약처방, 골반교정 등 복합치료를 통해 뚜렷한 치유효과를 관찰했다. 음양균형장치와 표준형구강내 균형장치 등 턱관절의 균형조절을 통한 기능적뇌척주요법의 치료가 경추와 흉추의 구조변화는 물론 전신자세에도 긍정적인 변화를 주고 있음을 관찰했다.

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