• Imaging Science in Dentistry
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• v.32 no.2
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• pp.99-105
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• 2002

Purpose: To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. Materials and Methods: Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. Results: The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. Conclusion: There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

• Imaging Science in Dentistry
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• v.38 no.1
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• pp.23-27
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• 2008

Purpose: The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). Materials and Methods: CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB $Mercuray^{TM}$ (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with $Vimplant2.0^{TM}$ (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. Results: The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p< 0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was $79.6{\pm}2.7^{\circ}\;and\;80.1{\pm}5.7^{\circ}$ respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. Conclusion: We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

• The korean journal of orthodontics
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• v.45 no.2
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• pp.66-73
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• 2015

Objective: To compare condylar position and morphology among different vertical skeletal patterns. Methods: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. Results: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. Conclusions: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.18 no.1
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• pp.167-176
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• 1988

This study was designed to evaluate the morphology of the temporomandibular joint components and dentofacial characteristics of patients with clicking and painful temporomadibular joint. The materials consisted of 80 conventional pantomographs in normal an symptomatic individuals aged 18-23 and divided into 2 groups by symptom of temporomandibular joint. The results were as follows; 1. In morphologic analysis of condylar head, type Ⅰ (anterior, posterior smooth curve) was most dominant in both group(58.75%, 55.0%) and asymmetrical condylar shape was predominant in symptomatic group (18 cases, 45%). 2. In symptomatic group, the condylar width were slightly lesser and the ratio of condylar height to height of condyle-ramus were larger than those of normal group. 3. Vertical overlap of central incisor of symptomatic group was slightly larger than that of normal group. There was significant differences between each group in mandibular midline deviation. 4. The symptomatic group tended to steep mandibular plane angle and the degree of condylar path and condylar axis of normal group were larger than those of symptomatic group. 5. The condylar width was inversely correlated with inclination of condylar path and inclination of condylar path was correlated with condylar axis in both groups.

• The korean journal of orthodontics
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• v.23 no.3 s.42
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• pp.427-445
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• 1993

The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.105-121
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• 1989

The author analysed tomograms and submento-vertex radiograms of 90 temporomandibular joints from 45 asymptomatic young adults. 15 had Angle class Ⅰ malocclusion, 15 classⅡ and 15 class Ⅲ. Corrected lateral tomograms were obtained in three condylar positions; centric occlusion, centric relation and 1 inch mouth opening. The condylar angulation, depth of cut, joint spaces were analysed in each radiogram. The obtained results were as follows; 1. The mean condylar angulation in Angle class Ⅰ, Ⅱ, Ⅲ group was 17.55±5.51° 13.33±8.85° 16.25±6.60° respectively, and there was no significant difference in each group. The mean condylar angulation of right side (16.62±7.23°) was larger than left side (14.80±7.33°). 2. The mean depth of cut in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.13±1.61㎝, 3.05±3.80㎝, 7.75±2.19㎝, respectively. Angle class Ⅰ and class Ⅱ group revealed significant difference in measurement (p<0.0l). 3. The mean height of articular fossa in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.67±3.06㎜, 9.61±2.57㎜, 8.93±2.83㎜, respectively. And the mean width of articular fossa was 19.90±2.80㎜, 19.48±3.83㎜, 20.36±4.82㎜, respectively. 4. The mean height and width of condylar head was 5.11±1.16㎜, 11.20±2.26㎜, respectively. 5. In centric occlusion, the superior joint space was the largest (3.42±1.42㎜), followed by anterior joint space (2.94±1.95㎜) and the posterior joint space (2.64±1.19㎜. In centric relation, the anterior joint space was the largest (3.86±2.17㎜), followed by the superior joint space (3.64±3.68㎜) and the posterior joint space (1.18±0.77㎜). 6. The displaced measurement from centric relation to centric occlusion was 1.10±1.04㎜ anteriorly and 0.24±0.97㎜ inferiorly. In 1 inch mouth opening state, the condylar head displaced posteroinferiorly (2.49±2.49㎜ posteriorly, 1.17±1.34㎜ inferiorly) from the apex of articular eminence. And Angle class Ⅰ and Ⅱ group, Angle class Ⅱ and Ⅲ group revealed significant difference in posterior measurement, respectively (p<0.01).

• The Journal of the Korean dental association
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• v.10 no.3
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• pp.145-148
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• 1972

The authors have observed and treated the two patients with true bony ankylosis of temporomandibular joint in 16 years old school boy and 24 years old korean male. The ankylosed patients were treated by condylectomy and arthroplasty such as resin condylar head graft having been made into acrylic resin. 1. In 16 years old school boy, temporoandibular ankylosis of left side was surgical_y approached by condylectomy including coronoid process and posterior border of ramus and resin condylar head graft by means of interosseous wiring. 2. In 24 years old korean male, bilateral temporomandibular ankylosis was treted by bilateral condylectomies and resin condylar head grafts. 3. The mouth opening has been continued as 3-5cm since 13 months and 8 months before and facial appearances were very excellent.

• Imaging Science in Dentistry
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• v.31 no.3
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• pp.159-164
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• 2001

Purpose: To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. Materials and Methods: MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes, 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. Results: The most frequent Stage in internal derangement of TMJ was Stage I. And 28 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage II (1.8%) and III (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. Conclusion: MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.388-397
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• 2008

The present study was performed to evaluate the function of the mandible according to the pattern of fracture and treatment methods of condylar fractures of the mandible and help operators in making a treatment plan. Sixty patients (average follow-up period was $7.8{\pm}9.4$ months) who were treated for condylar fracture from June, 2002 to May, 2006 at the Department of Oral and Maxillofacial surgery, Chonnam National University Hospital were reviewed. The common causes of the condylar fracture were traffic accident and fall-down (35.0%). In concomitant injuries, laceration was 46.7% and the fracture of the mandibular symphysis was highest incidence (60.0%). The common site of the fracture was the condylar head (47.8%), followed by subcondyle (36.2%) and condylar neck (15.9%). Under 15 years old patients, the closed reduction was performed in 87.5% out of the patients. All of the condylar fragments were fixed to the mandible with titanium miniplates in cases of open reduction. The mean period of intermaxillary fixation (IMF) was $14.2{\pm}6.5$ days in closed reduction and $10.0{\pm}4.2$ days in open reduction. The old patient with bilateral condylar head fractures, who were treated by closed reduction with IMF for 3 weeks, showed the limitation of mandibular movements. But, there was no significant different results between open reduction and closed reduction with the respect of the Helkimo's mandibular mobility index and clinical dysfunction index (DI). Complications, such as fibrous ankylosis and resorption of the mandibular condyle, were not observed in all patients. These results suggest that the good results can be obtained by closed reduction with proper IMF periods and functional exercise in most condylar fractures of the mandible except severely displaced extracapsular fractures.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.121-134
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• 1984

The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms, duration of the diseases were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases, 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%). sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The condylar positional changes and bone changes according to the region were as follows: a) In the condylar head the most frequent bone change was erosion (30.45%) and the most frequent condylar positional change was downward position (37.40%) in closed state, restricted movement of condyle (33.2%) in open state. b) In the articular eminence the most frequent bone change was eburnation (39.91%) and the most frequent condylar positional change was downward position (39.79%) in closed state, restricted movement of condyle (27.22%) in open state. c) In the articular fossa the most frequent bone change was eburnation (53.94%) and the most frequent condylar positional change was downward position (42.57%) in closed state, restricted movement of condyle (30.32%) in open state.