• Journal of Korean society of Dental Hygiene
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• v.13 no.1
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• pp.136-145
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• 2013

Objectives : The goal of this study is to investigate how occupational stress affects temporomandibular disorders (TMD), dry mouth and oral symptoms. Methods : For this study, workers from 5 areas were selected and the survey was carried out from June 1st to 30th, 2012. A total of 410 questionnaires were analyzed. Results : The analysis of the structural model shows that occupational stress has no significant influence on temporomandibular disorder and dry mouth symptoms, but does affect other oral symptoms. The results also reveal that dry mouth symptom and temporomandibular disorder both have a significant effect on oral symptoms. Conclusions : Oral symptoms and job stress appeared to directly and indirectly influence the psychological and social factors of job stress. A systemic investigation on the improvement of oral health in workers is urgently required.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.431-439
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• 2007

This study was performed to investigate the dental ages of the patients with temporomandibular disorders(TMD), using a method of age estimation by dental attrition, and to compare the differences of dental ages between control and experimental groups. In addition, they were compared according to oral habit. Clinical evaluations for the tooth attrition were to examine the study models of 65 TMD patients (mean age of 26.6 years, aged 18 to 40) had visited to the Department of Oral Medicine and Orofacial Pain Clinic, Dental Hospital, Dankook University as a experimental group and 22 volunteers (mean age of 25.4 years, aged 23 to 36) without TMD as a control group. Age differences were calculated subtracting real age from estimated age. Age differences between experimental and control groups were compared statistically between groups classified according to oral habit. As a results, dental age was increased significantly in TMD patients compared with normal subjects. Oral parafunctions which increased dental age were bruxism, clenching and heavy chewing in order. Conclusively, it should be consider that there can be much discrepancy between real age and age estimated by dental attrition in patients with TMD. In addition, it is suggested that dentists should try to protect the tooth from attrition by various parafunction on treating the patients with TMD.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.289-294
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• 2019

Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.265-273
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• 2010

Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.241-245
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• 2000

In this case report, I discussed the diagnosis and treatment of two pregnant women with temporomandibular disorders(TMD) who visited the Department of Oral Medicine, PNUH. Also, I reviewed some investigations of diagnosis and treatment of TMD in pregnant women. The obtained results were as follows; 1. No single X-ray diagnostic procedure for TMD results in radiation dose that threatens the well-being of the developing embryo and fetus. 2. Most non-steroidal anti-inflammatory drugs(NSAIDs) have commonly used because these drugs are considered to be nonteratogenic, but these agents are not recommended for routine use after 3rd trimester. 3. Electro-acupuncture stimulation therapy(EAST) is contraindicated for 1st trimester, and ultrasonic deep heat therapy, microwave deep heat therapy, low level laser therapy, myo-monitor are not contraindicated for pregnant women but clinician must consider some risk of adverse fetal effects. 4. The occlusal stabilization splint may be used for pregnant women, if it is fabricated indirectly. 5. Surgical treatment is contraindicated for pregnant women.

• Journal of Korean Dental Science
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• v.13 no.1
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• pp.21-27
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• 2020

Purpose: The aim of this study was to investigate the types and frequency of the various incidental findings (IFs) on magnetic resonance images (MRI) taken from the patients with temporomandibular disorder (TMD) symptoms. Materials and Methods: Temporomandibular joint (TMJ) MRI taken from 1,013 patients with TMD symptoms were evaluated retrospectively. IF was defined as imaging features that were accidentally or unexpectedly found, rather than degenerative bony changes of TMJ complex or disc derangement. They were classified into two groups as TMJ site-specific findings and unexpected findings at other regions. The frequency of the sub groups was analyzed. Result: A total of 26 (2.57%) cases with IFs were classified into 13 cases with TMJ site-specific findings and 13 cases with unexpected findings at other region. TMJ site-specific findings included synovial chondromatosis in 6 cases, synovial cyst in 6 cases and osteochondroma in one case. Unexpected findings included salivary gland tumor in 3 cases, developmental cyst in 3 cases, vascular malformation in 2 cases, mastoiditis in 4 cases and sialadenitis on parotid gland in one case. Conclusion: When diagnosing TMD through TMJ MRI, clinicians should carefully read the image, considering the possibility of IFs because TMJ MRI can provide pathologic information in TMJ region and other oral and maxillofacial region.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.233-242
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• 2012

The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).

• Journal of Oral Medicine and Pain
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• v.35 no.3
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• pp.213-219
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• 2010

Aim: The aims of this study were to survey the frequency of pain to palpation of the occipitofrontalis muscle in a TMD patient group, and to identify patients showing pain to palpation of the occipitofrontalis muscle that is also consistent with patients' headache symptom. Methods: A total of 218 TMD patients ($32.0{\pm}13.1$ years) participated in this study. Patients' symptoms, including headache, were surveyed by questionnaire. Temporomandibular joints, jaw muscles, and pericranial muscles including the occipitofrontalis muscle were examined with digital palpation. Pain to palpation (i.e. tenderness) was scored from 0 to 3 according to the patients' response, and frequencies were calculated of pain to palpation scores for each site of the pericranial muscles. Results: Twelve patients among 218 TMD patients (5.5%) showed pain to palpation (scores of 1, 2) on the occipitalis or frontalis sites, and seven patients (3.2%) had moderate pain (a score of 2) to palpation. Among 218 TMD patients, there was only one patient whose primary symptomatic site of headache corresponded with the result of pain to palpation of the occipitofrontalis muscle. Conclusion: It can be concluded that examination with palpation of the occipitofrontalis muscle could be considered in the evaluation of TMD patients' headache symptom when other factors have been ruled out.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.67-74
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• 2017

Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.