• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.18.1-18.10
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• 2019

Background: Temporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis. Methods: A total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period. Results: All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS's guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery. Conclusions: Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.2
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• pp.61-74
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• 2016

Objectives The purpose of this research is to investigate recent clinical studies of Temporomandibular Joint Disorder in China. Methods We investigated recent clinical studies of Oriental Medicine therapies in traditional Chinese medical journals for Temporomandibular Joint Disorder through CNKI search. 20 clinical articles published from 2010 to 2015 were analyzed. This study examined the authors, published years, types of study designs, criteria for diagnosis and evaluation, periods, purposes of study and classified articles by techniques of treatment. Results Most of articles were classified as RCT. TMD was diagnosed by symptoms in a high proportion of articles. The criteria for evaluation that most frequently used were grading scale, but there was a lack of objectivity. The techniques of treatment were Tuina, acupuncture, herb medicine, electrotherapy, splint, PNF, congnitive behavior therapy, laser therapy, magnetic therapy. Conclusions In order to develop treatment of TMD in the Korean medicine, clinical studies for various therapies on a high level and cooperative studies between medical communities are needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.93-107
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• 1997

Magnetic resonance imaging has been used in the temporomandibular joint(TMJ) primarily to define morphology and positional relationship of associating structures. This report examines signal intensity characteristics of the posterior attachment as they related to the severity of internal derangement. Fifty six joints in 35 patients with a history of TMJ dysfunction were imaged writ MR using $T_1$-weighted spin echo sequence. According to disk position, ability to reduction, and the presence of osteoarthritis, the joints were categorized into three groups. A group 1 was anterior disk displacement with reduction; a group 2 was anterior disk displacement without reduction; a group 3 was anterior disk displacement without reduction and condyle had osteoarthritic change. The control group was determined by the clinical absence of any signs or symptoms of current or past TMJ pain and dysfunction. Calculated the relative value of MR signal intensity in posterior attachment and disk to cerebral cortex of temporal lobe by means of computer program, we have compared them with each groups. The result showed statistically little significant difference of disk signal intensity among each groups. but, signal intensity from posterior attachment in group 2 and 3 were significantly(p<0.05) decreased than control group. this might reflect an fibrosis or hyalinization of posterior attachment, which was part of remodeling process that occurs in disk displacement without reduction. However, this study could not demonstrate histologic confirmation of the decreased signal intensity in the posterior attachment. So, further investigation could be needed to understand the association between them.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.27-35
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• 1992

The purpose of this study was to evaluate the size of the temporomandibular joint space by the increase of the occlusal force on the working side and the non-working side during unilateral biting. For the study, 22 normal adults, age from 23 to 25, who had normal or class I molar relationship and had no symptoms on TMJ area and masticatory muscles were selected. Transcranial TMJ radiograph was taken during unilateral biting with the sensor of occlusal load measuring device (MPM-3000 ; Nihon Kohden Kogyo Co. Ltd., Japan) on 1st molar teeth of right and left side given to force of 0kg, 10kg, 20kg and 30kg respectively with Accurad-200(Denar Corperation's product). The radiographs were traced on the screen, with enlaged as 5 times. The size of temporomandibular joint space at anterior, superior and posterior compartment were measured with Dumas's method (reference line between squamotympanic fissure and the lowest point of articular eminence). The following results were obtained by this study. 1. The size of anterior TMJ space showed a tendency to decrease on the working side and increase on the non-working side by the increase of the occlusal force, but had no statistical significancy (P>0.05). 2. The size of superior TMJ space showed a tendency to increase on the working side and decrease on the non-working side by the increase of the occlusal force (P<0.05). 3. The size of posterior TMJ space showed a tendency to decrease on both working and nonworking side, but had no statistical significancy (P>0.05)

• Imaging Science in Dentistry
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• v.43 no.1
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• pp.25-30
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• 2013

Purpose: This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. Materials and Methods: A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Results: Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). Conclusion: BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

• Imaging Science in Dentistry
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• v.48 no.1
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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.

• The korean journal of orthodontics
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• v.42 no.3
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• pp.144-154
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• 2012

This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

• Journal of TMJ Balancing Medicine
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• v.11 no.1
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• pp.20-24
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• 2021

Objectives: This study was designed to report the clinical improvement of the patient with glossodynia. Methods: During the treatment period (from Jul. 7^th, 2021 to Aug. 3^rd), a patient was treated using acupuncture, Korean Medicine, pharmacopuncture and FCST (Functional Cerebrospinal Therapy). Symptoms were evaluated by Visual Analogue Scale (VAS), the Oral Health Impact Profile-14 (OHIP-14). Results: After the treatments for 28 days, the OHIP-14 score decreased from 53 to 7. Also, the patient's VAS score decreased from 6 to 0. Conclusions: Korean medicine treatment with FCST may be valuable for glossodynia patients. Nevertheless further studies are needed.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.19-24
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• 1989

The purpose of this study was to investigate the reliability of electromyographic examination in a day and detect the objective measurement timing of electromyography. 18 normal students who were in dental collage of C national university were selected for this study. They had no symptoms on temporomandibular joint area, no restorations and missing tooth on dentition. Their molar relationship was normal or class I of Angle's classification. Electromyography had been taken every one hour from 9:00 A.M. to 5:00 P.M. in the state of clenching and rest by using Bioelectric processor EM2 interfaced with mandibular kinesiograph K-6 diagnostic system. We compared and analyzed the variances of electromyography values of each subjects. The obtained results were as follows : There were no significant differences on variability of electromyography values in each state clenching and rest. In the aspect of this circumstances, the use of electromyography could be a good objective procedure to diagnose the temporomandibular disorders and to detect the effect to the treatment of temporomandibular disorders at any time in a day from 9:00 A.M. to 5:00 P.M.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.7-18
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• 1989

The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.