• 제목/요약/키워드: Temporo-mandibular joint

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턱관절균형의학에서 편차발생현상의 신경과학 및 재료역학적 해석과 일반화 (Interpretation and Generalization by Neuroscience and Material Mechanics on Deviation in Temporomandibular Joint Balancing Medicine)

  • 지규용
    • 턱관절균형의학회지
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    • 제12권1호
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    • pp.1-6
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    • 2022
  • Objectives: For the deviation phenomenon occurring during the treatment process in temporo-mandibular balancing medicine (TBM), hypotheses were established regarding the cause and mechanism of formation from the perspective of neuro-science and material mechanics, and a verification method was proposed. Methods: The deviation phenomenon was theoretically analyzed based on the structure theories of material mechanics of the joint and the neurological pain mechanism. Results: Deviation occurs due to temporary yield by the accumulation of heterogeneous stress in the temporo-mandibular joint and the affected joint. Because the joint structures are corresponding with material mechanics showing compressive and tensile properties. The size of the deviation is expressed in terms of strain. The occlusal surface of the teeth is level with the axial joint. Since the magnitude of the deviation has a proportional relationship with the degree of abnormality of the temporo-mandibular joint, the magnitude of the deviation calculated by the balance measurement can be replaced by the strain. The major variables involved in the occurrence of deviations are the strength of joint structures and neurological conditions. Therefore plastic deformation and adaptation occur as a long-term depression of neural circuits is strengthened in different ways at different locations each time in various clinical situations. This is the reason why the sequence of the restoration process while correcting deviations is following reverse order of the accumulation in many layers in the muscular nervous system. Conclusions: From the above results, it can be inferred that the occurrence and correction of the deviations are corresponding with the plastic deformation and neuro-plasticity.

악교정 골성형술후 약관절 장애의 변화 (CHANGES IN TEMPORO-MANDIBULAR DISORDERS FOLLOWING THE ORTHOGNATHIC SURGERIES)

  • 김명래;성만호;박창환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권3호
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    • pp.178-181
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    • 1993
  • Sixty four patients were followed-up for over 6 months following the orthognathic surgeries and were examined for the Temporo-mandibular joint dysfunction. The results are as follows: 1. Of 64 patients, 9(14.1%) had been suffered from TMD preoperatively : 4.7% in the prognathism and 46.2% in the laterognathism. 2. Following the orthognathic surgeries, 7 of 64 patients(10.9%) complained TMD, and 55.6% of the TMD patients resulted in significant improvement. 3. By the type of deformities, laterognathism with TMD could be expected to be improved in 30.8%, while 7.7% in the prognathism. 4. Non-rigid fixation resulted in higher incidence of TMD than the Rigid fixation after the SSRO ; 4 of 15(26.5%) and 2 of 25(8.0%) respectively.

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스테레오 카메라를 이용한 측두하악관절 교정장치(NO SICK)의 성능 평가 (Evaluation of orthodontics for treating temporo-mandibular joint disorders using a stereo camera)

  • 윤홍일;박준수;정구영;신기영;박준기
    • 한국정보전자통신기술학회논문지
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    • 제8권5호
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    • pp.359-366
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    • 2015
  • 카이로프래틱 치료에서 측두하악관절(TMJ)는 인체의 균형을 유지하는데 중요한 역할을 하는 관절로서 구강내 교정장치를 통해 인체의 균형을 교정할 수 있게 된다. 현재 이러한 구강내 교정장치의 효과를 스테레오비전을 이용하여 정량적으로 평가할 수 있는 측정 장치가 없었기 때문에 본 연구에서는 이를 측정 할 수 있는 시스템을 개발하였다. 이 시스템은 스테레오 비전과 적외선 조명, 적외선 통과 필터 등으로 구성되어 있으며, 광학식 마커를 피험자의 주요 부위에 부착하여야 한다. 마커의 부착위치는 얼굴의 주요 랜드 마커 중 구강내 교정장치의 착용으로 인해 변화가 나타날 수 있는 8개의 부위를 선택하였다. 개발된 시스템을 이용하여 11명의 피험자를 대상으로 교정장치 착용 전/후 마커의 변화량을 측정하였을 때, 피험자의 얼굴에 부착된 마커의 위치 변화가 정량적으로 측정되었다.

측두하악관절장애(TMD)환자의 기능적 회복을 위한 온열적용과 도수관절운동치료(Mobilization)의 비교연구 (The Study of Comparison of the Heat Therapy and Mobilization for Functional Activity of the Patient with TMD)

  • 이종민;김헌면;문순주;윤정규
    • 대한물리치료과학회지
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    • 제7권2호
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    • pp.653-662
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    • 2000
  • A single experimental design (alternating treatment design) was used to compare the effects of the mobilization and heat therapy on the pain and mouth opening in patient with temporo-mandibular disorder (TMD). In the mobilization sessions, the physiotherapist performed two methods of the mobilization on the temporo-mandibular joints. In the heat therapy sessions, the patient received infrared and ultrasono on the temporo-mandibular joint. The mobilization and heat therapy were performed on alternate days during 10 days. Pain was measured by visual analogue scale (VAS) and mouth opening was measured by caliper. The results showed that mobilization and heat therapy were effective in pain reduce and mouth opening increase, and mobilization was superior to heat therapy in mouth opening increase and pain reduce.

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교근 근전도 비교를 통한 턱관절 기능장애 평가 (Temporo-Mandibular Disorder Syndrome Evaluation by Masseter EMG)

  • 어승준;전진우;염호준;한휘종
    • 문화기술의 융합
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    • 제4권4호
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    • pp.349-354
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    • 2018
  • 인류는 과학기술의 발전과 함께 의학기술도 눈부신 발전을 거듭해왔다. 그러나 과거에도 난치성 질환은 여전히 존재하였듯이 지금도 난치성 질환이 존재하는데, 그 중 턱관절장애가 있다. 현재 의료선진국이라 불리는 대한민국 의료진들의 진단은 환자의 발언, 의사의 청음진단과 자를 이용한 진단, X-ray 촬영 진단 방식을 고수하며 시대에 뒤떨어지고 있다. 그렇기 때문에 환자의 정확한 증상 여부, 의사 본인의 진단 실력과 경력이 중요하고, 증상의 경중에 따른 진단 횟수의 증가와 이로 인해 발생하는 의료비용은 막대하다. 본 연구에서는 이를 해결하기 위해 저작운동(최대폐구)시 교근에서 발생되는 근전도 신호를 %MVC를 통해 정량화하였다. 정량화된 근전도는 Cortex로 비교, 평가하여 턱관절 상태 평가 기준 지표를 확립할 것이다.

하악과두의 형태 및 위치에 관한 방사선학적 연구 (A RADIOGRAPHIC STUDY OF MANDIBULAR CONDYLE SHAPE AND POSITION IN AN ASYMPTOMATIC POPULATION)

  • 이상훈;이상래
    • 치과방사선
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    • 제18권1호
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    • pp.203-212
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    • 1988
  • This study was designed to observe mandibular condyle shape and position in an asymptomatic popular ion. Using Accurad-200 head holder(Denar Corp.) for transcranial radiography of the temporo-mandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population(90.4%), the locally concave shape and wedge shape were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43nm superiorly, 2.17㎜ anteriorly, and 2.61㎜ posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below the top of the articular eminence.

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악관절의 통증에 관한 연구 (The Study for Treatment of Temporo-mandibular Joint Pain)

  • 최중립;송찬우
    • The Korean Journal of Pain
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    • 제8권1호
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    • pp.86-92
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    • 1995
  • Temporomandibular disorders typically present findings of limited or asymmetric patterns of jaw opening and joint sounds usually described as clicking, popping, grating, or crepitus. Recently, patients with temporomandibular disorders have received an increasingly aggressive treatment with a greater emphasis on surgical and dental reconstruction. Scientific studies have not clearly identified the specific causes of the temporomandibular disorders and therefore some of the treatments are empiric, without a firm scientific foundation. We carried out a study on the patients of pain clinic OPD and concluded that the causes of the temporomandibular joint(TMJ) pain are the prolonged contraction of the muscles of mastication, especially the masseter muscle. Therefore, the spasmolytic treatment of masseter muscle would be a better treatment for TMJ syndrome rather than the surgical and dental reconstruction.

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mCFAR 과 CLMS 필터를 이용한 교근의 휴지기 기간 측정법 (A Measuring Method of Duration of Massteric Silent Period using mCFAR and CLMS filter)

  • 김덕영;박중호;양덕진;강병길;김태훈;이영석;김성환
    • 대한의용생체공학회:의공학회지
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    • 제20권6호
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    • pp.601-607
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    • 1999
  • 상악(maxilla)과 하악(mandibular)의 최대 교합상태에서 하악을 기계적으로 자극(jaw jerk)할 경우 교근(masseter muscle)의 근전도 (electromyography)에서는 근신호가 일시적으로 침묵하는 형태의 휴지기(silent period) 현상이 발생한다. 턱관절 질환(temporo-mandibular joint dysfuntion)이 없는 정상인의 경우 24ms 정도의 휴지기가 나타나지만, 턱관절 질환 환자의 경우 평균 60ms 정도임을 볼 때 휴지기는 턱관절 질환을 진단하는 중요한 요소라 할 수있다. 본 논문에서는 이러한 휴지기 기간을 자동적으로 결정하기 위해 mCFAR 알고리즘을 제안하고 CLMS 적응 필터를 사용하여 근전도 신호의 왜곡을 가져오는 전원 잡음의 영향을 효과적으로 제거하였다. 실험 결과 전원 잡음에 대해 강건하며, 정확한 휴지기 기간을 결정할 수 있다.

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반복적 개구운동과 두부자세의 변화가 악관절진동에 미치는 영향 (Effect of Repetitive Opening Movement and Head Posture on the Vibration of the Temporomandibular Joint)

  • 곽동근;한경수;김종영
    • Journal of Oral Medicine and Pain
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    • 제25권1호
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    • pp.87-97
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    • 2000
  • This study was performed to investigate the effects of repetitive mandibular opening movement and change of head posture on the vibration of temporomandibular(TM) joint. For this study, 23 patients with internal derangement of TM joint were selected. All they had clinically noticeable TM joint sound. Observation of the joint vibration were performed in four head postures, namely, natural head posture (NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For recording of joint sound vibration, Sonopak of Biopak system(Bioresearch Inc., Milwaukee, USA) was used, The author could take results related to integral higher than 300Hz, integral lower than 300Hz, ratio of integral higher than 300Hz to integral lower than 300Hz, total integral which was sum of higher and lower integral, peak amplitude, and peak frequency in each opening movement, which was carried out three times in each head posture. Integral means amount of vibration. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In NHP, total integral in right TM joint was 5O.3Hz in the first opening, 67.9Hz in the second opening, and 74.0Hz in the third opening movement, bur there was no significant increase of total integral with repetitive opening movement. This finding was similar in left TM joint. Integral lower than 300Hz were higher than integral higher than 300Hz in almost every opening movement. 2. There was no significant difference of total integral between right and left side of TM joint, but there was a tendency of higher total integral in right TM joint than that in left TM joint except for results in DHP. 3. Peak amplitude in NHP ranged from 2.0 to 4.7, and peak frequency in NHP were 101.4-170.0Hz. And there was no consistent findings related to increase or decrease of these value according to repetitive opening in each head posture. 4. Change of head posture did not result any difference in integral, peak amplitude, and peak frequency. In conclusion, change of head posture and repetitive mandibular opening movement did not make any significant effect on the vibration of temporo-mandibular joint, especially, on total integral, peak amplitude, and peak frequency.

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서울에 거주하는 직장인의 측두하악장애에 대한 역학적 연구 (An Epidemiology Study on Temporo-mandibular Disorders of Employees Residing at Seoul)

  • 이희경
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.308-323
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    • 1996
  • 저자는 설문지 방식에 의해 1995년 8월1일부터 1995년 11월 30일까지 서울에 직장을 갖고 있는 직장인 282명을 대상으로 그들이 작성한 설문지를 분석하여 측두하악장애의 분포 및 관련요인과의 상관관계에 대해 다음과 같은 결론을 얻었다. 1. 측두하악장애의 증상을 가진 사람이 남자 41.88%, 여자 46.15%로 전체의 43.26%였다. 2. 일반관절 및 근육통의 증상이 심할수록, 두통 및 진통제 복용빈도가 높을수록, 측두하악장애증상의 빈도가 높았으며 이들 사이에 매우 유의한 상관이 있었다(p<0.001). 3. 이갈이, 이악물기, 구강악습관의 빈도가 높을수록 측두하악장애 증상의 빈도가 높았으며 Stress에 예민하게 반응할수록 이갈이나 이악물기, 깨무는 습관 등 이상기능 빈도가 높게 나타났다. 4. 편측저작이 양측저작에 비해 측두하악장애지수가 높게 나타났으며 통증부위와 측두하악장애 지수와의 연관성은 나타나지 않았다.

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