• 제목/요약/키워드: Temporomandibular joint clinical examination

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측두하악장애 환자에서 악관절 세정술과 교합안정장치를 동반한 치료의 효과 (AN EFFECT OF COMBINATION WITH ARTHROCENTESIS AND STABILIZATION SPLINT TREATMENT OF TEMPORPMANDIBULAR JOINT DISORDER PATIENT)

  • 박용희;이상화;윤현중
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권1호
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    • pp.32-36
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    • 2010
  • The purpose of this study was to evaluate the clinical outcomes of patients with temporomandibular joint disorder before and after performance of arthrocentesis and stabilization splint therapy. The subjects of this study were 33 patients with limited mouth opening or pain or joint effusion who visited the Department of Oral and Maxillofacial Surgery, St Mary's Hospital, Catholic University of Korea. The arthrocentesis was performed and the stabilization splint was worn immediately after the arthrocentesis. Comparing the clinical outcomes of treatment at the times of first medical examination, 3 months and 6 months later on treatment. The results are as follows; 1. Statistically significant increase in the amount of maximum mouth opening occurred 3 months and 6 months later on treatment. 2. Statistically significant decrease in the average value of pain on test measured by VAS during maximum mouth opening, protrusive movement, right lateral movement, left lateral movement occured 3 months and 6 months later on treatment. The results suggested that arthrocentesis and stabilization splint therapy provide a improvement on patients with temporomandibular joint disorder when the exact diagnosis were provided.

측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 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.

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Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings

  • Candirli, Celal;Yuce, Serdar;Cavus, Umut Yucel;Akin, Kayihan;Cakir, Banu
    • Imaging Science in Dentistry
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    • 제42권1호
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    • pp.13-18
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    • 2012
  • Purpose : The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). Materials and Methods : ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. Results : All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. Conclusion : The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation.

3D 프린터를 이용하여 턱관절 MRI검사에 사용되는 TMJ device제작 (Additive Manufacturing of TMJ Device used in Temporomandibular Joint MRI Scan by using 3D Printer)

  • 장혜원
    • 한국콘텐츠학회논문지
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    • 제18권7호
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    • pp.628-634
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    • 2018
  • 턱관절 디스크 검사 시 MRI는 유용한 검사법으로 디스크의 정확한 위치변화를 관찰하고자 개구상태에서 오랜 시간 검사가 필요하다. 이에 3D프린팅 기술을 이용하여 개구상태를 유지시켜 줄 고정 장치(TMJ device)를 제작하고 이를 기존 고정 장치와 비교하여 유용성을 평가하고자 하였다. 기존 TMJ device를 사용한 영상에 비해 3D 프린터로 자체 제작한 TMJ device를 사용한 영상에서 SNR이 다소 낮은 결과를 보였지만 임상적으로 사용하는데 큰 결함이 없고 환자 개인별 특화된 맞춤형 제작이 가능하고 더불어 3D 프린팅 기술을 활용하여 유사도구 제작에 기여함으로서 비용대비 편익이 상승될 것이라 사료된다.

측두하악관절의 활액성 연골종증 4예 (The synovial chondromatosis of the temporomandibular joints: review of the 4 cases)

  • 이동현;신정섭;곽주희;김진우;김선종;김명래
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권2호
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    • pp.134-140
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    • 2010
  • Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a characteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressive resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 18 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for this synovial chondromatosis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spaces and to remove the loose bodies without interruption of the whole synovial membranes.

Factors Influencing the Duration of Occlusal Appliance Treatment for Patients with Temporomandibular Joint Internal Derangement

  • Lee, So-Youn;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • 제41권3호
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    • pp.110-117
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    • 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.

강직성 척추염에 수반된 양측성 측두하악관절 강직 (Ankylosing Spondylitis Associated with Bilateral TMJ Ankylosis)

  • 송주섭;고광준
    • Imaging Science in Dentistry
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    • 제30권3호
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    • pp.217-222
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    • 2000
  • A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

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측두하악장애 치료유형 분석 (Analysis of treatment patterns of temporomandibular disorders)

  • 차용훈;김범준;임재형;박광호;김형곤;허종기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.520-527
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    • 2010
  • Introduction: This study examined the treatment patterns of temporomandibular disorders (TMD) including conservative and surgical procedures. Materials and Methods: Patients with TMD who visited Gangnam Severance Hospital from June 2007 to May 2008 were enrolled in this study. All patients were examined from the orthopantomogram, temporomandibular joint (TMJ) tomography, and a clinical examination. The patients who required a further evaluation were examined by magnetic resonance imaging and/or computed tomography. The treatment patterns were divided into counseling, medication, splint therapy, botulinum toxin injection (BTI) and surgical treatment. Results: Among the 2,464 patients, the average age was 31.8 years (ranging from 6 to 93); 764 (31.0%) were male and 1,700 (69.0%) were female. 2,355 (95.6%) patients were treated with conservative therapy; 1,460 (62.0%) patients were treated with medication, 931 (39.5%) patients were treated with splint, and 46 (2.0%) were treated with BTI. There were 109 (4.4%) patients treated surgically. Eight (0.3%) patients were treated with total temporomandibular joint replacement surgery. Conclusion: Almost all patients with TMD were treated using conservative methods. Those patients who received surgical treatment because of an ineffective response to conservative treatment had definite problems with the internal derangement and/or osteoarthritis or had severe clinical symptoms.

Mouth opening limitation caused by coronoid hyperplasia: a report of four cases

  • Kim, Sung-Min;Lee, Jin-Hyeok;Kim, Hak-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권6호
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    • pp.301-307
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    • 2014
  • Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.

Evaluation of Korean teenagers with temporomandibular joint disorders

  • Lee, Ji-Young;Kim, Young-Kyun;Kim, Su-Gwan;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권5호
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    • pp.231-237
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    • 2013
  • Objectives: This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. Materials and Methods: Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. Results: The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. Conclusion: Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction.