• Journal of Oral Medicine and Pain
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• v.17 no.1
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• pp.9-17
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• 1992

The purpose of this study was to investigate the characteristics of TMJ sounds by computerized sound power-spectrum analyser(SONOPAK, Bioresearch Inc., U.S.A.). TMJ sounds were recorded and anaylsed in the 87 patients wit TMJ noises by SONOPAK. The followings are the criteria of TMJ sound analysis. 1. It is possible to record the location of the TMJ sound in relation to the opening/closing cycle of mouth. 2. It is possible to record amplitude of sound(loudness) and frequency of sound (Hz) 3. Clicks display a narrow band of sound within the 0-300 Hz range. The peak frequency generally occurs between 50-150 Hz. And crepitus appear as a wide band of sound, occuring from 0-1300Hz. The data obtained from quantitative TMJ sound analysis give lots of information, but further researches are needed.

• The Journal of Korean Academy of Prosthodontics
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• v.26 no.1
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• pp.113-131
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• 1988

Although TMJ sound is common, its relationship to subjective and objective evaluation and the magnitude and the position of the sound during the mandibular movement is not fully understood. So, the purpose of this investigation was to provide further insight into the characteristics of the TMJ sounds. Twelve subjects (9 men and 3 women) with TMJ sounds were selected from students at Chosun University, School of Dentistry. Condylar movements and TMJ sounds of each subject were recorded and analyzed using a simplified condylar path recorder and a sound checker. Although specific conclusions were difficult to make from this study, the finding suggested the followings. 1. The position of TMJ sounds were visually observed and marked on the condylar tracings during maximum opening and closing, protrusive and retrusive and right and left lateral movements. 2. Information about the size, location and number of condylar deviations and the translation freedom of the condyle was recorded and analyzed objectively. 3. The most obvious characteristic of TMJ sounds was their variability. 4. TMJ sounds were categorized into one of four groups (soft click, hard click, soft crepitus, hard crepitus) by the quality and quantity of the duration and amplitude components.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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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.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.140-145
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• 2014

Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.

• The Journal of Korean Academy of Prosthodontics
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• v.27 no.2
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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.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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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.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.277-284
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• 2011

This study is based on the data of adults between ages of 19~65 yrs of the National Health and Nutrition Survey 4th in year of 2009, which includes symptoms of temporomandibular disorder within gender and age. Subjects included in this study were 2,738 males and 3,427 females, total of 6,165. All statistical analysis was measured by Window SPSS 17.0K Program (SPSS Inc., Chicago, USA). Prevalence of analysis of gender, age, and symptoms of temporomandibular disorder was measured by descriptive statistics, and in order to find relationship among gender, age, and symptoms of temporomandibular disorder was based on crosstabulation analysis. As results, prevalence of TMJ sound was 10.1%, of TMJ pain was 1.5%, and of TMJ limitation was 2.0%. Among the three symptoms of temporomandibular disorder, subjects who have at least one symptom was 1.2%. Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in female were 10.7%, 1.8% and 2.2%, respectively, which were greater than in male 9.3%, 1.2% and 1.6% respectively but it was stastically insignificant (p>0.05). Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in ages between 19~24 yrs were 18.7%, 3.4% and 4.2% respectively, which were higher than any other ages (p<0.05). Also prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were higher in females but stastically insignificant (p>0.05). On the other hand, prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were greater in age below 45 yrs and was stastically significant (p<0.05).

• Journal of Oral Medicine and Pain
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• v.24 no.1
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• pp.9-24
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• 1999

Pumping into the upper joint cavity of the TMJ was done on patients who had reducible disc displacement with pain. This article discusses the change in TMJ sounds before and after the Pumping treatment. 20subjects(mean age of $32.1{\pm}10.2yr$)were selected among those who visited the department of Oral Medicine of Yonsei University for the treatment of craniomandibular dysfunctions. Through a thorough history taking, clinical exam and X-ray taking these subjects were diagnosed as reducible disc displacement patients, and they were subdivided into two groups as acute and chronic according to the time the TMJ sound was made. Sonopak was used to measure the TMJ sound before, right after and one-week after the Pumping treatment. VAS was used to measure the degree of subjective TMJ complaints(sounds and pain) before and one-week after the Pumping treatment. Vibration related items included total integral, high integral, low integral, ratio of high integral to low integral, peak amplitude, peak frequency and median frquency. 1. It was not statistically significant between the acute and chronic groups before the treatment. However, total integral, high integral, low integral, peak amplitude, peak frequency, median frequency showed to be greater in the chronic group. 2. In all the subjects, just after the Pumping treatment was done, total integral, high and low integral, peak amplitude and peak frequency significantly decreased (p<0.05). Even after one week, low integral, peak frequency and median frequency significantly decreased (p<0,05), and the TMJ sound diminished accordingly. 3. Comparing the two groups(before and right after the Pumping treatment), there was the following difference ; in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05). In the chronic group, total integral, high integral, low integral, ratio, peak amplitude and peak frequency significantly decreased(p<0,05). It was not statistically significant between the acute and chronic group. 4. Comparing the two groups(right after and one week after the Pumping treatment), there was the following difference : in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05), In the chronic group, low integral significantly decreased(p<0.05). However, although it was not statistically significant, after one week, there was an increase in total integral, ratio, peak amplitude and peak frequency compared to right after the treatment group. 5. In the VAS of before and one week after the Pumping treatment of the TMJ pain and sound, the TMJ pain significantly decreased(p<0.05) in both the acute and chronic group. However, it was not statistically significant between the two groups. There was a statistically significant decrease(p<0.05) in the TMJ sound in the acute group after one week of Pumping treatment, but no change was notable in the chronic group and it was not statistically significant between the two groups. From the above results, we can conclude that Pumping into the upper joint cavity of patients having reducible disc displacement is effective in reducing clicking and pain. Therefore, it can be applied in diverse clinical fields.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.97-104
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• 2003

It is clinically important to determine the physiologic mandibular position as the therapeutic position of the patients who needs the oral rehabilitation and occlusal treatment. Several methods have been employed for the recording the mandibular position. The gothic arch tracer is one of methods to record the mandibular position. The purpose of this study is to record the border position, chewing position, and myocentric position using the newly developed intra oral tracer in 10 subjects with TMJ clicking sound and 10 subjects without TMJ clinking sound.. This study showed that newly developed intra oral tracer allowed clinician the determination of the treatment position on the same horizontal plate which can be used in the full mouth rehabilitation and occlusal treatments. There was no statistically significant difference between clicking group and nonclicking group in the distance of border position-chewing position and the distance of border position-myocentric centric position.