• Journal of Oral Medicine and Pain
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• 제39권1호
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• pp.2-9
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• 2014

Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권4호
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• pp.212-218
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• 2003

Matrix metalloproteinases (MMPs) play an important role in the normal morphogenesis, maintenance, and repair of matrix and also have important functions in pathologic conditions characterized by excessive degradation of extracellular matrix, such as rheumatoid arthritis, osteoarthritis, periodontitis and in tumor invasion and metastasis. In this study, expression of MMP-1 and -2 mRNA in retrodiscal tissue of the temporomandibular joint (TMJ) was examined and compared with magnetic resonance imaging (MRI) and surgical findings. MMP mRNAs in the retrodiscal tissue samples were detected by reverse transcription - polymerase chain reaction. TMJ internal derangement (ID) was categorized as normal disc position, disc displacement with reduction, early stage of disc displacement without reduction (DDsR) and late stage of DDsR. TMJ osteoarthrosis (OA) was classified with normal, mild and advanced OA. The amount of synovial fluid collection was divided into not detected, small, large and extremely large amount on MR T2-weighted imaging. Perforation and adhesion were examined during open surgery of the TMJ. Six out of 37 samples were excluded because of little amount of extracted total mRNA. MMP-2 mRNA was detected whole joints, and so the MMP-2 mRNA seems to be expressed normally in retrodiscal tissue. However, MMP-1 mRNA was expressed in 8 of 31 joints. Frequencies of MMP-1 mRNA expression according to the TMJ IDs, amount of synovial fluid and surgical findings made no significant difference. MMP-1 mRNA was detected more frequently in OA groups (7/16 joints, 43.8%) than in normal bony structure group (1/15 joints, 6.7%). Expression of MMP-1 mRNA in retrodiscal tissue might be related with OA of the TMJ.

• 대한치과교정학회지
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• 제49권6호
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• Journal of Veterinary Science
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• 제23권3호
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• pp.44.1-44.10
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• 2022

Background: The equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient. Objectives: The objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds. Methods: In this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured. Results: The mean H:W in Jeju horses was significantly lower than that in Thoroughbreds. The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds. Conclusions: In this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.

• 한국치위생학회지
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• 제14권3호
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• pp.303-310
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• 2014

Objectives : The purpose of the study is to investigate the effects of bite force by gender and physical features. Methods : A self-reported questionnaire was filled out by 212 college students in Chungnam province from October to December, 2013. The questionnaire consisted of oral health condition. The bite force of the first molar teeth was measured. Results : Males showed the greater bite force than females(p<0.001). Those who had temporomandibular joint(TMJ) disorder suffered from mouth opening difficulty and weaker bite force than those who had not(p<0.05). Those who had malocclusion showed weaker bite force (p<0.01). Those who had a habit of chewing gums tended to have greater bite force than those who had not(p<0.05). The bite force was correlated with height(r=0.309), weight(r=0.345), and BMI(r=0.249)(p<0.01). Conclusions : Males showed greater bite force than females. The temporomandibular joint (TMJ) disorder, subjective malocclusion, and eating habit also affected the bite force.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.99-105
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• 2002

Purpose: To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. Materials and Methods: Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. Results: The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. Conclusion: There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.137-140
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• 2016

Spinal muscular atrophy (SMA) is an autosomal recessive, severe neuromuscular disorder in which degeneration of alpha motor neurons in the spine progressively weakens and ultimately paralyzes the proximal muscles. It occurs in one per 6,000-10,000 infants, and is a genetic disorder with the second-highest mortality rate worldwide. An 18-year-old male patient with SMA was referred for general anesthesia for difficulty in performing dental treatment due to limited mouth opening caused by temporomandibular joint (TMJ) pain. However, the patient had a high risk of general anesthesia complications, so TMJ pain during mouth opening was reduced through local anesthesia of the TMJ. Fortunately, the anesthesia was successful in reducing pain during mouth opening, enabling the patient to receive dental treatment with an adequate mouth opening.

• 대한치과교정학회지
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• 제45권3호
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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.

• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.123-130
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• 2023

This case report describes the orthodontic treatment of a patient with severe anterior open bite and skeletal class II malocclusion with temporomandibular joint (TMJ) osteoarthritis (OA) of the left condyle. The 21-year-old male patient had open-bite malocclusion, mild crowding, and protrusion of the anterior teeth. Mild erosive changes were detected in the anterior part of the left mandibular condyle on cone-beam computed tomography; however, because no clinical symptoms were present, orthodontic treatment was performed. It is imperative to consider the potential implications of orthodontic treatment on the stability of the TMJ throughout the duration of treatment, as any instability can exacerbate TMJ OA. Hence, it is crucial to opt for the least invasive treatment modality available. In this regard, orthodontic treatment using a skeletal anchorage system as an alternative to conventional orthognathic surgery for patients with open bite holds great promise, as it not only ensures mandibular stability but also significantly ameliorates the open-bite condition.

• Imaging Science in Dentistry
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• 제54권2호
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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.