• Journal of Oral Medicine and Pain
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• v.44 no.4
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• pp.154-159
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• 2019

Purpose: The aim of this study was to assess the change in thickness of the roof of the glenoid fossa (RGF) in patients undergoing orthognathic surgery using cone-beam computed tomography (CBCT) images. Methods: This retrospective study measured the thickness of the RGF in 19 patients (10 males, 9 females) who underwent orthognathic surgery at Chosun University Dental Hospital. The thickness of the RGF was measured perpendicularly between the 'glenoid fossa line' and 'middle cranial fossa line' on parasagittal and paracoronal reconstructions. Results: The mean RGF thickness increased from 0.83±0.44 mm to 0.86±0.46 mm after surgery. The average change in thickness of the RGF was 0.17±0.18 mm. The thickness of the RGF in the temporomandibular joint (TMJ) showed no significant difference by sex, and the change in thickness of the TMJ did not vary by surgical method. Conclusions: We found that the thickness of the RGF increased after orthognathic surgery, as revealed by CBCT. Further studies including larger numbers of subjects and long-term follow-up are needed to confirm the results of this study.

• Physical Therapy Korea
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• v.6 no.3
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• pp.94-109
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• 1999

The purposes of this study were to assess the effect of therapeutic exercise and to offer an approach to the physical therapy and rehabilitation procedure of the temporomandibular joint (TMJ) following surgery. In this research, 42 patients with TMJ surgery were assigned one of two groups. The experimental group included 21 patients who performed therapeutic exercise, and the control group included 21 patients who did not perform therapeutic exercise. Conservative therapy such as an ice pack, a hot pack, and pulsed ultrasound was applied to both groups. Treatment was applied twice a day during the admission period and, after discharge, everyday for six weeks. Visual analogue scale (VAS), incisal biting force, and joint ROM were measured before surgery and at 30 days after surgery. The results were as follows: VAS (p<0.05), mouth opening (p<0.01), lateral excursion to unaffected side (p<0.05), and protrusion (p<0.05) between experimental group and control group showed statistically significant differences. Incisal biting force and lateral excursion to affected side between experimental group and control group showed no statistically significant difference.

• The korean journal of orthodontics
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• v.45 no.3
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• pp.136-145
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• 2015

This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.201-206
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• 2024

This report showed a case of temporomandibular joint (TMJ) ankylosis suspected to be associated with ankylosing spondylitis based on the observation of bony ankylosis of the cervical spine on computed tomography (CT) images. A 53-year-old man presented with a chief complaint of difficulty in opening his mouth. His medical history indicated that in his 20 s, he became aware of the difficulty in moving his neck. CT revealed marked osteoarthritic changes in the right mandibular condyle, suggesting fibrotic TMJ ankylosis. In addition, bony ankylosis of the cervical vertebral body and facet joints from the axis (C2) to C5 in continuity was observed. CT of the entire spine also showed bony deformity of the sacroiliac joints and bony ankylosis. Based on these findings, ankylosing spondylitis was suspected. The possibility of an ankylosing spondylitis complication should be considered in cases of TMJ ankylosis if bony ankylosis of the cervical spine is observed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.3
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• pp.273-280
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• 1994

The Magnetic Resonance Imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the Dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of Dynamic MRI for the diagnosis of internal derangement of the temporomandibular joints. 30 joints(15 patients) were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. The comparative results are as follows : 1. All internal derangements of TMJ disk displacement without reduction were consistent with MRI findings. 2. 5 joints (50%) of disk displacements with reduction could not be confirmed by MRI findings. 3. The disk displacements in MRI were found in 55% of painful joints, 50% of clicking joints, and 70% of the joints with restricted movement. 4. The reliability of MRI for the diagnosis of TMD was evaluated as 77% ; 24 of 30 joints who presented with clinical diagnosis of TMD. 5. MRI is very reliable to diagnose the disk displacement without reduction, but it is rather not so effective to diagnose the early derangement or muscle disorders.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.544-549
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• 2000

The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and high incidence of recurrence. TMJ ankylosis has been treated by excision and total joint reconstruction with alloplastic, allogeneic, autogenous materials as interpositional materials. The temporalis myofascial flap had been considered to be a successful interpositional material, due to its anatomical, topographical, and functional properties. This study evaluated the efficacy of the temporalis myofascial flap for nine TMJs (five patients) through the preauricular approach and coronoidectomy. Radiographic and physiologic long term result was investigated in this study. The result reveals that the temporalis myofascial flap is a good autogenous tissue satisfying the criteria of an ideal interpositional material, which offers a material that fulfills the physiological function of the disc. In spite of favorable functional outcome, mild postoperative openbite tendency remains another challenge.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.120-130
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• 1999

This investigation studied the effect of ovariectomy on the temporomandibular joint (TMJ) of rat. Forty female Sprauge-Dawley strain white rats, each weighing about 200grams were used and divided into two groups. The one group was performed ovariectomy, and the other was performed sham operation. Both group were killed at the intervals of 3 days, 1, 2, 4, and 8 weeks postoperatively, paraffin section were stained with H&E, MT and histomorphometric study of the TMJ was performed in a synchronous manner with an sham operated control group The result were as follows: 1. At 4 weeks after ovariectomy, an adhesion between the inferior surface of the articular disc and the condyle was observed in the central portion. At 8 weeks after ovariectomy, a focal thickening of the bone (osteophyte) was observed in anterior portion and there was a marked decrease in the trabecular bone in the posterior region. 2. The thickness of cartilage zone was increased at 2 weeks postopratively in the central portion, and decreased at 4 weeks postopratively in the posterior portion. The thickness of transitional zone was decreased at 1 week postoperatively in the anterior and proliferating zone was decreased postoperatively. The thickness of articular zone was decreased at 3 days postopratively in the anterior portion, and decreased at 1 week postoperatively in the central portion. From the above finding, we could conclue that estrogen deficiency in rats causes alteration of TMJ in marked early stage.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.15-20
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• 2019

Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ${\geq}35mm$ and visual analogue scale [VAS] score ${\leq}3$), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ${\geq}35mm$ and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.95-102
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• 2001

Temporomandibular ankylosis is defined as a situation in which the condyle is fused to the fossa by bone or fibrous tissue. Conditons such as trauma, infection, or systemic disease may predispose to various types of ankylosis, bringing about different levels of limitation in mandibular movement. Most patients with temporomandibular ankylosis are associated with limitation of maximal mouth opening, deviation of the chin toward the affected side, impaired occlusion, chronic pain, compromised oral hygiene, severe facial asymmetry & impeded mandibular molar eruption occurring in childhood. Several techniques to release ankylosis have been described in the literature, showing variable and often unsatisfactory results. The most frequently used operations are gap arthroplasty, interpositional arthroplasty, and exicision and joint reconstruction with autogenous or alloplastic materials. We have managed the two patients of TMJ ankylosis. They had previously TMJ surgery and we treated with gap arthroplasty & active physial therapy. We have obtained favorable results and report these cases with literatures review.