• Journal of Oral Medicine and Pain
• /
• v.13 no.1
• /
• pp.71-84
• /
• 1988

The author examined 206 temporomandibular disorders patients, who visited department of Oral Diagnosis and Oral Medicine in Seoul National University Hospital during the period from May 1st 1987 to April 30th 1988, clinically and radiologically and with prepared questionnaire. By clinical and radiological examination, the patients were divided into 2 groups(the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome: the patient with temporomandibular joint internal derangement only). The symptom severity index and contributing factors were examined with the questionnaire, and differences in 2 groups were studied. The conclusions are followings : 1. The symptom severity index presenting the severity of symptom was higher and the scope of symptom was wider in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction compared to the patients with temporomandibular joint internal derangement only. 2. Emotions, behaviors, cognitions, and social factors were more undesirable in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome than the patients with temporomandibular joint internal derangement only.

• Journal of Oral Medicine and Pain
• /
• v.23 no.2
• /
• pp.127-141
• /
• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

• Imaging Science in Dentistry
• /
• v.32 no.4
• /
• pp.221-225
• /
• 2002

Purpose: To evaluate the relationship between internal derangement and osteoarthrosis in the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). Materials and Methods: One hundred and six MR images of TMJs in 53 patients were evaluated. Disc displacements and osseous changes of the TMJs were assessed. Lateral and rotational disc displacements were also evaluated on coronal images. Results: No significant differences in the frequency of osseous changes of the TMJs between disc displacement with reduction and disc displacement without reduction groups were found. The erosion of the condylar head and the sclerosis of the articular eminence were more frequent in the internal derangement group than in the no disc displacement group. The flattening was the most frequently observed osseous change of both the condylar head and articular eminence. Conclusion : The relationship between internal derangement and osteoarthrosis is obscure, but it is thought that both disorders adversely affect each other.

• Journal of Oral Medicine and Pain
• /
• v.41 no.3
• /
• pp.110-117
• /
• 2016

Purpose: The purpose of this study is to determine factors influencing the duration of occlusal appliance (OA) treatment for patients with temporomandibular joint (TMJ) internal derangement. Methods: Ninety patients were included for this study, who satisfied the following including criteria: (i) those who were diagnosed as disc displacement of TMJ by taking magnetic resonance imaging (MRI) and (ii) those who were finished OA treatment. The subjects were classified into three groups according to the period of OA treatment: (i) early response group (<6 months), (ii) moderate response group (6 months-1 year), and (iii) delayed response group (>1 year). Demographic data, data from chief complaints and past history of temporomandibular disorder, data from clinical examination and diagnostic imaging including panoramic view and TMJ MRI were compared among groups. One-way ANOVA and chi-square analysis were used to test statistical significance. Results: There were no significant differences in demographic data, data from chief complaints and TMJ imaging. However, only the prevalence of oral parafunctional habits including bruxism, clenching, and unilateral chewing showed significant differences among groups. Conclusions: Oral parafunctional habits could be factors to influence the duration of OA treatment in the patients with TMJ internal derangement.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.1
• /
• pp.78-86
• /
• 1996

This is a retrospective study of 31 patients, who were diagnosed as bilateral TMJ internal derangement in consequence of magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) at Department of Dentistry, Ajou University Hospital, and who were compared clinical findings with radiological findings. The results obtained were as follows. 1. The average of the patients of bilateral TMJ internal derangement was 27.3 years with a range from 12 to 74 years, and 93.6% of the patients were yonger than 40 years of age. The male-female ratio was 1 : 6.8, and the females of $20{\sim}29$ years were most common in 35.5%. 2. In the patients of bilateral TMJ internal derangement, the patients who complained clinical symptoms bilaterally were 38.7% and the patients who complained clinical symptoms untilaterally were 61.3%. 3. The most common disc position of bilateral TMJ internal derangement was anterior disc displacement without reduction on both sides in 38.7%. The most common disc configuration of bilateral TMJ internal derangement was biconcave on both sides and amorphous on both sides in closed mouth, and was amorphous on both sides in open mouth. 4. In the patients of bilateral TMJ internal derangement, the joints which really showed clinical symptoms were most common in anterior displacement without reduction of 48.9%.

• The Journal of the Korean dental association
• /
• v.58 no.6
• /
• pp.364-376
• /
• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

• Journal of Oral Medicine and Pain
• /
• v.11 no.1
• /
• pp.37-43
• /
• 1986

The purpose of this study was to investigate the effects of the posterior slope of articular eminence on internal derangement of temporomandibular joint. The author had taken transcranial oblique lateral projections of both TMJs in 30 normal subjects and 40 internal derangement patients who had 54 affected sides and 26 unaffected sides, and then analyzed the films. The results were as follows : In normal subjects, there was no significant difference between in the males and females, and between in the right and left sides. The posterior slope of articular eminence of affected sides in patients was stiffer than that of unaffected sides in patients and also stiffer than that of normal subjects. Therefore, the author concluded that stiffer posterior slope of articular eminence was, the more susceptibility to internal derangement would be.

• Imaging Science in Dentistry
• /
• v.35 no.2
• /
• pp.69-75
• /
• 2005

Purpose : To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. Materials and Methods : The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the preauricular area and masticatory muscles and TMJ sounds. Results : There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Conclusion : Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

• Imaging Science in Dentistry
• /
• v.33 no.2
• /
• pp.63-70
• /
• 2003

Purpose: To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. Materials and Methods: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. Tl-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. Results: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment(TPA) were correlated neither with clinical, nor with other MRI findings. Conclusion: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

• Imaging Science in Dentistry
• /
• v.31 no.3
• /
• pp.159-164
• /
• 2001

Purpose: To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. Materials and Methods: MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes, 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. Results: The most frequent Stage in internal derangement of TMJ was Stage I. And 28 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage II (1.8%) and III (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. Conclusion: MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle.