• Title/Summary/Keyword: 관절강

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DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법)

  • Chung, Hoon;Jung, Hak;Kino, Koji
    • 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.

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A case of oral rehabilitation using implant fixed prosthesis (skeletal class III malocclusion patient) (골격성 III급 부정교합을 가진 환자에서 임플란트 지지 고정성 보철을 이용한 구강회복 증례)

  • Minjung Kang;Minji Sun;Hong Seok Moon;Jong-Eun Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.125-134
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    • 2023
  • When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient's occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient's chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

Efficacy of Fluoroscopy-Guided Lumbar Facet Joint Synovial Cyst Rupture with Intra-Articular Steroid Injection after Laminectomy (척추 후궁절제술 이후 발생한 요추 후관절 활액낭에서 투시유도 하 낭종파열술 및 관절 내 스테로이드 주입술의 임상적 경험)

  • Hyo Jin Kim;Eugene Lee;Joon Woo Lee;Yusuhn Kang;Joong Mo Ahn
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.162-172
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    • 2021
  • Purpose We retrospectively evaluated the technical success rate and long-term efficacy of fluoroscopy-guided synovial cyst rupture followed by an intra-articular steroid injection at the post-laminectomy lumbar facet. Materials and Methods We selected subjects who had undergone a fluoroscopy-guided synovial cyst rupture with simultaneous intra-articular steroid injection within 6 months of MRI and demonstrated a symptomatic facet joint synovial cyst at the level of a previous lumbar laminectomy. Fourteen patients were enrolled, and we determined whether cyst rupture and symptom improvement were achieved after each procedure. The degrees of symptom improvement were categorized into 4: 1) symptoms improved (30% or more reduction, based on pre-procedural and post-procedural Numerical Pain Rating Scale scores), 2) symptoms not improved, 3) patient underwent surgery after injection, and 4) loss of follow-up. Results The success rate of percutaneous synovial cyst rupture decreased with repeated procedures (62.5% for the first procedure and 0% to 33.3% for additional procedures). However, 80% of the patients had symptom improvement with the procedures, overall. The surgery rate was 14.3% in 14 patients. Conclusion For patients with post-laminectomy symptomatic lumbar facet joint synovial cysts, fluoroscopy-guided synovial cyst rupture with intra-articular steroid injection may be an effective and less invasive treatment before considering a surgical approach.

Effect of mechanical surface treatment on the fracture resistance and interfacial bonding failure of Y-TZP zirconia (Y-TZP zirconia의 기계적 표면처리가 파절저항과 접착계면 실패에 미치는 영향)

  • Yi, Yang-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.102-111
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    • 2014
  • Purpose: Surface damage and bonding strength difference after micromechanical treatment of zirconia surface are to be studied yet. The aim of this study was to evaluate the difference of fracture resistance and bonding strength between more surface-damaged group from higher air-blasting particle size and pressure, and less damaged group. Materials and Methods: Disk shape zirconia ($LAVA^{TM}$) was sintered and air-blasted with $30{\mu}m$ particle size (Cojet), under 2.8 bar for 15 seconds, $110{\mu}m$ particle size (Rocatec), under 2.8 bar for 15 seconds, and $110{\mu}m$ particle size (Rocatec), under 3.8 bar for 30 seconds respectively. Biaxial flexure test and bonding failure load test were performed serially (n = 10 per group). For bonding test, specimens were bonded on the base material having similar modulus of elasticity of dentin with $200{\mu}m$-thick resin cement for tension of surface damage. Failure load of bonding was detected with acoustic emission (AE) sensor. Results: There were no significant differences both in the biaxial flexure test and bonding failure load test between groups (P > 0.05). Sub-surface cracks were all radial cracks except for two specimens. Conclusion: Within the limitations of no aging under monotonic load test, surface damage from higher air-blasting particle size and pressure was not significant. Evaluations of failure load with bonded zirconia disks was clinically relevant modality for surface damage and bonding strength, simultaneously.

High Grade Surface Osteosarcoma - Case Report - (고등급 표면(High Grade Surface) 골육종 - 증례 보고 -)

  • Lee, Bong-Jin;Lee, Sung-Rak;Yoo, Tae-Yeul;Eom, Ki-Seong;Ha, Chang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.32-37
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    • 2002
  • High grade surface osteosarcoma is the most rare subtype of osteosarcoma arising on the surface of bone, accounting for less than 1% of the total number of osteosarcomas. Only a few case reports and studies have been reported in the world. In Korea, only one case out of 127 osteosarcomas has been described up to now, but there was no information about the patient, clinicopathologic features and treatment. We experienced a case of high grade surface osteosarcoma in the subtrochanteric area of a 66-year-old female and treated her with neoadjuvant chemotheraphy, wide resection and limb salvage operation with tumor prosthesis and adjuvant chemotheraphy. This tumor is identical to conventional high grade intramedullary osteosarcoma in histology, treatment and prognosis. So, this tumor should be differentiated from other surface osteosarcomas such as parosteal osteosarcoma and periosteal osteosarcoma.

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Prosthetic rehabilitation for patient with hemi-maxillectomy: Obturator combined with a hybrid telescopic double crown using friction pin (편측 절제된 상악골 환자에서 하이브리드 텔레스코픽 이중관 의치를 이용한 구강 폐색기 수복 증례)

  • Seo, Jeong-Gyo;Cho, Jin-Hyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.317-323
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    • 2018
  • When oral cancer develops in the maxilla, oro-nasal communication occurs after surgical treatment including removal of the primary site. Restoration through an obturator is necessary to prevent food from storing due to non-oral opening, and to ensure proper pronunciation and aesthetic restoration. In this case, the patient was treated with right hemi-maxillectomy due to oral cancer and has residual abutment and poor periodontal support due to the effect of head and neck radiotherapy. The obturator was treated with a hybrid telescopic double crown denture. Reporting a successful prognosis in 18 months of follow-up.

Factors Influencing Aquatic Exercise Adherence of Patients with Arthritis (만성관절염 환자의 수중운동 지속에 영향을 미치는 요인)

  • Kang, Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.3
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    • pp.350-359
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    • 2008
  • Purpose: The purpose of this study was to identify change in the exercise behavior and to identify factors influencing long-term adherence to aquatic exercise in patients with arthritis as a follow-up study after five years. Method: Baseline data had been collected using a structured interview 6 months after participants completed the aquatic exercise educational program. This second follow-up data collection included 133 participants from the original baseline study and was done 5 years after the original baseline study. Data was analyzed using SPSS 16 Win program. Results: The stage of change for the participants was as follows: Precontemplation (44.3%), Contemplation (24.1%), Preparation (3.0%), Action (0%) and Maintenance (adherence, 28.6%). The adherers (N=38) had significantly higher scores than non-adherers (N=91) in self-efficacy, outcome expectancy, group coherence and self-evaluation, and significantly lower scores in barriers to exercise. In logistic regression analysis, self-efficacy, group cohesion, barriers to exercise and self-evaluation were associated with exercise adherence (Chi Square=17.14, p=.002). Group cohesion (OR=2.5871, 95% CI=1.094-6.113, p= .030) was the most important factor. Conclusion: Self-efficacy, group cohesion, barriers to exercise and self-evaluation need to be considered in planning exercise programs to improve exercise adherence.

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Effect of Bee Venom-acupuncture on Patients with Osteoarthritis of Knee Joint (퇴행성슬관절염(退行性膝關節炎)의 봉약침(蜂藥鍼) 치료(治療) 효과(效果))

  • An, Byeong-Jun;Kim, Kyung-Tae;Kang, Mi-Suk;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.15-20
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    • 2006
  • Objectives : This study was to evaluate the effect of Bee venom-Acupuncture on knee joint with osteoarthritis. Methods : We investigated 30 cases of patients with osteoarthritis of knee joint. We flip a coin and divide into two groups. Bee venom-acupuncture was performed at one group, and the other group didn't do it. We evaluated the treatment effect of each group by using the WOMAC score. Results : 1. As a result of evaluation by using the WOMAC, the score after treatment was marked higher than that before treatment within each group. 2. After treatment, Bee venom-Acupuncture group showed significant difference on WOMAC score compared with acupuncture group. Conclusion : These results suggested that Bee venom-Acupuncture treatment should be more effective in the patient with osteoarthritis of knee joint.

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A Clinical Study of Bee Venom Acupuncture Therapy on Chronic Arthritis of Ankle (만성(慢性) 족관절(足關節) 염좌(捻挫)에 대한 봉약침(蜂藥鍼) 요법이 미치는 영향(影響))

  • Kim, Kyung-Tae;An, Byeong-Jun;Kang, Mi-Suk;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.21-26
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    • 2006
  • Objectives : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on chronic arthritis of ankle, Methods : We divided chronic arthritis of ankle patient into 2 group; one group combined bee venom acupuncture therapy and acupuncture therapy, another group was only acupuncture therapy. To estimate the efficacy of treatment that applied for two groups, we used visual analog scale(VAS). We compared the VAS score of two groups statistically. Results : 1. As a result of evaluation by using visual analog scale(VAS), treatment score at final was marked more higher than score before treatment on each groups. 2. treatment at final, acupuncture and bee venom acupuncture therapy group had significant result on visual analog scale(VAS) compared with acupuncture therapy group. Conclusion : Bee Venom acupuncture therapy can be used with acupuncture therapy for highly effective treatment for chronic arthritis of ankle.

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Multicentric Osteoid Osteoma mimiking Sclerosing Osteomyelitis -A Case Report- (경화성 골수염양 다핵성 유골 골종 - 1예 보고-)

  • Chung, Yang-Guk;Kang, Yong-Koo;Jee, Won-Hee;Lee, An-Hi;Rhee, Seung-Koo;Bahk, Won-Jong;Park, Ill-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.183-187
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    • 2005
  • The typical radiologic findings of a small radiolucent nidus with surrounding sclerosis and night pain responding to aspirin make the diagnosis of osteoid osteoma not too difficult. We report a case of multicentric osteoid osteoma with unusual clinical and imaging features which were strongly suggestive of subacute sclerosing osteomyelitis.

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