• Journal of Oral Medicine and Pain
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• v.19 no.2
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• pp.181-192
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• 1994

There have been many different theories on the etiology of temporomandibular disorders(TMDs). The objective of the study was to investigate the effects of occlusal fctors and recent life event changes as prediposing fctor on the development of temporomandibjlar disorders. To evaluate the above predisposing factor, the author used T-scan system(Tekscan Co. U.S.A.) for quantitative occlusal analysis, clinical examination for occlusal state and Social Readjustment Rating Scale(SRRS) for recent life event change units (LCU). 63 patients with TMDs and 57 patients with malocclusion presented at Wonkwang University Dental Hospital participated in this study. The subjects were grouped by Angle's classification and presence of absence of TMDs and parafunctional oral habits. Data gained with regard to contact number, contact force, contact time, occlusal state(number of total teeth and occluding teeth, overjet, overbite) and occlusal interferences (protrusive posterior contact, nonworking side interference, and RCP-ICP slide) and recent life event changes. The data were processed and analysed by SAS statistical package program, The results of this study were as follows : 1. There were no significant differences on both quantitative occlusal contact analysis and occlusal state between TMDs group and Angle's malocclusion group. Also, there were no differences among the Angle's classifications. But amount of overjet in TMDs group were more greater than that of malocclusion group. 2. There was no difference on protrusive posterior contact, and balancing contact between TMDs group and Angle's malocclusion group. Premature contact was more frequent in malocclusion group, but RCP-ICP slide was more frequent in TMDs group. And RCP-ICP slide was more freqent in Angle's class II malocclusion than Angle's I or III malocclusion. 3. Life changes units in TMDs group were higher than those in malocclusion group. And recent life change units in group with parafunctional oral habit were higher than those in group without parafunctional oral habits. Clenching was the most common habit among parafunctional oral habits.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.95-99
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• 2003

Krabbe disease is a rare autosomal recessive disorder clinically characterized by retardation in motor development, prominent spasticity, seizures, and optic atrophy. Pathologically, there are many globoid cells in the white matter, in addition to the lack of myelin and the presence of severe gliosis. Hence Krabbe disease is known as globoid cell leukodystrophy. Biochemically, the primary enzymatic deficiency in Krabbe disease is galactocerebroside beta-galactosidase. Patients with Krabbe disease can be subdivided into the early-onset type and late-onset type, according to the onset of clinical manifestations. Most patients with early-onset type die before their second birthday. We describe a girl with Krabbe disease associated with uncontrolled seizures, which was confirmed with biochemical study and MRI. The clinical findings of this patient included hyperirritability, scissoring of the legs, flexion of arm, and clenching of the fists, and generalized tonic seizures. EEG showed hypsarrhythmia, and MRI demonstrated degenerative white matter changes in bilateral periventricular white matter, posterior rim of internal capsule, basal ganglia and brain stem on T2W1 and FLAIR image. The diagnosis was based on clinical features of progressive neurologic deterioration in conjunction with low galactocerebroside beta-galactosidase activity.

• Journal of Oral Medicine and Pain
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• v.24 no.2
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• pp.189-206
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• 1999

This study was performed to investigate the factors affecting muscle activity and cephalometric variables according to change of head postures. For this study, 150 patients with temporomandibular disorders and 80 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the normal group, respectively. Head position to body-midline in frontal plane and upper quarter posture to body plumb line in sagittal plane were observed clinically and electromyographic(EMG) activity of anterior temporalis, masseter, sternocleidomastoideus, and trapezius on clenching were recorded with $BioEMG^{(R)}$ in four head postures, which were natural head posture(NHP), forward head posture(FHP), $20^{\circ}$ upward head posture(UHP), and $20^{\circ}$ downward head posture(DHP). Cephaloradiographs were also taken in the same head postures as in EMG taking, but that was taken only in NHP for the patient group. Cephalometric variables measured were SN angle, CVT angle, atlas inclination angle, occlusal plane angle, Me-C2 angle, pharyngeal width, occiput~axis distance, area of pharyngeal space, and cervical curvature. The data were analyzed by SAS statistical program. The results of this study were as follows : 1. Between the patient and the normal group, there were significant difference in distance from plumb line to acromion, eye-tragus angle, electromyographic activity of the four muscles, and cephalometric variables of linear measurement. 2. There was no consistent pattern of correlation between upper quarter posture, EMG activity and cephalometric variables in any case without relation to cervical curvature and head position in frontal plane. 3. Sternocleidomastoid muscle only showed variation of electromyographic activty with changes of head postures, but all the muscles did show correlation with head postures. 4. All the cephalometric variables measured in this study showed difference of mean value by head posture, and CVT angle, pharyngeal width, occiput-atlas distance, and area of pharyngeal space showed correlation between these variables with change from NHP to FHP, and from NHP to UHP.

• Journal of Oral Medicine and Pain
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• v.42 no.4
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• pp.89-101
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• 2017

Purpose: The purpose of this study is to investigate the prevalence of temporomandibular disorders (TMDs) in children and adolescents, their characteristic contributing factors, the characteristic features of symptoms and symptoms, and the response to treatment. Methods: We studied the researches, that were the results of the searches for words such as temporomandibular disorder, TMD, children, adolescents, and juvenile through PubMed and DBpia. Results: According to a study conducted in Busan, the ratio of adolescents increased from 18.3% to 21% in 2008 compared to 2000, and the proportion of boys increased from 38.58% to 45.38%. One of the characteristic contributing factors for adolescents is the macrotrauma such as jaw trauma, vehicle accidents, sports, physical abuse, forceful intubation, and third molar extraction. The second is a microtrauma from parafunctional habit such as bruxism, clenching, hyperextension, wind instrument, and fingernail biting that can cause joint overload, cartilage breakdown, synovial fluid alterations, and other changes within the joint. The diagnosis of TMDs in juvenile adolescents is not significantly different from that of adults. Medical history, clinical examination and radiological examinations are required. Conclusions: In the temporomandibular joint history and assessment, all comprehensive dental history examination is required, including head and neck pain, mandibular dysfunction, previous orofacial trauma, history of present illness with an account of current symptoms. For the treatment and management of temporomandibular arthritis in juvenile adolescents, understanding the characteristics of TMDs in juvenile adolescents and thoroughly analyzing appropriate diagnosis and possible contributing factors through comprehensive history taking & examination, conservative treatment, including fast and active cautions education, will be essential.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.498-510
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• 2005

Purpose: The purpose of this study was to compare the maximum occlusal force implant prostheses to natural teeth. Material and Method: Fifty nine patients treated either with $Br{\aa}anemark$ implants and ITI implants during the recent ten years were involved in this study. The maximum occlusal force were measured with unilateral bite force recorder and dental prescale system. Results: 1. The maximum occlusal forces of the implant prostheses and natural teeth were not significantly different where measured with unilateral bite force recorder and dental prescale system. 2. The maximum occlusal forces were not significantly different between $Br{\aa}nemark$ implant and ITI implant prostheses. 3. The maximum occlusal forces of the implant prostheses had lower when compared with natural teeth during 1-6 months functional periods when measured with the unilareral bite force recorder(P<0.05) and 1-12 months functional periods when measured with the dental prescale system(P<0.05). After these periods there was not statistical significant difference between the implant prostheses and natural teeth. 4. The maximum occlusal forces of the wide diameter implant prostheses were higher than the maximum occlusal forces of the regular diameter implant prostheses when measured with dental prescale system(P<0.05), but there was no significant difference between the wide diameter and the regular diameter implant prostheses when measured with unilateral bite force recorder. 5. The maximum occlusal forces of the single implant prostheses were not significantly different with the splinting implants prostheses. 6. The maximum occlusal forces of the implant prostheses were not significantly different by age and sex. 7. There was significantly different between maximum occlusal forces measured with unilateral bite force recorder and dental prescale system(P<0.0001) but there was positive correlation(r=0.52. P<0.05). Conclusion: The maximum occlusal forces of the implant prostheses were not significantly different to natural teeth during clenching and unilateral maximum biting.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.1
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• pp.36-44
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• 2014

Bruxism is a much-discussed clinical issue in dentistry. Although bruxism is not a life-threatening disorder, it can influence the quality of human life, especially through dental problems, such as, frequent fractures of dental restorations and pain in the orofacial region. This research has a goal to investigate the diagnostic methods of bruxism, to provide an appropriate information about various treatment in clinical situation, and to evaluate the effect and the usefulness of those methods. There is no certain remedy for bruxism that is a technically efficient and definitely reliable diagnosis and treatment. So, the primary purpose is to prevent the oral and maxilofacial tissue injuries from bruxism and to relieve the pain and symptom. Therefore, Combining various reversible treatments together, such as behavior modification, Oral appliances therapy and physiotherapy, is recommended. For a bruxism treatment in dental field, more researches about the factors influencing on diagnosis and cure are necessary.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.6
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• pp.560-571
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• 2002

Jaw relations and the recording methods have been controversial aspects of dentistry. The purpose of this study was to quantify the relative muscle activity of the masseter and temporal muscles in relation to different intermaxillary relations recorded by intra-oral tracer during maximal clenching and to decide the optimal mandibular position. Ten volunteers with healthy TMJ were studied. Intra-oral tracer was assembled and bite block was fabricated in the articulator. Intra-oral tracer was placed in the mouth, and four mandibular positions were recorded. EMG activity was recorded on a BIO-PAK system (Bio-Research Associates, Inc. USA.) in masseter and temporal muscle and compared in each mandibular positions. The results were as follows: 1. In comparison with maximum intercuspation, the chewing position was the most similar followed by tapping position, myocentric position and posterior border position. However the differences were not statistically significant. 2. In comparison of bilateral symmetry of masseter muscle, tapping position was the most symmetrical followed by chewing position and maximum intercuspation. Myocentric position and posterior border position were not symmetrical. (P<.05). 3. In comparison of bilateral symmetry of anterior temporal muscle, chewing position was the most symmetrical followed by posterior border position, maximum intercuspation, myocentric position and tapping position. However the differences were not statistically significant. 4. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on left side, posterior border position was the greatest followed by myocentric position, taping position, chewing position and maximum intercuspation. And the proportionality of posterior border position was greater than that of maximum intercuspation. (P<.05). 5. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on right side, myocentric position was the greatest followed by posterior border position, tapping position, maximum intercuspation and chewing position. However the differences were not statistically significant.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.48-53
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• 2016

Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.

• Journal of Korean society of Dental Hygiene
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• v.19 no.2
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• pp.317-327
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• 2019

Objectives: This study aimed to evaluate the effects of occlusion patterns using the T-scan $III^{(R)}$ system and oral parafunctional behaviors on temporomandibular joint disorder (TMD) in female college students. Methods: A questionnaire survey assessed TMD symptoms and oral behavioral checklist (OBC) scores in 120 female college students in their early twenties. Occlusion was evaluated using the T-scan $III^{(R)}$ system. Logistic regression analysis was performed to investigate the relationship between occlusion and OBC scores based on patients' symptoms of TMD and to determine whether OBC scores were a predictor of TMD. Results: A total of 101 participants with an average age of 22 (${\pm}2.17$) years were included in the analysis. The reported symptoms of TMD were categorized as moderate (28.8%), slight (27.7%), severe (25.7%), and asymptomatic (17.8%). Occlusion was analyzed using the T-scan $III^{(R)}$ system, and the mean occlusion time was 0.42(${\pm}0.5$) seconds. The results of logistic regression analysis showed that the group that would 'clench or grind teeth' during sleep showed an odds ratio for TMD that was 8.9 times higher than that in the group without this behavior. The group that would 'hold, tighten, or tense muscles without clenching' while awake showed an odds ratio for TMD that was 21.3 times higher than that in the group without this behavior. Conclusions: We confirmed that oral parafunctional behavior affects TMD. Therefore, we would like to continue studying the diagnosis and treatment of TMD by evaluating occlusion patterns and related OBC scores.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.201-208
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• 2019

Background: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. Methods: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. Results: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. Conclusion: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.