개구장애 환자의 병인, 감별진단 및 치료방식에 대한 임상연구

CLINICAL STUDY ON THE ETIOLOGY, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF TRISMUS

  • 강희제 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 황대석 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김용덕 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 신상훈 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김욱규 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김종렬 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치과대학 구강악안면외과학교실)
  • Kang, Hee-Jea (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Hwang, Dae-Seok (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Kim, Yong-Deok (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Shin, Sang-Hun (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Kim, Uk-Kyu (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Kim, Jong-Ryoul (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Chung, In-Kyo (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University)
  • 발행 : 2006.12.31

초록

Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture, and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.

키워드

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