• Journal of Korean Dental Science
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• v.17 no.1
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• pp.14-35
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• 2024

The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.453-457
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• 2006

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients' complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 ㏄) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.

• Journal of TMJ Balancing Medicine
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• v.1 no.1
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• pp.1-8
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• 2011

Objectives: TMJ is the joint that connects the mandible to the skull, and it balances the body by holding the skull in the right position. The Meridian flows through the whole body. The objective of this study is to examine and clarify the relationship between the Temporomandibular Joint (TMJ) and the Meridian flow, especially around the TMJ. Methods: We reviewed the literature on the 8 Extra Meridians and the 12 Main Meridians around the TMJ. Results & Conclusion: Eight Extra Meridians keep the balance and harmony of the TMJ, and also play an important role in maintaining equilibrium of Yin and Yang of the whole body. The 12 Main Meridians, twelve Meridian Divergence (12經別) and Meridian Sinew also play an important role in the balance and harmony of the whole body based on the function of the Vicera and Bowels (臟腑). So it is conceivable that the role of TMJ is important in terms of health care.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.3
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• pp.178-181
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• 2022

Williams-Beuren syndrome (WS) is a rare genetic disorder that results from microdeletion at chromosome 7, which harbors the elastin gene. Clinical findings include arteriopathy, aortic stenosis, hypertension, and laxities and contractures in different joints throughout the body. While many components of the temporomandibular joint (TMJ) normally contain elastin, there are few reports on TMJ manifestations of WS. This study reports a TMJ ankylosis case in a WS patient and shares insight on a possible link between development of TMJ ankylosis and elastin deficiency in WS patients. A WS patient presented with bilateral TMJ ankylosis and was successfully treated with TMJ gap arthroplasty. Hypermobility of TMJ and lack of elastin in retrodiscal tissue can induce anterior disc displacement without reduction. Due to lack of elastin, which has a significant role in the compensatory and reparatory mechanism of TMJ, WS patients might be prone to TMJ ankylosis.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.103-113
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• 1996

The author examined the clinical signs and symptoms , routine radiographs, laboratory test and bone scan in 73 subjects with TMJ disorders and studied the responses of clinical test on patients, the distribution of signs and symptoms of joints, the simple uptake rate(SUR) of affected joints , the SUR of subclassified groups of TMJ disorders, active joints of subclassified groups of TMJ disorders and the SUR of joints with noises. The obtained results were as follows : 1. The percentage of joint pain on palpation, joint noises joint pain on function, mandibular dysfunction and active finding of bone scan in aptients with TMJ disorders were higher 2. The SUR was higher in joints affected by joint pain on function, joint pain on palpation, mandibular dysfunction and creptius. 3. The SUR of osteoarthrosis was the lowest. 4. The percentage of active joints were the highest in joints with discdisplacement without reduction, and followed by osteoarthritis, and disc displacement with reduction. 5. The SUR of TMJ showing joint noises only was lower.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.143-153
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• 2006

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

• Journal of TMJ Balancing Medicine
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• v.7 no.1
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• pp.11-16
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• 2017

In order to understand Changeologically on the meaning of FCST's TMJ (temporo-mandibular joint) treatment procedure, Yi, Shike, Bi, Gen trigrams concerning the jaw and change by treatment were analyzed from the viewpoint of semiotic context of hexagon and holistic interpretation on disease. Yi is meant by jaw but actually indicates mouth made by maxilla and mandible, and it's characters are related with nourishing by aliment and words. But when we eat and speak in the daily life, jaw does not nourish properly it's own body by bad habit or postures. For the treatment of this ill state, there needs punishment and correction symbolized with Shike. Shike has fourth nine meaning obstacles between the two strong lines in the upper and lower end, and so it has the function of mastication and get rid of the fourth nine metaphorically indicating subluxation of axis using CBA and auxiliary measures of four movement or laughing methods. Bi expresses the achievement and effects of consecutive mastication process implicating normalized manifestation of jaw and its linked spinal function. Gen symbolizes removing selfish motive or partiality in advance and reaches the best state of the saint righteously self-nourishable human being.

• Journal of TMJ Balancing Medicine
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• v.8 no.1
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• pp.11-15
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• 2018

Recently, clinical efficacies of the intraoral balancing appliance therapy have been reported by several researchers, and it has been found that there are various kinds of diseases that can be effectively applied. However, studies on cerebrovascular disease, one of the main diseases with a high mortality rate, are still poorly reported, and studies of temporomandibular joint disorder (TMD)-induced changes in brain function suggest that cerebrovascular disease is more appropriate as an adaptive disorder of the temporomandibular joint (TMJ) balancing device. In the developed countries, the importance of research on the structure and function of the brain has been recognized and spurred on the related research. In Korea, the research on brain function and cognitive disorders should have promoted more massively. In order to regain its former reputation in the Korean medicine in the field of cerebrovascular disease, it should be spurred on basic research and clinical case studies. In addition, extensive and in-depth studies including animal studies are needed to establish the basis of underlying mechanisms of the TMJ balancing therapies.

• 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.

• Journal of TMJ Balancing Medicine
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• v.10 no.1
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• pp.21-25
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• 2020

Objectives: The aim of this study was to report the effectiveness of TMJ balancing therapy and Traditional Korean Medicine (TKM) treatments on a thalamus cerebral infarction patient with hemiparesis and gait disturbance. Methods: The patient was treated with TMJ balancing therapy, along with korean herbal medicine, acupuncture, moxibustion, cupping and physical therapy. The motor function was evaluated through the Manual Muscle Test (MMT), Grasp power and Functional Ambulatory Category (FAC). And the daily life ability was evaluated by the Korean version of the Modified Barthel Index (K-MBI) and Korean National Institute of Health Stroke Scale (K-NIHSS). Results: After 17 days of TMJ balancing therapy and TKM treatments, the score of MMT did not improved, but the score of FAC, K-MBI, K-NIHSS improved. Conclusions: This study suggested that TMJ balancing therapy and TKM treatments could be effective for hemiparesis and gait disturbance in patients with thalamus cerebral infarction.