• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.227-230
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• 2016

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

• Journal of Korean Neurosurgical Society
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• 제30권10호
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• pp.1229-1232
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• 2001

A rare case of tenosynovial giant cell tumor of invading left temporomandibular joint(TMJ) extending the middle cranial fossa is reported. Report of this entity in the temporomandibular joint is rare. A 39-year old male patient presented with mild discomfort and swelling in preauricular area. MR image demonstrated a destructive lesion of the left TMJ, with bony erosion of temporal bone and extension into middle cranial fossa. The patient underwent radiotherapy as adjuvant therapy to prevent recurrence, followed by resection. The histological and radiological features of this tumor are discussed along with a brief description of the disease entity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권6호
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• pp.368-372
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• 2017

We conducted a retrospective study and reviewed the temporomandibular joint (TMJ)-related papers published in a leading international journal, Journal of Oral and Maxillofacial Surgery, between January 2014 and December 2015. The study was conducted to ascertain and compare the trends of articles being published in the years 2014 and 2015. A total of 28 articles were reviewed, of which most of the full-length articles were on clinical management and outcomes and the role of radiology. The bulk of the studies were prospective, and less interest was shown in experimental research. A thorough review and analysis thus gives the impression that there is a great need for well-designed clinical studies on TMJ.

• 대한치과의사협회지
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• 제55권10호
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• pp.706-714
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• 2017

Background Synocial chondromatosis(SC), a proliferative disorder of the synovial membrane. The etiology or cause of SC remains unclear. SC usually occurs in large articular joints such as knee, hip, elbow, and ankle. SC of the TMJ is very rare. It is a benign disease that mainly affects unilateral side. It can form cartilagenous and calcified loose bodies of various sizes and cause abnormal function of TMJ. Case Report In this paper, we report two cases of SC in the upper joint space of the left TMJ. One complained that "Sometimes the left jaw joint feels disoriented" and the other had no symptoms. CT scan and MRI showed left TMJ space widening, multiple tiny calcified mass. After clinical and radiographic analysis, we performed surgical removal of the lesion under genereal anesthesia. In the histologic examination, synovial chondromatosis was diagnosed in both patients. Conclusions We report two cases of synovial chondromatosis in the upper joint space of the left TMJ. We performed surgical removal of the lesion. The two patients showed good prognosis without recurrence or pain up to date.

• Imaging Science in Dentistry
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• 제48권2호
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• pp.147-152
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• 2018

Synovial chondromatosis is a rare metaplastic disease affecting the joints, including the temporomandibular joint (TMJ). Since its symptoms are similar to those of temporomandibular disorders, a careful differential diagnosis is essential. A 50-year-old male patient was referred with the chief complaint of pain and radiopaque masses around the left TMJ on panoramic radiography. Clinically, pre-auricular swelling and resting pain was found, without limitation of mouth opening. On cone-beam computed tomographic images, multiple calcified nodules adjacent to the TMJ and bone proliferation with sclerosis at the articular fossa and eminence were found. T2-weighted magnetic resonance images showed multiple signal-void nodules with high signal effusion in the superior joint space and thickened cortical bone at the articular fossa and eminence. The calcified nodules were removed by surgical excision, but the hypertrophic articular fossa and eminence remained. A histopathological examination confirmed the diagnosis. The patient was followed up few months later without recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.221-225
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• 1989

Arthrography is one of highly accurate diagnostic tools for internal derangements of the temporomandibular joint (TMJ). Both TM joints are connected by the mandible and one may have influence upon the other. We performed bilateral TMJ arthrograms in 42 patients with TMJ disorders to evaluate the bilaterality of internal derangements of the TMJ. The results were as follows : 1. We could not find any specificity in clinical symptoms according to each state of internal derangements of the TMJ. 2. The bilaterality of internal derangements of the TMJ was 61%. 3. Statistically, significant correlation was found in the aspects of the presence of arthrographic abnormality in both TMJ and each state of internal derangements in them. Therefore, the patients, who are diagnosed as any internal derangement of the TMJ, need to have assured examination in the contralateral joint.

• Journal of Oral Medicine and Pain
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• 제38권1호
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• pp.87-95
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• 2013

측두하악관절 골관절염은 측두하악장애의 한 형태로 관절조직의 생리적 내성을 초과하는 기능적 부하가 지속적으로 관절에 가해졌을 때 관절연골 및 연골하 골조직의 점진적 파괴와 이차적 염증을 특징으로 하는 질환이다. 관절면에 가해지는 물리적 하중은 관절내에서 기질파괴 단백효소나 염증성 cytokine, 유리기의 활성을 증가시키고, 그에 따라 골조직의 퇴행과 재형성 사이의 균형을 깨뜨려 골조직의 흡수를 야기한다. 최근에는 물리적 하중 이 외에 비만세포에서 유래하는 adipokine이 골흡수를 증가시킨다는 보고들이 있으나 측두하악관절에 적용하기에는 아직 추가적인 연구가 필요하므로 현재로서 골관절염의 치료는 관절의 기능적 부하를 줄이고 환자의 생리적 내성을 증가시키는 방향으로 이루어져야 한다. 임상증상은 충분한 기간 정확한 술식대로 시행한 물리치료, 약물치료, 교합안정 장치치료 등의 보존적 처치와 관절강내 주사요법이나 관절세척술 및 관절경 수술과 같은 추가적인 외과적 처치에 의해 성공적으로 조절될 수 있으나, 임상증상의 개선이 골파괴의 중지와 재형성을 담보하는 것은 아니므로 임상증상의 개선 이 후에도 지속적인 골변화의 추적관찰이 필요하다. 또한, 골변화 활성 자체를 직접적으로 조절할 수 있는 활용 가능한 치료법이 없는 한, 지속적인 동기유발과 행동조절을 통해 관절에 가해지는 기능적 부하를 환자 스스로 조절할 수 있도록 끊임없이 교육하는 것이 골변화를 겪는 측두하악관절로 하여금 보다 이른 시기에 보다 유리한 정형적 안정에 도달하게 함으로써 골관절염을 보다 성공적으로 조절할 수 있는 길이라고 할 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.143-153
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• 2006

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

• Imaging Science in Dentistry
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• 제48권1호
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• pp.1-9
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• 2018

Purpose: To evaluate osseous changes of temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA) using cone-beam computed tomography (CBCT) and to correlate the imaging findings with the severity of TMJ dysfunction, clinical findings, and laboratory findings. Materials and Methods: This study consisted of 28 subjects, including 14 RA patients and 14 controls, who were scheduled to undergo CBCT imaging for the diagnosis of a complaint not related to or affecting the TMJ. The Fonseca's questionnaire was used to assess the severity of TMJ dysfunction. Rheumatoid factor (RF) and the erythrocyte sedimentation rate (ESR) were assessed in the RA patients. CBCT was then performed in all subjects and osseous TMJ abnormalities were assessed. Results: According to the Fonseca's questionnaire, 14.3% of the patients had no TMJ dysfunction, while 50%, 21.4%, and 14.3% had mild, moderate, and severe dysfunction, respectively. RF was positive in 64.3% of patients, and the ESR level was high in 100%. Imaging findings revealed a statistically significantly higher prevalence of erosion (85.7%), flattening (89.3%), osteophyte formation (32.1%), subchondral cyst (32.1%), sclerosis (64.3%), and condylar irregularities (28.6%) in the RA patients than in the controls. No correlations were found between CBCT findings and the clinical findings, the severity of TMJ dysfunction, disease duration, or laboratory results. Conclusion: RA patients might show extensive osseous abnormalities with no/mild clinical signs or symptoms of TMJ dysfunction that necessitate TMJ imaging for these patients. CBCT is a valuable and efficient modality that can assess osseous TMJ changes in RA patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.6.1-6.6
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• 2017

Background: The purpose of this study is to evaluate the outcomes of four patients receiving stock Biomet TMJ prosthesis for reconstruction of the TMJs. Methods: TMJ reconstruction with stock Biomet TMJ prosthesis was performed in four patients who had joint damages by trauma, tumor, resorption, and ankylosis, which represent the indications of alloplastic prosthesis. Results: Loss of condyle from trauma and resorption of joint are good indications for prosthesis, but the patients should be informed about limitation of jaw movement. In case of structural damage of TMJ by tumor, tumor recurrence should be considered before planning TMJ reconstruction. Considering heterotopic bone formation in case of ankylosis, periodic follow-up and special surgical technique are required. Conclusions: Given careful treatment planning and understanding the functional limitation of TMJ prosthesis, alloplastic prosthesis is a safe and effective management option for the reconstruction of TMJs.