• Title/Summary/Keyword: Temporomandibular Disorders(TMJ)

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The Clinical and Radiographic Features of Temporomandibular Joint Dysfunction in Patients with Rheumatoid Arthritis (류마티스성 관절염 환자에서 나타나는 측두하악관절장애의 임상적 및 방사선학적 특징)

  • Al-Mehdi, Aslam;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.237-243
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    • 2006
  • The aims of this study was to investigate the clinical and radiographic features of temporomandibular dysfunction in the patients with RA to elucidate whether the RA patients would be a risk group for TMD. The 35 patients with temporomandibular joint dysfunction were included for this study, of which 15 had rheumatoid arthritis diagnosed by a rheumatologist, and other 20 was control group and they didn't have any history or clinical signs related to it. Clinical symptoms and signs of temporomandibular joint disorders, radiographic and MRI findings of temporomandibular joint were investigated. The results were compared between two groups. In RA group bilateral pain, morning stiffness, reduced opening range, and crepitations were more frequently reported than control group. Radiologic findings such as sclerosis and flattening of condylar head, marginal proliferation, and erosion of glenoid fossa were more frequently observed in RA group than control group. Disk destruction, cortical bone erosion, and intraarticular enhancement were more prominenet in RA group. From theses results, it can be concluded that many RA patients will develop TMD symptoms and the structural changes of TMJ is more extensive than the usual TMD cases.

A Comparative Study on the Temporomandibular Joint Sounds before and after Occlusal Splint Therapy Using Electrovibratography (두개하악장애환자의 교합안정장치에 의한 치료후 Sonopak을 이용한 악관절음 변화)

  • Hye-Sook Park;Jong-Hoon Choi;Chang-Seo Park
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.67-78
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    • 1996
  • This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

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LONG-TERM EVALUATION OF MANDIBULAR CONDYLE FRACTURES (하악 과두 골절에 관한 장기추적조사연구)

  • Min, Seung-Ki;Park, Sang-Kyu;Oh, Seung-Hwan;Kwon, Kyung-Hwan;Choi, Mun-Ki;Chae, Young-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.535-544
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    • 2005
  • The management of mandibular condyle fractures continues to be a subject of much debate. It is suggested that, if not properly managed, these fractures may give rise to serious problems, such as malocclusion, mouth opening limitation, temporomandibular joint disorders. Treatment planing of mandibular condyle fractures is very important. The aim of this present study was to evaluate the long-term results according to treatment methods in condylar fractures. Also, it was to evaluate results of treatment according to condylar fracture level. We conducted a retrospective analysis of 43 mandibular condyle fractures. 43 patients followed for average period of 9.00 years(mini. 7yr, max. 12yr). All patients underwent a clinical and radiologic evaluation focusing on mouth opening, mandibular movements, TMJ function, change of ramal height, condylar remodelling. If the level of fracture was positioned in high, especially in level II, mandibular movement disability and ramus length loss was more prominent. This results were similar to the cases of treatment of fragment removal. In high level fracture and fragment removal cases, It is thought that more intensive and long term management are needed than other treatment cases using different operation methods. Also, direct fixation by each approach showed good results in mandibular movement, ramal height change and condylar shape. Through this results, accurate reduction of the mandibular condyle fractures was a very important factor in postoperative prognosis.

PERFORATION OF THE TEMPOROMANDIBULAR JOINT MENISCUS: DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MAGNETIC RESONANCE IMAGING을 이용한 악관절 원판 천공 진단)

  • Kim, Houng-Gon;Dolan, Eward;Vogler, James B.;Nokes, Steven R.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.11-18
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    • 1989
  • Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

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Full mouth rehabilitation with extremely worn dentition (심한 치아 마모 환자의 전악보철 수복 증례)

  • Cha, Hwa-Ryun;Yeom, Kyeong-Yeon;Lee, Yong-Sang;Kim, Na-Hong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.238-244
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    • 2017
  • Pathologic attrition leads to pathologic damage on occlusal plane, functional disorders, occlusal disharmony, esthetic problems, pulpal lesion, temporomandibular joint (TMJ) disorder. In this case, treatment plan should be considered for possibility of vertical dimension loss, occlusal pattern, esthetics, phonetics, amount of vertical dimension increase. This case report was a 71-year-old man who had severely worn dentition. Full mouth rehabilitation was carried out with vertical dimension increase due to limited space for prosthesis. After evaluation of provisional restorations for patient's compliance, final restorations were fabricated and routine clinical assessments were made. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition.

The Care of Facial Palsy after Inferior Alveolar Nerve Block Anesthesia and Temporomandibular Joint Dislocation in Diabetic Mellitus Patient -A Case Report- (당뇨환자에서 하치조신경 전달마취와 턱관절 탈구후 유발된 안면신경 마비 치험 1예 -증례보고-)

  • Lee, Chun-Ui;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.45-50
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    • 2011
  • Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.

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

  • Kim, So-Hyun;Kim, Do-Young;Baek, Joon-Seok;Jung, Tae-Young;Park, Sang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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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.

A Study of Conservative Treatment for Patients with Osteoarthritis of the TMJ (측두하악골관절염 환자의 보존적 치료에 관한 연구)

  • Son, Dae-Eun;Ok, Seung-Joon;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.227-239
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with osteoarthritis of the TMJ(OA), the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as osteoarthritis of the TMJ, and treated with conservative methods from 1994 to 2006. 101 patients with diagnosis of osteoarthritis of the TMJ were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorders(MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subject's status at the first and the last visit. The results were as follows : 1. In the OA group, satisfactory treatment outcome was obtained with conservative methods. But, at the last visit, the symptoms of the OA group were not improved enough compared with those of the MMD group. 2. In the OA group, radiographic findings of panorama view and transcranial projection were positive by about 60 percent. But, computed tomography and single photon emission computed tomography were positive by more than 90 percent. 3. At the last visit of the OA group, the joint noise was reduced significantly. 4. In the majority of the OA group, satisfactory treatment outcome was obtained with conservative methods such as medication, physical therapy, and occlusal stabilization appliance. In the majority of the MMD group, satisfactory outcome was obtained with medication and physical therapy. 5. It took the OA group from 6 months to 2 years to be cured well while the MMD group within 6 months.6. The OA group needed more than 10 times' treatment for satisfactory outcome while the MMD group needed less than 10 times' treatment.

A Comparison Study on Animal Models for Osteoarthritis in Temporomandibular Joint (측두하악관절에서의 골관절염 유도 동물모델 비교연구)

  • Yu, Sun-Nyoung;Yi, Young-Chul;Park, Hae-Ryoun;Ryu, Mi-Heon;Jeon, Hye-Mi;Kim, Kwang-Youn;Kim, Sang-Hun;Ok, Soo-Min;Ko, Myung-Yun;Ahn, Yong-Woo;Ahn, Soon-Cheol;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.261-271
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    • 2011
  • Osteoarthritis in patients with temporomandibular disorders(TMDs) induces pain, limitation of mouth opening, occlusal problems, and most commonly affects their life quality. Control method and progressive process of osteoarthritis are being extensively researched. The researchers focus on histologic changes, synovial changes, muscular and ligamental changes and observed reaction to pain. Therefore most of them developed the animal model for osteoarthritis in TMD patients. In this study, we applied several methods which induces osteoarthritis of temporomandibular joint(TMJ) in rats or mice. For locally induce osteoarthritis in TMJ, Monosodium iodoacetate(MIA) or interleukin-$1{\alpha}$(IL-$1{\alpha}$) were injected into TMJ joint space for 5 or 3 weeks. Other groups are chosen for osteoarthritis under systemic control including hormonal changes and aging. To observe cellular change, increased collagen, degenerative bony destruction and distribution of proteoglycans (PGs), safranin-O staining and Masson's trichrome staining were used.

Clinical Characteristics of Headaches in Temporomandibular Disorder Patients : Primary Headache vs Headache Attributed to TMD (측두하악장애 환자의 두통 양상의 분류 : 일차성 두통 vs 측두하악장애로 인한 두통)

  • Ryu, Ji-Won;Bae, Kook-Jin;Hong, Seong-Ju;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.325-331
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    • 2009
  • The objective of this study was to describe the prevalence of the headache attributed to Temporomandibular disorder(TMD) symptoms and to investigate the relationships of headache and TMD. 66 patients seeking care for signs and symptoms of Temporomandibular disorders(TMD) and Orofacial pain in the department of oral medicine, Dental Hospital, Chosun University, from January, 2008 to June, 2008, were recruited. The obtained results were as follows : 1. A muscle and TMJ origin combined was the most common in study populations(54.55%), grouped as TMD classification. 2. Tension type headache was the most common in study population(89.39%), grouped as headache classification. 3. 36 patients out of 66(54.55%) had headaches which related to TMD. 4. Out of 36 patients who had suffered the headache which were attributed to TMD, 19 patients(52.78%) described that their headache related to TMD was different from their own primary headaches. In conclusion, headache attributed to TMD is relatively common in the patients who had headaches and TMD symptoms together. And the new headache patterns may related to headache and TMD chronification. Larger-scale studies and more specified and controlled comparison study is needed to confirm the relationship between the headache and TMD.