• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권2호
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• pp.81-91
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• 1993

Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.

• 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.

• 턱관절균형의학회지
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• 제11권1호
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• pp.25-36
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• 2021

It was observed that the effectiveness of Yin-yang balancing therapy of the tempromandibular joint (YBT) or functional cerebrospinal therapy (FCS) in three cases: an acute and a chronic motor tic disorder and a Tourrette's disorder (TD). These three cases were mainly managed with cervical balancing appliance for the Yin-yang Balancing on tempromandibular joint (TMJ) and pelvic balance therapy. They were treated concurrently with acupuncture, cupping and herb-medicine. Clinical outcome measurement was based on subjective measures with visual analogue scale (VAS), Yale Global Tic Severity Scale (YGTTS) and clinical observations for 235, 279 and 273 days respectively. The patient showed positive changes after the treatment and this effect maintained over the follow-up period. Although it is not clear whether the effect is sustained afterwards or not, a positive effect on the motor tic disorders and TD was observed. And so, furthermore strict clinical and structural researches for verification on YBT is expected.

• The Journal of Korean Physical Therapy
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• 제19권4호
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• pp.43-51
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• 2007

Purpose: The purpose of this study was to determine the effects on improvement of the range of motion in the TM joint. Methods: 26 subjects who have TM joint limitation were divided to passive movement group(n=13, $21.3{\pm}2.95$ years) and active movement group(n=13, $20.62{\pm}1.39$ years). All of the subjects were treated 5 to 10 minutes per one time, five times once a week for 4 weeks by the physical therapist. The open bite and cross bite were investigated at before, during(2 wks) and treatment(4 wks). Results: In order to assure the statistical significance of the result, a Repeated measures ANOVA were applied at the 0.05 level of the significance. There was a significant difference in terms of the rates of open bite mean change in within-open bite effects among pre-test, post-test 2weeks and post-test 4weeks in each group(P=0.029). There was no significant difference in the rates of mean change in between-open bite effects(P=0.441) but interactions between two types of effects(P=0.025) were statistical significance among pre-test, post-test 2 weeks and post-test 4 weeks in each group. There was no significant difference in the rates of mean change in within-close bite effects(P=0.112), between-cross bite(P=0.179) and interactions between the two types of effects(P=0.098) among pre-test, post-test 2 weeks and post-test 4 weeks in each group. Conclusion: The results of this study showed that passive movement and active movement were effect on increase of TM joint ROM about open bite and cross bite.

• 대한소아치과학회지
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• 제51권2호
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• pp.185-196
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• 2024

Temporomandibular joint disorders (TMDs) can occur at any age, including childhood and adolescence, and pain-related TMDs can affect growth and quality of life. In the present study, recent trends in the diagnosis and treatment of TMDs in children and adolescents were analyzed over a 10-year period. Using 10 years of data from the Health Insurance Review and Assessment Service (HIRA) and Jeonbuk National University (JBNU) Dental Hospital, patients between 0 and 19 years of age diagnosed with K07.6 (temporomandibular joint disorders) were analyzed by 5-year bins. Both datasets indicated a higher prevalence in females (1.2-fold in HIRA, 1.5-fold in JBNU) and in ages 15 to 19 years (72.1% in HIRA, 74.7% in JBNU). HIRA reported a 42.3% increase in prevalence per 100,000 people, from 651.4 in 2011 to 927.0 in 2020. JBNU reported K07.66 (masticatory muscle disorders) as the most common diagnosis in subjects under 10 years of age and K07.60 (internal derangement of temporomandibular joint) in those over 10 years of age. In addition, both were treated mainly by a combination of physical therapy and medication, and the treatment rate increased in accordance with age. Because TMDs can affect various structures in the orofacial region and cause pain that tends to differ with age, an early and specific diagnosis appropriate for age is important for treatment. Therefore, pediatric dentists need to promptly recognize TMDs in children and adolescents and consult with specialists as the prevalence increases.

• 한방재활의학과학회지
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• 제25권4호
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• pp.41-46
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• 2015

Objectives This systematic review will analyse randomised controlled trials (RCTs) of manual therapy in patients with temporomandibular disorders (TMDs) to evaluate the efficacy of this approach. Methods RCTs will be identified in the following ten databases based on searches starting with their inception: MEDLINE, EMBASE, CENTRAL, four Korean databases as KoreaMed, DBPIA, NDSL, and RISS and three Chinese databases as CNKI, VIP and Wanfang. The quality of these studies will be analysed using the Cochrane risk of bias. A meta-analysis will be conducted, and subgroup analysis will be considered if comparatively large heterogeneity is detected. Conclusions We plan to publish this systematic review in a peer-reviewed journal. Findings from this review may contribute to the treatment process in clinical situations. Trial registration number: PROSPERO 2015: CRD42015024090

• 대한물리의학회지
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• 제4권4호
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• pp.257-267
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• 2009

Purpose：The purpose of this study is to examine the effectiveness of ultrasound and myofascial release in patients who have opening mouth limitation and temporomandibular disorder. Methods：Twenty students were randomly assigned to a myofascial release group(n=10) or an ultrasound group(n=7). Each group was treated for 15 minutes per a every treatment session for four weeks. Cervial range of motion(CROM) was used to measure cervical R.O.M., and a mm(millimeter) graduated ruler was used to measure opening mouth limitation. Results：Results of the follows : 1. The neck extension of range of motion of both groups was significantly increased in length of time (p<.05). 2. The neck flexion of range of motion of both groups was significantly increased (p<.05). 3. The quantity of opening mouth of temporomandibular joint of both groups was significantly increased (p<.05). Conclusion：These data suggest that myofascial release and ultrasound are beneficial to increasing a functional recovery of neck(flexion and extension) and opening mouth.

• 대한통합의학회지
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• 제8권3호
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• pp.93-101
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• 2020

Purpose : Temporomandibular joint disorder (TMJD) is often accompanied by pain and limited range of motion of the jaw joint, which affect patients' quality of life and result in hypertrophy or hyperactivity of the muscles around the jaw joint. In this study, we compared the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and the jaw range of motion in individuals with and without TMJD. Correlation comparison was performed on the results of the TMJD group. Methods : This study included 40 patients; 20 patients were assigned to an experimental group (TMJD group) and 20 to a control group (non-TMJD group). Ultrasonography, myotonometry, and measurements performed with digital Vernier calipers were used to determine the changes in muscle thickness, muscle tone, and maximum jaw opening, respectively. The independent t-test was used for intergroup comparison of data, and Pearson correlation coefficients were used to compare correlations in the TMJD group results. Results : We observed a significant intergroup difference in the masseter and SCM thickness during the relaxed and clenched phases (p<.05). A significant intergroup difference was also observed in maximum jaw opening (p<.05). With regard to muscle tone, we observed a significant intergroup difference in frequency (p=.011) and stiffness (p=.011) of the masseter, as well as in the frequency (p=.009) and stiffness (p=.026) of the SCM. We observed a moderate negative correlation (r=-.524) between maximum jaw opening and the frequency of the masseter. Additionally, we observed a moderately negative correlation between jaw opening and muscle stiffness (r=-.321). Conclusion : Planning exercise programs to treat patients with TMJD who present with pain should focus on efforts to reduce muscle thickness and achieve muscle relaxation (to reduce muscle tension) for improved jaw range of motion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권2호
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• pp.65-66
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• 2016