• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.532-538
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• 2008

Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their lip, tongue and finger. In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.53-64
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• 2018

Using the AUDIT-K (Korean versions of alcohol use disorders identification test), it was able to select a large number of potential danger drinkers who routinely live. There were no statistically significant differences in age, religion, marital status, occupation, family history of alcohol drinking, age at onset of alcohol use, smoking, and BMI (body mass index). However, only education and drinking periods were statistically significant. These results are consistent with the previous study, which suggests that alcohol consumption is higher among men who are educated. The level of education also suggests that there is a need to look at the differences depending on what you learned and how. Alcohol consumption by education also shows different results. Also, drinking at a young age will lead to a longer drinking period, which is consistent with previous studies on the age at onset of drinking. In this study, drinking period was the most important factor of alcohol use disorder and it is considered that measures and education of national government system which can delay drinking age as much as possible is needed as a method to shorten drinking period.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.601-606
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• 2009

Amelogenesis Imperfecta (AI) is a genetic disorder which retards the development of enamel and it can be classified into three types: hypoplastic, hypomaturation, hypocalcified type. This can occur both in deciduous and permanent dentition. A 8 year 8 month old patient with a chief complaints of delayed eruption on upper anteriors, calculus deposit on lower anteriors and anterior openbite visited the clinic. Anteriors had thin layer of enamel and were very narrow. Especially lower anteriors had rough surface and were in bad shape. Teeth were very hypersensitive to thermal changes. Upper and lower first molars showed severe attrition on the occlusal surface. Radiographs also verified hypoplastic enamel in the whole dentition including the teeth in the tooth bud. The patient was diagnosed as hypoplastic AI, and is being treated at the pediathc and prosthodontic department of the Kyunghee dental university hospital. To improve the function, esthetics, hypersensitivity of the AI patients, restorations on the posteriors and the anteriors with oral hygiene instruction are necessary, Constant follow-up check is needed until full growth and after full growth, cooperative care with the other department is needed.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.25-37
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• 2011

The purpose of this study is to investigate the relationship between personality type and symptoms and contributing factors of temporomandibular disorders. 199 college students completed the MBTI(Myers-Briggs Type Indicator) and a questionnaire and collected data were analyzed by SAS 9.2 program. The obtained results were as follows : 1. The prevalence of symptoms of temporomandibular disorders and mean scales of positive answers of contributing factors appeared to be higher in I type, S type, T type, P type than in E type, N type, F type, J type. 2. ISTP and ISFP among 16 types of personality seemed to have higher prevalence of symptoms and contributing factors of temporomandibular disorders than other types of personality. 3. Symptom of TMJ pain during mouth opening seemed to occur more frequently in I type, S type, F type, J type than in E type, N type, T type, P type. 4. Contributing factors including clenching and stressful state occurred significantly more frequently in I type than E type. Gum chewing habit occurred significantly more frequently in E type than in I type. 5. Unilateral chewing habit occurred significantly more frequently in J type than in P type. 6. Nervous or sensitive persons had significantly higher mean scales of positive answers of subjective symptoms than relaxed or general persons. 7. General persons had significantly lower mean scales of positive answers of contributing factors than nervous, sensitive and relaxed persons. In conclusion, these results show that there is the relationship between personality and temporomandibular disorders and patient education and counselling considering personality type may contribute to treating patients with temporomandibular disorders.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.81-90
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• 2009

This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.1
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• pp.99-107
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• 2008

Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.146-153
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• 1992

In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.45-63
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• 1997

A Study was conducted to examine the nature and extent of psychological differences among diagnostic subgroups of temporomandibular disorders(TMD) patients and to whether psychological distress acts as a precipitator for TMD or is only an incidental consequence of the discomfort and frustrations presented by the disorder. Ninty six TMD patients and ninty seven non-TMD dental patients were included for the study as an experimental group and control group. TMD patients were classified into subgroups according to their primary pain sites and labeled as: 1) Myogenous TMD group; 2) Arthrogenous TMD group; 3) Mixed TMD group. After Hilkimo indices were rated from patient history and clinical examination, levels of psychological distress were measured using SRRS (Social Readjustment Rating Scale) and MMPI (Minnesota Multiphasic Personality Inventory). Outcomes from Helkimo indices, SRRS, and MMPI were assessed in terms of diagnostic subgroups and pain chronicity. The relationship between SRRS and MMPI scores were also assessed. The results were as follows : 1. The TMD patients showed higher frequencies of AiII, DiII, and DiIII of Helkimo indices than those in the control subjects. 2. The chronic TMD patients showed lower frequencies of DiII and DiIII of Helkimo indices than those in the acute group. 3. The arthrogenous TMD group showed higher frequencies of DiII and DiIII of Helkimo indices than those in the myogenous TMD group. 4. The TMD patients showed higher SRRS mean score than that in the non-TMD patients. 5. The SRRS mean score was highest in the myogenous TMD group and lowest in the arthrogenous TMD group. 6. The chronic TMD patients showed higher SRRS mean score than the acute TMD group. 7. The TMD patients showed higher MMPI mean scores on the Hs, D, Hy, and Pt scales than those in the non-TMD patients. 8. The MMPI mean scores on th Hs, D, and Hy scales were higher than of other MMPI scales in the TMD patients as well as in the myogenous and the mixed TMD group and they showed 1-3-2(Hs, -Hy, -D.) profile pattern, conversion "V". 9. The MMPI mean scores on the Hs and Hy scales were higher in all subgroups of TMD patients than non-TMD patients. 10. Although there were no significant differences in the MMPI mean scores on all the scales between the acute and the chronic groups of all TMD patients, the chronic myogenous TMD group showed higher MMPI mean scores on the Hs, Hy, Pa, and Pt scales than the acute myogenous TMD group. 11. There were positive correlationships between SRRS score and each MMPI scores on the Hs and Hy scales.Hy scales.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.439-447
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• 2019

The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.2
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• pp.97-101
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• 2018

Lesch-Nyhan syndrome is a rare X-linked recessive genetic disorder. During purine metabolism, the hypoxanthine guanine phosphribosyl transferase (HGPRT) enzyme is deficient causing phosphoribosyl transferase to accumulate and resulting in excessive uric acid. Clinical symptoms include hypercalcemia, choreoathetosis, spasticity, mental retardation, and self-injury to lips, tongue or fingers. This results not only in pain caused by the self-injury but also secondary infection of the wound site and the esthetic damage of the soft tissue defect. Dental treatments include conservative methods using intraoral appliances such as soft mouthguards, fixed lip bumpers, and occlusal guards, and invasive methods such as extraction of all teeth or forming an artificial anterior open bite. We report two cases of Lesch-Nyhan syndrome patients with self-mutilation behavior; one was treated with a preservative method using a soft mouthguard, and the other was treated with extraction of all teeth.