• Journal of Korean society of Dental Hygiene
• /
• v.17 no.4
• /
• pp.601-611
• /
• 2017

Objectives: The purpose of this study is to identify the perceived symptoms of oral and temporomandibular joint disorders in adults and to analyze the factors affecting subjective symptoms of temporomandibular joint disorders. Methods: 249 adults over 20 years old who had subjective symptoms of temporomandibular joint disorders were surveyed and analyzed. Independent t-test and ANOVA test were used to examine the relationship between oral habits and temporomandibular joint disorder according to general characteristics. $Scheff{\acute{e}}$ test was used for post-hoc analysis. Multiple regression analysis was conducted to examine the factors affecting oral habits and temporomandibular joint disorder. Results: First, the factors affecting oral and habitual behaviors were married (p<0.05) and monthly income between 1 million~1.9 million won (p<0.001), higher temporomandibular joint disorder (p<0.01) And the degree of habit was increased. Second, the factors affecting temporomandibular joint disorder were increased in occupation (p<0.05) and the degree of oral habit (p<0.01). Conclusions: In conclusion, it was confirmed that oral habit influences temporomandibular joint disorder. Especially, it is suggested that prevention and promotion of temporomandibular joint disorder are needed to recognize the removal of oral habits.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.2
• /
• pp.134-137
• /
• 2017

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

• Journal of Oral Medicine and Pain
• /
• v.34 no.3
• /
• pp.303-316
• /
• 2009

This study was designed to evaluate the Temporomandibular Disorders(TMD) with Tension-Type Headache(TTH) by gender. Patients with TMD and/or TTH visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study. Experimental group(n=60) is composed of TMD with TTH and control group(n=111) is composed of TMD without TTH. Evaluation list was pain quality, pain intensity, pain laterality, pain increase by routine physical activity and then it was analyzed statistically. The results were as follows ; 1. In the control group, pain quality was significantly different by gender(p=0.04). But, in the experimental group, pain quality was not significantly different by gender. 2. In the control group, pain intensity was not significantly different by gender. And, in the experimental group, pain intensity was not significantly different by gender. 3. In the control group, pain laterality was not significantly different by gender. And, in the experimental group, pain laterality was not significantly different by gender. 4. In the control group, pain increase by routine physical activity was not significantly different by gender. And, in the experimental group, pain increase by routine physical activity was not significantly different by gender. Therefore, it is considered that not temporomandibular disorder patients with tension-type headache but temporomandibular disorder patients without tension-type headache was influenced by gender in the pain quality.

• Journal of Oral Medicine and Pain
• /
• v.36 no.1
• /
• pp.39-51
• /
• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.4
• /
• pp.225-231
• /
• 2021

There are many studies on the indications and efficacy of splint therapy commonly used in patients with temporomandibular disorders (TMD). However, there have been no studies on the splint weaning in terms of the splint use tapering period in relation to symptom improvement of TMD. This retrospective study aims to analyze a proper splint weaning method in patients with TMD based on symptom improvement. Materials and Methods: The authors examined 130 TMD patients with TMJ disorders, masticatory muscle disorders, and clenching/bruxism who had received splint therapy (occlusion stabilization splint, anterior positioning splint) of patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital from 2015 to 2020. They were evaluated according to the method to wean splints. Results: The mean splint therapy period was 29.0 months, during which patients wore splints 7 days a week for 8.4 months, 3 - 4 days a week for 9.5 months, and finally 1 - 2 days a week for 11.1 months (a total of 29.0 months, about 2.5 years). Conclusion: It seems that TMD symptoms can be alleviated and side effects such as occlusal change can be minimized if patients wear a splint 7 days a week for the first 6 months, followed by 3 - 4 days a week for the next 6 to 18 months, and finally 1 - 2 days a week after 18 months.

• Journal of Oral Medicine and Pain
• /
• v.34 no.3
• /
• pp.325-331
• /
• 2009

The objective of this study was to describe the prevalence of the headache attributed to Temporomandibular disorder(TMD) symptoms and to investigate the relationships of headache and TMD. 66 patients seeking care for signs and symptoms of Temporomandibular disorders(TMD) and Orofacial pain in the department of oral medicine, Dental Hospital, Chosun University, from January, 2008 to June, 2008, were recruited. The obtained results were as follows : 1. A muscle and TMJ origin combined was the most common in study populations(54.55%), grouped as TMD classification. 2. Tension type headache was the most common in study population(89.39%), grouped as headache classification. 3. 36 patients out of 66(54.55%) had headaches which related to TMD. 4. Out of 36 patients who had suffered the headache which were attributed to TMD, 19 patients(52.78%) described that their headache related to TMD was different from their own primary headaches. In conclusion, headache attributed to TMD is relatively common in the patients who had headaches and TMD symptoms together. And the new headache patterns may related to headache and TMD chronification. Larger-scale studies and more specified and controlled comparison study is needed to confirm the relationship between the headache and TMD.

• Journal of Yeungnam Medical Science
• /
• v.13 no.2
• /
• pp.308-323
• /
• 1996

This study tried to find the prevalence and distribution of temporo-mandibulr disorders(TMD) for workers (employee) in Seoul area to investigate the correlation between TMD and possible etiological factors such as general muscle and joint symptoms, headache, unilateral chewing and parafunction. This study was an epidemiological investigation of answers obtained from 282 persons by questionaire from Aug. 1995 to Nov. 1995. The major findings from the questionaire were as follows. (1) 43.26% of the subjects(282 persons) has TMD. (41.88% of man and 43.26% of women) (2) The more often people have general muscle and joint symptoms and headache, the more susceptible they are to TMD. Their correlation was very significant(p<0.001). (3) The more people have bad oral habits such as bruxism, clenching and biting habit, the more likely they have TMD. The more sensitive people are to stress, the more frequently they have bad oral habits such as bruxism, clenching and biting habit. (4) Unilateral chewing has higher TMD index than bilateral chewing. There is no relationship between ache areas and TMD index.

• Journal of Oral Medicine and Pain
• /
• v.41 no.1
• /
• pp.30-33
• /
• 2016

Malignant tumors located in the head and neck areas intermittently show symptoms similar to a temporomandibular disorder (TMD). In our case, a patient who first visited us complaining of TMD-like symptoms, such as trismus and temporomandibular joint (TMJ) pain on the left side, was identified as a sufferer of adenoid cystic carcinoma (ACC) that arose from the left maxillary sinus. The patient may have a TMD symptom, but we are skeptical because the patient also complained of a spontaneously developed numbness on the same side of his upper lip. We observed the panoramic radiograph closely and found the blurred maxillary sinus inferior wall. Dental cone-beam computed tomography confirmed the tentative diagnosis of malignancy on the maxillary sinus. After he had been referred to the Department of Otolaryngology, the diagnosis of the ACC was confirmed. Adequate diagnosis is vital for a quick treatment of the malignancy. There are some keys for differential diagnosis of TMD-like symptoms.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.6
• /
• pp.337-356
• /
• 2020

This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

• The Journal of the Korean dental association
• /
• v.58 no.6
• /
• pp.364-376
• /
• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.