• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.1-6
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• 2017

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.369-382
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• 1996

The author performed this study to investige the relationship between condylar movements recorded with Pantronicⓡ and mandibular rotational torque movements with BioEGNⓡ. For this study 56 patients with Temporomandibular disorders(TMD) and 30 dental students without any masticatory signs and symptoms were selected as patients group and control group, respectively. The items recorded with Pantronicⓡ(Denar Corp., USA) were immediate side-shift, progressive side-shift, angle of orbiting path, protrusive path and PRI. BioEGNⓡ(Bioelectric gnathography, Bioresearch Inc., USA) were used to measure the amounts of mandibular rotational torque movements in frontal and horizontal plane, and the distance of mandibular translation at incisal area. Amount of mandibular rotational torque movement depicted between the condyles was automatically analysed by angle and difference in frontal and horizontal plane. The obtained data were processed with SAS program and the conclusion of this study were as follows : 1. Mean values of items between patients group and control group in Pantronic measurements were not significantly different except in left protrusive path and in Pantronic Reproducibility Index(PRI). There were no significant difference of condylar paths by preferred chewing side and affected side between the two groups. 2. The amount of mandibular rotational torque movements were differed in frontal angle and difference on protrusion, and in frontal and in horizontal difference on left excursion between the two groups. But the amounts of translatory movements were actually same on all eccentric movements. 3. The amount of mandibular rotational torque movements with splint mere almost not changed from those without splint, with the exception of in horizontal measurements on protrusion. 4. The correlations of items between in Pantronic measurements and in BioEGN measurements wert not consistently, significant, however, generally the ISS related significantly with horizontal torque movement positively, and with frontal torque movement negatively on the contrary, the PSS showed positive correlation with frontal torque movement, and negative correlation with horizontal torque movement.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.891-902
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• 2018

Objectives: The purpose of this study was to propose contents of a curriculum and training program for dental hygienists as medical professionals by surveying the opinions of clinical dental hygienists and dental hygiene professors. Methods: The subjects were 192 clinical dental hygienists and 193 dental hygiene professors. They answered questionnaires that consisted of grading each task based on its importance: a) for dental hygiene students to learn, b) to perform autonomously in clinical practice, and c) the expectancy of the task to change when dental hygienists become medical professionals. Data analysis was performed using an independent sample T test to capture differences between clinical dental hygienists and dental hygiene professors. The terms in the answers of open-ended questionnaires were extracted. We used R 3.5.0, R Recommender, and Wordcloud software packages. Results: Calculus removal had the highest scores for dental hygiene students to learn and expectancy to change when dental hygienists become medical professionals. Physiotherapy of temporomandibular disorders (TMD), planning, performing, and assessment of community oral health programs had the lowest scores in autonomy in clinical practice. The dental hygiene professors gave higher scores in most of the tasks for dental hygiene students to learn, autonomy in clinical practice, and expectancy to change, than did clinical dental hygienists. Cardiopulmonary resuscitation (CPR), job ethics, and communication were the most frequently mentioned terms in the training as medical professionals program contents. Conclusions: In the future, it will be necessary to study the curriculum to improve the proficiency of dental hygienists as medical professionals.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.187-197
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• 2011

Temporomandibular disorders(TMD) is a collective term which is embracing a number of clinical problems that involve the masticatory musculature, the TMJ and associated structures, or both. Myofascial pain, which is a kind of masticatory muscle disorder of TMD, is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. There has been some controversies regarding etiologies of TMD and MFP. Especially the issue of occlusal conditions has been a critical issue for long time. Despite much efforts, the results of studies regarding occlusal conditions were contradictory. These controversies might be mostly due to various factors resulting from the complex nature of TMD, however, inaccurate and inappropriate study design, selection criteria, methodologies also play significant roles. Recently, a computerized occlusal analysis system, T-Scan II which made it possible to reveal quantifiable time data and relative force data for analyzing occlusion, was introduced. Some authorities suggested that the concept of disclusion time and prolonged disclusion time of posterior tooth and MFP are related using T-Scan II. But the previous studies which used T-SCAN II are not reliable for they did not provide accurate diagnostic criteria of MFP. Morever they did not compare with controls, and had many other problems. The purpose of this study was to evaluate the relationship between MFP and prolonged disclusion time of posterior tooth, which is one of the occlusal factors of TMD, by selecting 30 subjects as the study group through strict criteria and comparing them with 38 controls using T-SCAN II, computerized occlusal analysis system. The results, statistically analyzed, are summarized as follows: 1. Cronbach ${\alpha}$ coefficient of repeated measurements of disclusion time was 0.92. 2. There were no statistically significant differences at repeated measured disclusion time of both side between control and study group. 3. There was no statistically significant diffefence in the disclusion time between right and left side. From the results above, we can suggest that there was no relationship between MFP and disclusion time, so irreversible treatments leading to the reduction of disclusion time for treating MFP would not be appropriate. However more controlled, large scaled study, which consider various occlusal factors, and quantification of symptoms using Helkimo index would be necessary in the future.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.354-364
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• 2016

To evaluate the oral health status and to assess the resultant dental treatment needs in adolescents, 2,062 adolescents aged 14-17 years attending middle and high schools in Yangsan were surveyed by clinical examination and questionnaires. The obtained results were as follows. In the dental caries examination based on WHO criteria, the treatment needs of 66.7% of the subjects were determined. Assessment of dental erosion by the VEDE system indicated the treatment needs in 27.8% of the subjects, while MIH examination based on EAPD criteria indicated the treatment needs in 14.7%. Assessment of malocclusion using the occlusal index showed good occlusion in 67.8%, no need for treatment in 19.7%, slight need for treatment in 6.8%, definite need for treatment in 4.5%, and worst occlusion in 1.1% of the subjects, showing 12.5% of average treatment need. The prevalence and treatment need for periodontal disease was found to be 71.2% by CPITN assessments. The assessment of temporomandibular disorders by Helkimo's anamnestic index showed no symptoms in 67.1%, mild symptoms in 13.4%, and severe symptoms in 19.5% of the examinees. The overall treatment need of TMD was 20.6%. Periodontal diseases were ranked the highest in treatment need, followed by dental caries, dental erosion, MIH, TMD, and malocclusion in order. The results of this study indicated the overall status of adolescents'oral health and dental treatment needs. These might hopefully provide fundamental data and contribute to establishing promotional projects for adolescent oral health in Korea.

• Journal of Oral Medicine and Pain
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• v.37 no.3
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• pp.169-182
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• 2012

This study was designed to evaluate the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into three group; saline injection group(n=10), lidocaine injection group(n=10) and morphine injection group(n=10). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 10min, 30min, 60min and then it was analyzed statistically. The results were as follows : 1. The subjective pain evaluation and the objective pain evaluation were significantly different statistically in within subject effects(p<0.001). 2. The subjective pain drawing evaluation(p<0.001) were significantly different statistically in between subject effects. 3. The objective pressure pain threshold evaluation(p=0.025) were significantly different statistically in between subject effects. 4. The morphine injection group(p=0.001) were more significantly different than the saline injection group statistically in the subject pain drawing evaluation. Therefore, it was considered that the morphine injection was effective to pain control for masticatory muscle pain patients within 60 minute.

• Journal of Oral Medicine and Pain
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• v.36 no.4
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• pp.261-271
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• 2011

Osteoarthritis in patients with temporomandibular disorders(TMDs) induces pain, limitation of mouth opening, occlusal problems, and most commonly affects their life quality. Control method and progressive process of osteoarthritis are being extensively researched. The researchers focus on histologic changes, synovial changes, muscular and ligamental changes and observed reaction to pain. Therefore most of them developed the animal model for osteoarthritis in TMD patients. In this study, we applied several methods which induces osteoarthritis of temporomandibular joint(TMJ) in rats or mice. For locally induce osteoarthritis in TMJ, Monosodium iodoacetate(MIA) or interleukin-$1{\alpha}$(IL-$1{\alpha}$) were injected into TMJ joint space for 5 or 3 weeks. Other groups are chosen for osteoarthritis under systemic control including hormonal changes and aging. To observe cellular change, increased collagen, degenerative bony destruction and distribution of proteoglycans (PGs), safranin-O staining and Masson's trichrome staining were used.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.441-447
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• 2007

Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

• Journal of Oral Medicine and Pain
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• v.25 no.1
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• pp.99-108
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• 2000

This study was performed to investigate the effect of suboccipital stretch on the head and neck posture and the electromyographic(EMG) activity of some cervical muscles. For this study, 39 patients with temporomandibular disorders(TMD) and 34 dental students without any signs and symptoms in the masticatory system were selected as the patients group and as the normal group, respectively. Head position by goniometer CROM$^{(R)}$(Performance attainment, St. Paul, USA), EMG activity by BioEMG$^{(R)}$(Bioresearch Inc., Milwaukee, USA), and craniocervical posture by cephaloradiography were observed in both natural head posture(NHP) and head posture with suboccipital stretch(tuck posture) abtained from slight posteroinferior finger pressure on the chin. Variables measured on the cephaloradiograph were SN angle, atlas angle, CVT angle, occiput-atlas and atlas-axis distance, and pharyngeal width. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In the sagittal plane, degree of anterior rotation of the head by suboccipital stretch was 6.3 in the patients group, and 6.2 in the normal group, respectively. So there was no significant difference between the two groups for degree of anterior rotation, but the position of the head in the patients group were more posteriorly extended than in the normal group in both NHP and tuck posture. 2. EMG activity of the stemocleidomastoideus in the patients group, and that of the upper trapezius and the sternocleidomastoideus in the normal group were increased by suboccipital stretch. The range of EMG activity, however, in these cervical muscles were 1.6 -2.3)u.V. 3. Cephalometric variables such as SN angle, atlas angle, CVT angle, occiput-atlas and atlas-axis distance except pharyngeal width were generally increased by suboccipital stretch. There was some difference, however, in results between the two groups. Atlas angle was not changed in the patients group whereas CVT angle was not changed in the normal group. 4. The distance from subocciput to spinous process of axis was significantly increased as much as 3.0mm in the patients group, and 3.7mm in the normal group by suboccipital stretch.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.421-437
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• 1999

This study was performed to investigate the electromyographic(EMG) activity, firing time and sequence of the mandibular elevator muscle on gum chewing. For this study, 28 patients with temporomandibular disorders(TMD), especially internal derangement of TM joint, and 16 dental students without any signs and symptoms in the masticatory system were selected as the patients group and as the normal group, respectively. The patients group was composed of 14 right and 14 left side affected patients. For recording of EMG activity(${\mu}V$) of the anterior temporalis(TA) and the masseter muscle(MM), and measuring of firing time(millisecond) from the start of mandibular opening movement to the firing of the muscles, BioEMG, BioEGN, and Combo program integrated in the Biopak system(Bioresearch Inc., Milwaukee, USA) were used. Gum chewing stroke was performed in both right and left side for several times, and the first and the second chewing strokes were analysed and compared with regard to EMG activity, firing time, firing sequence, correlation between EMG activity and firing time. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In the patients group, chewing on the affected side showed higher EMG activities in the masseter of the side than those of the contralateral side, but chewing on the unaffected side showed higher EMG activity in the masseter and in the anterior temporalis of the side than those of the contralateral side. 2. There were no difference of firing time between both sides on chewing on the affected side, but firing time in the chewing side were earlier than that of contralateral side on chewing on the unaffected side in patients group. 3. In the normal group, EMG activities in the masseter and in the anterior temporalis in the chewing side were always higher than those of the contralateral side, and there were no difference of firing time between the two sides. 4. In general, firing sequence of four muscles of both sides were ipsilateral TA, ipsilateral MM, contralateral TA, and contralateral MM in earlier order of time in both groups. Correlation coefficients between EMG activity and firing time were negative value, and more significant correlation were appeared in the normal group than in the patients group.