• 치과방사선
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• 제14권1호
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• pp.61-69
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• 1984

For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosed as rheumatoid arthritis through the clinical, radiographic examination and laboratory findings. Temporomandibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• 대한물리치료과학회지
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• 제5권4호
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• pp.717-728
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• 1998

The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

• 대한치과의사협회지
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• 제41권12호통권415호
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• pp.818-824
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• 2003

Visually guided irrigation and lysis(VGIL) using temporomandibular joint(TMJ) arthroscope is useful for decreasing pain and increasing the functional mobility of TMJ. Also it demonstrated similar effectiveness comparing with arthrocentesis. Arthroscopy permits intracapsular inspection that is imperative not only for identification of morphological characteristics of joint space, but also for adequate irrigation and lysis of specific joint space. Conventional 2.3mm diameter arthroscope with 2.7mm catheter was too wide. So it was traumatic and uncomfortable to manipulate on temporomandibular joint space, especially on TMJ internal derangement patient with reduced space. We report our clinical experience on 6 TMJ closed lock patients who were treated with new 1.2mm fiberscope at Chung Hoon Dental Clinic between March 2003 and August 2003. Also we present clinical advantage & disadvantage of new system with literature review.

• Journal of Korean Dental Science
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• 제8권1호
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• pp.1-9
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• 2015

Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권5호
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• pp.358-363
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• 2002

Purpose : Authors attempted to evaluate the effect on explanation of pathogenesis and stress management as the initial care of temporomandibular disorders. Materials and methods : The materials were 634 patients with temporomandibular disorder, who had been referred to our Department of Dentistry, Wonju Christian Hospital during recent 5 years. We examined about clinical aspects of temporomandibular disorders, such as, major signs of temporomandibular joint disorder, life environment and habits, radiological findings of temporomandibular joint and electromyography of masseter muscle. The patients were treated by explanation of TMJ pathogenesis and stress management. After that, the patient were evaluated about the effect in third week. Results : The result was more favorable (96.5% success rate) without intolerable signs of temporomandibular joint disorder. Conclusion : The explanation of TMJ pathogenesis and stress management were thought as the very effective care in management of patients with temporomandibular disorder.

• Imaging Science in Dentistry
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• 제33권2호
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• pp.107-112
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• 2003

Purpose : To determine the relationship between clinical symptoms and magnetic resoncance (MR) images in patients presenting with temoporomandibular joint (TMJ) disorders. Materials and Methods: This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. Results : There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. Conclusion: In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joints did not necessarily imply that the joints are normal according to MR image findings.

• 대한치과마취과학회지
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• 제13권3호
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• pp.121-126
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• 2013

Temporomandibular joint (TMJ) dislocation is an acute paintful condition that causes severe functional limitation. So, manual reduction is the treatment of choice and should be performed as early as possible. Long-term dislocation of the TMJ that has persisted for more than 1 month is comparatively rare. This may include severe illness, neurological diseases and prolonged intensive care hospitalization with oral intubation and sedation. A joint that remains prolonged dislocated undergoes morphological change which is also true for periarticular tissue, especially in ligaments and muscles. Treatment of long-term TMJ dislocation should be different from acute TMJ dislocation, as simple reduction is difficult to achieve and it's likely to redislocate. The prevention of redislocation after reduction should be considered. This is a case report of about manual reduction of temporomandibular joint long-standing dislocation under general anesthesia.

• 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.