The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.
Background: Myofascial pain dysfunction syndrome (MPDS) is the most common type of temporomandibular disorder. This study compared the efficacies of low-level diode laser therapy (LLLT) and laser acupuncture therapy (LAT) in the treatment of MPDS. Methods: This double-blind randomized controlled clinical trial included 24 patients with MPDS who were randomly divided into two equally sized groups. Patients in the LLLT group received 12 sessions of low-level diode laser irradiation applied to the trigger points of the masticatory muscles during 1 month. The same protocol was also used in the LAT group according to the specific trigger points. We measured pain intensity and maximum mouth opening in both groups at baseline, during treatment, and 2 months after treatment completion. Results: The pain intensities decreased from 6.58±1.31 to 0.33±0.65 and from 7.08 ± 1.37 to 0 in the LLLT and LAT groups, respectively. The maximum mouth openings increased from 32.25 ± 8.78 mm to 42.58 ± 4.75 mm and from 33 ± 6.57 mm to 45.67 ± 3.86 mm in the LLLT and LAT groups, respectively. Pain intensity (P = 0.839) and level of maximum mouth opening (P = 0.790) did not differ significantly between the groups. Conclusion: Our results showed similar efficacy between LLLT and LAT in the treatment of MPDS signs and symptoms.
The purpose of this study is to investigate the cephalometric characteristics of the open-bite patients with DJD of TMJ. The DJD open-bite cases were compared with normal samples and Class II open-bite cases with normal TMJ respectively. Twenty three open-bite patients with bilateral DJD of TMJ($13.9\~35.3$ yens old, Group I) were selected from the Department of Orthodontics, SNUDH. Group ll consisted of thirteen Class II open-bite cases($13.2\~27.4$ years old) with no TMD signs/symtoms and good condylar shapes. Group III samples were the forty eight healthy dental students who have Class I molar relationships with no history of orthodontic treatment, good facial balance and no TMD symptoms($20.0\~26.8$ years old). First, sixty measurements in the lateral cephalometric radiographs and analysis of variance(P<0.05, Scheffe) were used to compare these three groups. The seven measurements showed significant difference(p<0.05) between Group I and Group II. After analysis of variance, six of them were used for the discriminant analysis(Wilks' stepwise analysis) and the discrminant function for Group I/Group II was obtained. The results and conclusions were as follows : In most of the measurments, Group I and Group II showed the same skeletal and dental characteristics. But seven of the sixty measurements(FH-PP angle, SNB, FH-ArGo angle, articulare angle, genial angle, upper gonial angle and Ar-Go length) were significantly different(p<0.05) between Group I and Group II. These differences may be explained by the fact that in DJD cases the mandible rotated backward due to the shortening of the ramus following the degenerative destruction of condylar head and its surrounding structures. The resulting discriminant function was : $D={-0.120X}_1+{0.066X}_2+{0.144X}_3-{0.058X}_4+2000,\;where\;X_1=ArGo\;length(mm),\;X_2=SArGo\;angle(degree),\;X_3=FH-PP\;angle(degree),\;X_4=Gonial\;angle(degree)$. Mean of the group centroids was -0.555 and percent of the 'grouped' cases correctly classified was $88.89\%$.
Kim, Young-Kyun;Kim, Hyoun-Tae;Lee, Do-Hoon;Choi, Yoon-Jung;Chung, Hoon
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.27
no.4
/
pp.308-313
/
2001
The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin $E_2(PGE_2)$ concentration was measured in 11 joints. Leukotriene $B_4(LTB_4)$ concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean $PGE_2$ concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.
Objectives: The aim of this study was to investigate the influencing factors on oral and maxillofacial trauma prevention education experience of students majoring in physical education. Methods: A self-reported questionnaire was filled out by 268 students majoring in physical education in Busan. All statistical analyses were performed using SPSS 21.0. The questionnaire consisted of general characteristics(4 questions), TMJ symptoms(9 questions), oral habit(8 questions), and mouth guard awareness(5 questions). The questionnaire was carried out by 5 Likert scale. Higher points of Likert scale showed the negative tendency except the mouth guard awareness. The higher points of mouth guard awareness showed the positive tendency to use the mouth guard. Results: Male students had higher scores of 2.75 points in bad oral habit than the female students(p<0.05). Female students higher score of 1.30 points in mouth guard awareness than male students(p<0.05). TMJ symptoms experience in oral and maxillofacial trauma was 3.15 points which was higher than the prevention education experience without maxillofacial trauma(p<0.001). TMJ symptoms and Mouth guard awareness showed 2.71(p<0.01) and 1.20 points(p<0.001) respectively in students with maxillofacial trauma prevention education experience. These score were higher than those without education experience of trauma prevention education experience. The influencing factors on trauma prevention education experience are mouth guard awareness(p<0.001), oral habits(p<0.01), and temporomandibular joint symptom(p<0.01). Conclusions: The necessity of mouth guards should be emphasized to prevent the serious oral trauma. It is very important to establish the rule for mouth guard use in sports activities. Therefore, oral and maxillofacial trauma prevention education program is needed.
The purpose of this study was to help improve oral health care planning for the elderly in an effort to promote the oral health of elderly people in preparation for aging society. The subjects in this study were 200 elderly people who were selected by random sampling from senior centers in Seoul. An interview was conducted to gather data from June to September 2008, and the data collected were analyzed.: 1. The mean number of residual tooth was 13.71. 2. Concerning connections between gender and subjective oral symptoms, gender had a statistically significant relationship to temporomandibular joint dysfunction(p=0.000), dry mouth(p=0.001) and halitosis(p=0.006). The men underwent more oral symptoms than the women. 3. As for the relationship of mastication(p=0.000), oral pain(p=0.010), temporomandibular joint dysfunction(p=0.010) and dry mouth(p=0.001) to subjective oral health state, the elderly people who were not in a good oral health suffered more oral symptoms, and the gap between them and the others was statistically significant. 4. A larger number of tooth led to less mastication difficulties, less dry mouth and more gingival diseases, and the relationship between the factors was statistically significant. A better oral health state led to less mastication difficulties, less oral pain, less dry mouth and less bad breath, and the relationship between the factors was statistically significant. Through this study the oral health the elderly people perceive wss concerned with oral symptom, and the number of residual teeth also had links to subjective oral symptoms. Therefore, to maintain original teeth of the elderly people, the management system of oral health and the education program for oral health in order to prevent disease relateded with oral and enhance the perception standard of oral state are indispensably necessary to the elderly people.
Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).
Kim, Yong Hyuk;Lee, Young Jun;Jo, Hyun Kyung;Kim, Yoon Sik;Seol, In Chan;Yoo, Ho Ryong
Journal of Haehwa Medicine
/
v.21
no.2
/
pp.121-125
/
2013
Objectives : The report intended to estimate effect taken by using FCST(functional cerebrospinal technique) on the patient with one gait disturbance case. Methods : A gait disturbance one case with 2 weeks of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and herbl medicine. Results : After being treates for 2 weeks, the patint's 10mWT were improved. Assessment was made by self assessment of subjective symptoms and clinical observation. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.
The purpose of this study was to investigate the duration of the silent period of the masseter muscle in normal subjects after experimental bruxism. The material for this study consisted of 9 male subjects with an age range of 22-24 years who showed normal occlusion clinically and were free from any history or symptoms of temporomandibular joint dysfunction. A jaw-jerk was stimulated by tapping the mandibular symphysis during maximal voluntary clenching with a solenoid-driven hammer. And three separate silent period records were made from the left masseter muscle at the following times: at normal state, after experimental bruxism, 1 week after bruxism. The following conclusions were obtained: 1. The average value of the duration of masseteric silent period during maximal voluntary clenching was $33.62{\pm}1.86msec$ when tap force of approximate 650g was applied at normal state. 2. After experimental tooth grinding for 30 minutes, the duration of masseteric silent period increased to $46.29{\pm}4.40msec$. 3. Comparing the duration of silent period measured at normal state with that measured after 1 week, the duration of silent period showed reproducibility.
Therapeutic effect of temporomandibular joint postural training by functional cerebrospinal therapy (FCST) for the balance of the meridian and neurologic system was observed in a facial palsy case. An idiopathic facial palsy case of House-Brackmann grade V was managed with FCST, combined with acupuncture and postural training of the cervical and pelvic structures. Clinical outcome measurement was performed by House-Brackmann grade and Yanagihara's scale. The patient showed positive changes in the degree of palsy and subjective symptoms within one month. Further research on the effect of FCST is expected.
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