• Title/Summary/Keyword: TMJ disorder

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측두하악관절 장애 환자에서 관절원판후조직의 에스트로겐 수용체(ER)의 단백 발현 (EXPRESSION OF ESTROGEN RECEPTORS IN RETRODISCAL TISSUE OF THE TEMPOROMANDIBULAR JOINT DISORDER PATIENTS)

  • 김종윤;임재형;박광호;김형곤;허종기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.403-410
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    • 2009
  • Those composing temporomandibular joint (TMJ) complex such as the temporal bone, the disc and the mandibular condyle perform their own functions with organic relation. The retrodiscal tissue is the main area of pain induction and contributes to compositional change of synovial fluid. If displacement of the disc lasts long time, not only adaptive changes, but also destructive or degenerative changes may happen. It was reported that these changes and symptoms appear mostly to female rather than male and especially, in the case of patients suffering from TMJ disorder, a large quantity of female sex hormone is found in the joint synovium. And that may play a role in bone resorption and inflammation. Also, the frequency and the intensity of pain perception for female is reported to be much more than for male. In this study, we investigated the expression extents of estrogen receptors (ER) and progesteron receptors (PR) in retrodiscal tissue with immunohistochemistry among the patients received TMJ surgery and compared with MRI findings and surgical findings. We report the relations between the expression of ER in retrodiscal tissue and the pathological change in TMJ, such as inflammation, internal derangement and osteoarthritis.

원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS)

  • 문원규;정영수;이의웅;권호근;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

교합안전장치가 하악과두운동 및 악관절 잡음에 미치는 영향에 관한 연구 (A Study on the Mandibular Condylar Movement and the Temporomandibular Joint Sound Effected by the Stabilization Occlusal Splint)

  • 구철인;정재헌
    • 대한치과보철학회지
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    • 제27권2호
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    • pp.173-187
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    • 1989
  • The purpose of this study was to evaluate the effects of stabilization occlusal splint by using a simplified condylar path recorder and a dental sound checker. For this study, 11 subjects (10 men and 1 woman) with TMJ disorder were selected from students at Chosun University, School of Dentistry. And they were treated with the stabilization occlusal splint. The condylar movement and the TMJ sound of each subject were recorded and analyzed by using a simplified condylar path recorder and a dental sound checker. The obtained results were as follows: 1. No statistically significant reduction of reduced PRI scores occurred before and immediately after wearing of stabilization occlusal splint. 2. The reduced PRI scores after wearing of stabilization occlusal splint showed statistically significant reduction with the lapse of time. 3. After stabilization occlusal splint therapy, Fisher angle and Bennett angle had almost no change. 4. TMJ sound disappeared in 4 out of 11 subjects.

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악관절 장애 증상이 구강건강 상태와 정신건강 상태, 삶의 질에 미치는 영향 : 국민건강영양조사 2012년도 자료를 활용하여 (Effects of temporomandibular joint disorder symptoms on oral and mental health status and quality of life : using the 2012 data from Korea National Health and Nutrition Examination Survey)

  • 강현경;이지영;김유린
    • 한국치위생학회지
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    • 제21권6호
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    • pp.731-740
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    • 2021
  • Objectives: The purpose of this study was to examine the effects of oral and mental health status on temporomandibular joint disorders (TMDs) and the effects of TMD symptoms on quality of life using data from the 5th 2012 National Health and Nutrition Examination Survey. Methods: A total of 1,154 people were selected as subjects for the study. Temporomandibular joint (TMJ) sounds (672 persons), TMJ pain (227 persons), and TMJ dislocation (255 persons) were the factors studied. The complex sample chi-square test was performed to compare demographic characteristics according to the three groups of TMD symptoms. Complex sample logistic regression analysis was performed to confirm the effect of oral and mental health status on TMDs, and complex sample linear regression analysis was performed to check the effect of TMDs on the quality of life (EQ-5D). Results: After adjusting for demographic characteristics, those without TMJ sound symptoms had lower pain/discomfort (OR: 0.055, CI: -0.095 to -0.016) and anxiety/depression (OR: 0.053, CI: -0.092 to -0.014). Those without TMJ pain had lower pain/discomfort (OR: 0.119, CI: -0.192 to -0.046) and anxiety/depression (OR: 0.071, CI: -0.137 to -0.004). Pain/discomfort (OR: 0.063, CI: -0.125 to -0.001) was lower in those without TMJ dislocation symptoms. After adjusting for mental health status, pain/discomfort (OR: 0.088, CI: -0.161 to -0.014) was found to be lower in those without TMJ pain symptoms (p<0.05). Conclusions: Based on the results of this study, the treatment of TMDs, oral health, and also mental health, is needed to improve the quality of life.

Immediate Side Shift가 Pantographic Reproducibility Index에 끼치는 영향에 관한 연구 (A Study on the Effects of Immediate Side Shift to the Pantographic Reproducibility Index)

  • 남천우;한경수
    • Journal of Oral Medicine and Pain
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    • 제12권1호
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    • pp.75-83
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    • 1987
  • This study was designed to investigate the effects of TMJ incoordination to condylar movements, especially, the ISS. The sounds are one of the symptoms in TMJ incoordinated disorder, and it may cause the changes of mandibular movement trajectory. 19 students with only TMJ sounds and 16 students with no TMJ problems participated in this study. The subject performed Rt. lateral, Lt. lateral and protrusive movements, and repeated 3 times on each movement. Pantronic was used to record the measures of condylar movement paths. The obtained results were as follows : 1. The mean values of RISS and LISS in control group were 0.29mm, 0.36mm respectively, and those in experimental group were 0.49mm, 0.41mm repectively. The mean values of RISS was higher in experimental group than that of RISS in control group. 2. Correlation coefficients between PRI and RISS, LISS were slightly higher in experimental group than those in control group, therefore, PRI was more likely to be affected by ISS in experimental group. 3. In control group PRI was correlated to RISS, LORB, RPRO and LPRO, but in experimental group PRI was not correlated to those items. From the study, the author knew that the condylar movements was stable in control group.

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Evaluation of TMJ sound on the subject with TMJ disorder by Joint Vibration Analysis

  • Hwang, In-Taek;Jung, Da-Un;Lee, Jae-Hoon;Kang, Dong-Wan
    • The Journal of Advanced Prosthodontics
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    • 제1권1호
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    • pp.26-30
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    • 2009
  • STATEMENT OF PROBLEM. Qualitative and semi-quantitative methods have been developed for TMJ sound classification, but the criteria presented are completely inhomogeneous. Thus, to develop more objective criteria for defining TMJ sounds, electroacoustical systems have been developed. We used Joint vibration analysis in the BioPAK system(Bioresearch Inc., Milwaukee, USA) as the electrovibratography. PURPOSE. The aim of this study was to examine the TMJ sounds with repect to frequency spectra patterns and the integral > 300 Hz /< 300 Hz ratios via six-months follow-up. MATERIAL AND METHODS. This study was done before and after the six-months recordings with 20 dental school students showed anterior disk displacement with reduction. Joint vibrations were analyzed using a mathematical technique known as the Fast Fourier Transform. RESULTS. In this study Group I and Group II showed varied integral > 300 /< 300 ratios before and after the six-months recordings. Also, by the comparative study between the integral > 300 /< 300 ratios and the frequency spectrums, it was conceivable that the frequency spectrums showed similar patterns at the same location that the joint sound occurred before and after the six-months recordings. while the frequency spectrums showed varied patterns at the different locations that the joint sound occurred before and after six-month recordings, it would possibly be due to the differences in the degree of internal derangement and/or in the shape of the disc. CONCLUSIONS. It is suggested that clinicians consider the integral > 300 /< 300 ratios as well as the frequency spectrums to decide the starting-point of the treatment for TMJ sounds.

측두하악 증후군에 대한 침치료 군과 추나치료 군의 임상적 고찰 (Comparative Clinical Study between the Acupuncture Treatment and the Chuna Treatment on Temporomandibular Disorder)

  • 김태수;김창연;이기하;엄태웅;정영훈;고영탁
    • 척추신경추나의학회지
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    • 제1권1호
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    • pp.51-60
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    • 2006
  • Objectives : The purpose of study was to compare and analyze the effects of the distance Acupuncture and the Chuna on Temporomandibular Disorder. Methods : Clinical studies were done on 31 patients who were treated with Temporomandibular Disorder at Dept. of Acupuncture & Moxibusition of Hospital of Ha-na Oriental Medicine from May 23 2005 to Apr 30 2006. Subjects were divided Into two group, Distance acupuncture group and Chuna group. In Distance acupuncture group, we treated patients with Wijungyug(胃正格) or Damjungyug(膽正格). In Chuna group, we treated patients with Distraction & Translation technique. For evaluating Function of Temporomandibular joint of Patients, we use the Modified Craniomandibular Index(mCMI) before treatment and after 6th treatment. Results : In Mandibular Movement(MM) of patients, the patients of Acupuncture Group were more effective than Chuna group. In TMJ noise(TN) of patients, the patients of Chuna Group were more effective than Acupuncture group. Conclusions : The Distance acupuncture may be better effect on Mandibular Movement and The chuna maybe better effect on TMJ noise.

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호흡곤란 있는 불안장애 환자 치험 1례 (A Case Report of Anxiety Disorder Patient with Dyspnea)

  • 이은주;김태경;신창민;김철홍
    • 턱관절균형의학회지
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    • 제12권1호
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    • pp.22-27
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    • 2022
  • 본 증례에서는 발병일 이후 항우울제 복용 및 도수치료, 한방치료에도 증상의 개선이 보이지 않던 호흡곤란이 주증인 불안장애 환자를 대상으로 TBT를 병행한 약침, 침, 한약 등 한방치료를 적용하여 증상의 완화를 관찰하였다. 이에, 호흡곤란을 수반한 정신과질환의 치료에 있어서 한의학 치료 및 TBT가 효과가 있을 것으로 판단된다.

부산백병원 응급실로 내원한 치과 응급환자에 대한 임상적 연구 (Characteristics of Dental Emergency Patients at Busan Paik Hospital)

  • 김소현;김도영;백준석;정태영;박상준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권1호
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    • pp.58-64
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    • 2012
  • Purpose: Dental emergencies vary from toothaches to oral and maxillofacial traumas. Because the number of dental emergency cases has increased recently, we analyzed characteristics of patients seen during the last 2 years, in an effort to find a trend. Methods: This study was carried out with emergency room patients visiting the Department of Oral and Maxillofacial Surgery from 2009 to 2010. Results: The total number of patients studied was 1,162; the ratio of males to females was 1.73:1. The most frequent age group was 0 to 9 years, followed by 20 to 29 years. Trauma (58.7%) was the most frequent cause followed by acute toothache, oral hemorrhage, infection, and temporomandibular (TMJ) disorder. In the trauma group, injuries of soft tissue and alveolus were prevalent. The most common causes of soft tissue injury were falls, safety violations and assault. The highest incidence of emergencies was seen in patients 0 to 9 years old (41.8%). The most common causes of jaw fracture were falls, assaults, and traffic accidents in that order. In the acute toothache group, most patients had pulpitis (41.2%). In the infection group, most had buccal space abscesses (40.0%). In the hemorrhage group, post-operative bleeding cases (80.5%) were the majority, and hemostasis was obtained mostly by pressure dressings. For the TMJ disorder group, masticatory muscle disorder (65.4%) was more common than TMJ dislocation. Conclusion: In this study, trauma was the most frequent reason for patients who visited the emergency room. However, acute toothache, hemorrhage, infection and TMJ disorders were also seen frequently. Dental emergency patients could be better treated by understanding patterns of dental emergencies and performing proper diagnoses.

교정환자에서 MRI를 이용한 측두하악관절 장애의 연구 (MRI study of temporomandibular joint disorder in orthodontic patients)

  • 김태우;변은선;백승학;장영일;남동석;양원식
    • 대한치과교정학회지
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    • 제30권2호
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    • pp.235-243
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    • 2000
  • 측두하악관절의 자기공명영상(MRI)은 하악과두와 관절원판(disc)의 관계를 잘 보여주기 때문에 관절내장증(internal derangement)의 진단을 위해 매우 유용하다. 이번 연구의 목적은 서울대학교 치과병원 교정과에 내원한 측두하악관절 장애가 의심되는 환자들의 MRI 자료를 평가하여 관절 내장증의 유무, 발생빈도 및 심도를 파악하는 것이다. MRI를 촬영한 표본은 남자 10명, 여자 40명으로 총 50명이었고 평균 나이는 22.9세였다. 전체 50명 중에 43명에서 positive finding이 관찰되었다. Positive finding을 나타낸 환자 중에서 전방관절원판변위(anterior disc displacement : ADD)는 비정복성이 $56\%$로 가장 많았으며, 양쪽 관절에서 동시에 일어난 경우가 $65\%$로 가장 많았다. Positive finding을 나타낸 환자를 Angle 분류 시, II급 1류 부정교합 환자가 $39.6\%$, II급 2류 부정교합 환자가 $2.3\%$로 II급 부정교합이 $41.9\%$로 가장 많았고, I급 부정교합 환자는 $37.2\%$, III급 부정교합 환자가 $18.6\%$, 확인 안된 경우가 $2.3\%$였다. Positive finding을 나타낸 환자 중에서 안면 비대칭 환자는 $8.6\%$, 개교 환자는 $55.8\%$였다. 결론적으로 측두하악관절의 관절 내장증을 가진 환자에서는 II급 부정교합이 차지하는 비율이 매우 크다고 할 수 있다. 개교나 안면 비대칭은 측두하악관절 장애로 인한 보상적 또는 비보상적인 변형에 의해 나타날 수 있으며 퇴행성 관절 질환으로 진행되는 과정중 안면 골격 개조의 결과로 보인다. 그러므로 개교 및 안면 비대칭이 있는 환자는 교정 치료 시작 전에 측두하악관절의 이상 유무를 MRI로 확인(screening)할 것이 권장된다. 측두하악관절 장애가 있는 경우 교정 치료 후에도 재발의 경향이 크고 측두하악관절에 대한 계속적인 관찰이 필요하므로 감별진단이 필수적이다.

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