• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.75-80
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• 2023

Temporomandibular disorders (TMDs) are a group of musculoskeletal disorders that encompass symptoms caused by abnormalities of the craniofacial structures of the temporomandibular joint (TMJ), muscles involved in the masticatory system, and other related tissues or structures. Although TMDs can occur at any age, research on the prevalence, epidemiology, and treatment strategies of TMDs has been conducted in all age groups, but primarily in adults. Unlike adults, children and adolescents are in a period of cognitive and physical development. Because of this growth potential, children respond better to TMD treatment than adults do. However, clinicians must remember that chronic pain and growth abnormalities can occur if the patient's symptoms and signs are not accurately diagnosed and treated. This article reviews the growth and development of the craniofacial region, including the TMJ, and discusses considerations when diagnosing and treating TMDs in children and adolescents.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.484-487
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• 2012

Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.

• 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.

• Journal of Oral Medicine and Pain
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• 제23권2호
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• pp.127-141
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• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

• 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.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.30-33
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• 2016

Malignant tumors located in the head and neck areas intermittently show symptoms similar to a temporomandibular disorder (TMD). In our case, a patient who first visited us complaining of TMD-like symptoms, such as trismus and temporomandibular joint (TMJ) pain on the left side, was identified as a sufferer of adenoid cystic carcinoma (ACC) that arose from the left maxillary sinus. The patient may have a TMD symptom, but we are skeptical because the patient also complained of a spontaneously developed numbness on the same side of his upper lip. We observed the panoramic radiograph closely and found the blurred maxillary sinus inferior wall. Dental cone-beam computed tomography confirmed the tentative diagnosis of malignancy on the maxillary sinus. After he had been referred to the Department of Otolaryngology, the diagnosis of the ACC was confirmed. Adequate diagnosis is vital for a quick treatment of the malignancy. There are some keys for differential diagnosis of TMD-like symptoms.

• 대한한방내과학회지
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• 제45권1호
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• pp.87-99
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• 2024

Parkinson's disease (PD) is a chronic degenerative disorder of the central nervous system. It has no cure, but current treatments can relieve symptoms and maintain quality of life. As PD progresses, controlling its symptoms becomes difficult. Here, we present the treatment of two patients with idiopathic PD using traditional Korean medicine (TKM) and temporomandibular joint balancing therapy (TBT). We measured the progress of the two patients using the unified PD rating scale (UPDRS) and the Hoehn and Yahr (HY) scale. Combined treatment of TKM and TBT decreased the total UPDRS score from 52 to 26 after 21 days in case 1, while it decreased the total UPDRS score from 91 to 65 after 20 days in case 2. In both patients, the HY scale score was maintained at 3, and no adverse events were observed. Thus, the combined treatment of TKM and TBT can produce a treatment response in PD patients.

• Journal of Oral Medicine and Pain
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• 제48권1호
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• pp.25-30
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• 2023

We present the case of a 60-year-old male with post-macrotrauma disc displacement and retrodiscitis, in which temporomandibular joint (TMJ) injection and manual therapy were used to alleviate his symptoms. He visited our clinic with complaints of pain and swelling in his right facial area and malocclusion of his right side teeth after being hit on the right side of his face five days earlier. During clinical and radiological examinations, the inflammatory state of the joint and disc displacement on the right side, which led to malocclusion, were noted. At the initial visit, we performed TMJ intracapsular injection and prescribed medications to control pain and inflammation. Simultaneously, manual manipulation was performed to relocate the disc. The same treatments were employed two days later. However, 10 days after the first visit, his symptoms did not mitigate substantially. We also performed magnetic resonance imaging (MRI), prescribed nortriptyline, and created a stabilization splint. MRI images depicted inflammatory disc displacement and joint effusion in the right TMJ. Based on the accurate diagnosis, we kept administering a stabilization splint, intra-articular injection, and medication. His signs and symptoms were alleviated 20 days after the initial visit and did not reoccur for the next 40 days.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권3호
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• pp.176-181
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• 2009

Synovial chondromatosis is a rare, benign, monoarticular arthropathy that is characterized by the development of highly cellular, metaplastic cartilaginous nodules in the synovial membrane. It commonly affects larger joints such as the knee, elbow, wrist, shoulder, and hip. Synovial chondromatosis of the temporomandibular joint(TMJ) is rare. Moreover, the temporal involvement of synovial chondromatosis without connection with joint is greatly rare. A 44-year-old women had experienced pain of the right TMJ area and limitation of mouth opening. MRI and CT revealed multiple calcified loose bodies and widening in right upper joint space of TMJ and osteolytic lesion in right temporal bone. Treatment consisted of removal of multiple loose bodies, resection of the osteolytic lesion through the preauricular approach. She was diagnosed with primary transitional synovial chondromatosis of TMJ with involvement of temporal bone. In spite of remaining of the loose bodies, pain and mouth opening improved and there have been no recurrence of signs and symptoms for 5 years follow up.

• 한국치위생학회지
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• 제18권5호
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• pp.763-770
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• 2018

Objectives: The purpose of this study was to investigate the relationship between mental healthlevel,usual lifestyle, and thelevelofsubjectivesymptoms of some adults. Methods: From 17 September-28 November 2017, 260 adults living in Seoul, Gyeonggi, and Incheon comple tedaquestionnaireconsistingofgeneral characteristics (6 items), mental health level (14 items), usual lifestyle (9 items), and subjective symptoms level (9 items) on a 5-point scale. Results: In the mental health level, there was a significant difference in sex, age, marital status, education level, andexistenceofstress, and there were differences in age, marital status, occupation, and existence of stress in usual lifestyle. There were statistically significant differences in age, marital status, occupation, and existenceofstress in the subjective symptoms of temporomandibular disorders. Conclusions: It is necessary to develop a program that can be applied in parallel with counseling therapy related to mental health during the clinical treatment of temporomandibular disorders.