• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.81-96
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• 1993

In order to evaluate the prognosis of conservative treatment for Craniomandibular Disorders, 127 patients were subjected at the Dept. of Oral Medicine, Pusan National University Hospital from 1983 through 1991. All the changes of patients' symptoms and related factors were analyzed before treatment, after treatment and at follow-up examination by means of subjective and objective symptom indicies (Ai, AAI, SDS, Di, CDS, MCO). 1. All the indices were reduced and MCO became increased at follow-up examination (p<0.01). 2. As the duration after treatment became longer, all the indices became reduced and MCO became increased. 3. There were no significant differences in index scores according to sex and age. 4. Long-term patients showed higher index scores and lower MCO than short-term patients(p<0.01). 5. Chronic group showed higher index scores and lower MCO than acute group (p<0.05). 6. Macrotrauma group showed higher index scores and lower MCO than microtrauma group (p<0.05) 7. While muscle group showed the lowest MCO, muscle and joint group showed the highest index scores (p<0.01). 8. The long-term success rate of conservative treatment was more than 80% (p<0.01)

• Journal of Oral Medicine and Pain
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• v.15 no.1
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• pp.61-68
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• 1991

The author studied the changes of subjective, objective symptoms and muscle activities with EM2 (myo-tronics Co., Seattle, USA) before and after MRA therapy. The 11 patients were treated with MRA and active range of motion, pain and mouth opening limitation were checked at each visit for 6-8 weeks. Electromyographic activities were measured in both anterior lobe of temporalis and middle fibers of masseter at the position in rest, clenching and mastication. The obtained results were as follows : 1. There were significant decrease in pain and mouth opening limitation and significant increase in active range of motion after MRA therapy. 2. The muscle activities tended to decrease in general, especially in the temporal and masseter muscles on clenching and in the masseter on mastication after MRA therapy. 3. There were no significant differences in muscle activities between affected and unaffected side, but there was significant differences in temporal muscle on clenching side after therapy. 4. There were no significant differences in active range of motion, pain and mouth opening limitation between acute and chronic groups. 5. There was more significant decrease in muscle activities of the affected side in acute group than those in chronic group.

• Journal of Oral Medicine and Pain
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• v.19 no.2
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• pp.111-123
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• 1994

저자는 1990년부터 1993년 사이에 부산대학병원 구강내과에 내원하여 두 개하악장애로 진단되어 보존적 치료를 시행받은 884명의 환자를 대상으로 Solberg의 악관절장애조사 설문지를 작성케한 후, 성, 연령, 병력기간, 진단명, SCL-90-R, 치료에 대한 반응에 따라 환자군을 세분하여 각 환자군의 설문지 문항별 응답양태 및 이에 따른 예후예측을 분석한 바 다음과 같은 결론을 얻었다. 1. 악기능 및 예후악화요인 문항에서는 여성이 높은 응답수를 보인 반면, 기여요인 및 습관문항에 서는 남성이 높은 응답수를 나타내었다. 2. 고령층의 환자에서 행동 및 예후악화요인이 두드러졌다. 3. 만성군이 급성군에 비해 전 문항에서 높은 응답수를 나타내었다. 4. 혼합군 및 근육장애혼자가 관절장애환자에 비해 설문지 전 문항에서 많은 응답을 하였다. 5. SCL-90-R에서 비정상인 환자가 정상군의 환자에 비해 악기능을 제외한 전 문항에서 높은 응답수를 보였다. 6. 치료에 무반응인 환자가 성공한 환자에 비해 습관요인 문항을 제외한 설문지 전체에서 많은 응답을 하였다.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.31-43
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• 1993

To evaluate the correlationship between sign/symptoms of craniomandibular disorder(CMD) and possible contributing occlusal factors, the author analyzed craniomandibular index(CMI), clinical dysfunction index(CDI) and occlusal index(Oi) obtained from 88 subjects (32 males, 56 females, mean age 28.7) consisted of 49 CMD patients(15 males, 34 females, mean age 28.7) and 39 non-CMD patients (17 males, 22 females, mean age 24.5). The obtained results were as follows : 1. There was very high significant correlation bebween CMI and CDI in total subjects (r=0.83, p<0.01) 2. There was very low correlation between working-side interference and TMJ noise which was observed as a statistically significant value(p<0.05). And also there ws very low correlation between nonworking side interference and muscle tenderness, CDI, dysfunction index(DI), palpation index(PI) which were observed as statistically significant value (p<0.01) 3. There was very low correlation between as ymmetry of tetruded contact position(RCP)-intercuspal position(ICP) slide and muscle tenderness, TMJ tenderness, TMJ noise, CMI, DI, PI which were observed as statistically significant values(p<0.05) 4. In general there was low correlation between Oi and muscle tenderness, CDI, CMI, DI, PI which were observed as statistically significant values (p,0.05). But Oi had a relatively higher correlation with muscle tenderness, PI than whith CDI, DI.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.29-41
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• 1993

A prevalence study was carried out on 847 CMD patients who had visited the Department of Oral Medicine in Pusan National University from 1990 to 1993. To obtain the same type of information, all subjects were interviewed and examined clinically using a standardized examination form, The ratio of women to men was about 3:1 and all subjects were divided into acute and chronic groups on the basis of 6 months of duration. Diagnostic groups consisted of muscle disorder, joint disorder and muscle-joint disorder. As related to gender, duration and diagnosis subjective and objective symptoms in CMD were studied. The obtained results were as follows : 1. Muscle-joint disorder had the highest percent, followed by muscle disorder and joint disorder. 2. The most common reasons for CMD treatment were pain, joint noise and limited opening, while headache and neckache were relatively often reported as associated symptoms and dizziness, ringing in the ears also reported as secondary CNS excitatory effects. 3. Pain was more ofter seen in women, acute group and muscle-related disorder groups (p<0.05, p<0.01). Noise was significantly frequent in chronic group and joint-related groups (p<0.01). 4. Analysis of contributing factors presented that macrotrauma was found frequently in men (p<0.05), and that muscle-related groups were more related to stress than joint disorder grop (p<0.05). 5. Hard end feel was seen significantly often in joint-related disorder group (p<0.05). On the other hand, soft end feel was frequent in muscle disorder. 6. Reciprocal clicks and crepitation increased with chronicity. Subjects with joint-related disorder groups significantly often reported all kinds of noises (p<0.01). 7. Tender muscles and joints were more often reported in women and chronic group. Whereas muscle-related disorder groups revealed significantly more tender muscles (p<0.01). joint-related disorder groups presented significantly more tender joints (p<0.01).

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.477-487
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• 1995

The purpose of this study was to assess the thermographic differences of craniomandibular area between normal individual and patients with craniomandibular disorders and to compare the differences between clinical and thermographical assessment. The author had used 50 subjects as materials for this study, which was divided into 2 groups (first group included 15 healthy subjects and second group included 35 patients) with craiomandibular disorders; 17 subjects had normal disc-condyle relationship, 13 subjects had disc displacement with reduction and 5 subjects had disc displacement without reduction. Agema 870 thermovision(D.I.T.I.) was used to take thermographs with $0.1^{\circ}C$ difference of gradual temperature shift. The results were as follows : 1. Of 34 patients with craniofacial pain, 15(44%) subjects showed hyperthermia on the pain site in the thermography, 8(23.5%)exhibited hyperthermia on the site opposed to the pain site, and 11(32.4%) did not show any significant thermal change. One patient without craniofacial pain showed hyperthermia on the site opposed to the site of disc displacement without reductin. 2. Of 35 patients with craniofacial pain or disc displacement, 24(68.6%) subjects showed a significant thermal difference between symptomatic and asymptomatic sides of the face, but 11(31.4%) did not show any difference. 3. Of 17 patients with pain but with normal disc-condyle relationship, 8(47.1 subjects showed hyperthermia on the pain site, 4(23.5%) showed on the site opposed to the pain site, and 5(29.4%) did not show any significant thermal change. 4. Or 13 patients with pain and disc displacement with reduction, 6(46.2%) subjects showed hyperthermia on the pain site, 3(23.1%) showed on the site opposed to the pain site, and 4(30.8%) did not show any significant thermal change. 5. 15 healthy subjects did not show any thermal differences between the both sides of the face.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.37-49
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• 1992

80 patients who presented at Wonkwang University Dental Hospital with craniomandibular disorders were collected for this study. To observe the occlusal contact pattern such as contact numbers, contact force and presence or absence of anterior occlusal contact, the author used T-Scan system (Tekscan, Inc, U.S.A.) with are computerized occlusal analysing system. And to study the correlation between craniofacial profile and occlusal contact pattern, cephalogram were also taken, The cephalometric items related to growth pattern, jaw bone relation and denture pattern were measured and analysed according to routine method by computerized program. The obtained data were statistically processed with SPSS/PC+ package about anterior contact pattern and its craniofacial relationship. The obtained results were as follows : 1. In terms of growth pattern, patients without anterior tooth contacts showed a tendency to downward growth of craniofacial profile. The value in this subjects were significantly different from the value of patients with anterior tooth contacts in items of low gonial angle, Jarabak ratio, SN to GoMe angle, FMA, occlusal plane to mandibular plane angle and ramus height. 2. In terms of jaw bone relationship, patients without anterior tooth contacts showed a tendency to backward growth of craniofacial profile. The value of this patients were significantly different from the value of patients with anterior tooth contacts in items of SNB, ANB, mandibular plane to anterior cranial base ratio, SNPo, NAPo and APDI items. 3. But in denture pattern, no statistically significant difference by the presence or absence of anterior tooth contacts were showed between this patients groups. 4. From this study, it could be proposed that anterior open bite in the patients with craniomandibular disorders would be originated from not dental discrepancy but skeletal discrepancy.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.63-73
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• 1992

This study was performed for the purpose of investigating the relation between width of temporomandibular joint space and craniofacial morphology in patients with CMDs. The subjects utilized here were aged from 16 to 63 years old and 19 male and 46 female. For the study, each patient was taken radiographs by Transcranial and Lateral Cephalographic projection and the films were traced with routine method. The measured items were anterior, superior, posterior joint space and relative condylar position to the deepest part of glenoid fossa in Transcranial film and items related vertical and/or horizontal growth in Cephalogram. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows : 1. Anterior joint space in affected side were wider than that of unaffected side, but for superior and posterior joint space, the value of unaffected side were more than those of affected side. 2. Superior or posterior joint space of affected side were significantly correlated with items related vertical growth, such as ramus height, Jarabak ratio, FMA. From this, the following cold be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed growth pattern of counter clockwise. 3. Superior or posterior joint space of affected side were significantly correlated with items related horizontal growth, such as SNPo, NAPo, APDI and ANB. From this the following could be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed anterior displacement of mandible. 4. It would be proposed that the diagnositic value of superior and posterior joint space of affected side in transcranial radiograph was excellent.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.291-304
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• 1994

The purpose of this study was to analyze the facial asymmetry of the patients with the craniomandibular disorder. In this study, 50 patients, who have joint clicking and pain, mouth opening limitation, and 40 dental students, Chosun University, who did not posses any restoration and orthodontic treatment, joint clicking and pain, mouth opening limitation, were selected as the control group. Both the control group and the patient group were takened skull P-A, submento-vertex radiogram by standized methods. After that, the deviation and facial asymmetry were measured and analyzed. The results of the this study were as follows: 1. In the Skull P-A radiogram, the width difference of control group and patient group measured that the △ Cg-Go-Cl: control group were 3.35㎜, patient group were 4.51㎜ (P<0.05), the △Cg-Zy-Go: control group were 1.83㎜, patient group were 3.27㎜(P<0.001). 2. In the Skull P-A radiogram, the height difference of control group and patient group measured that the △ Cg-Go-Cl: control group were 131.85㎜, patient group were 188.45㎜(P<0.05), the △Cg-Zy-Go: control group were 1.58㎜, patient group were 2.68㎜(P<0.00l). 3. In the Skull P-A radiogram, the area difference of control group and patient group measured that the △ Cg-Go-Cl: control group were 120.76㎟, patient group were 185.49㎟(P<0.05), the △Cg-Zy-Go: control group were 2.29㎟, patient group were 3.37㎟(p<0.05). 4. In the submento-vertex radiogram, the width difference of control group and patient group measured that the △Mr-Cl-Ia: control group were 1.50㎜, patient group were 2.35㎜(P<0.05), the △Mr-Cm-Ia: control group were 1.75㎜, patient group were 3.17㎜(P<0.05), the △Mr-Go-Ia: control group were 1.96㎜, patient group were 3.24㎜(P<0.001), the △Mr-Cp-Co: control group were 1.74㎜, patient group were 2.73㎜(P<0.05). 5. In the submento-vertex radiogram, the height difference of control group and patient group measured that the △Mr-Cp-Ia: control group were 1.68㎜, patient group were 2.46㎜P<0.05), the △Mr-CI-Ia: control group were 2.38㎜, patient group were 3.74㎜(P<0.05), the △Mr-Co-Ia: control group were 1.63㎜, patient group were 2.80㎜(P<0.05), the △Mr-Cm-Ia: control group were 1.45㎜, patient group were 3.12㎜(P<0.001). 6. In the submento-vertex radiogram, the area difference of control group and patient group measured that the △ Mr-Cp-Ia: control group were 73.17㎟, patient group were 110.16㎟(P<0.05), the △Mr-Cl-Ia: control group were 105.09㎟, patient group were 180.87㎟(P<0.001), the △Mr-Co-Ia: control group were 103.31㎟, patient group were 148.48㎟(P<0.05), the △Mr-Cm-Ia: control group were 97.01㎟, patient group were 167.83㎟(P<0.05), the △Mr-Go-Ia: control group were 104.24㎟, patient group were 205.90㎟(P<0.05).

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.67-78
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• 1996

This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.