• Journal of Dental Rehabilitation and Applied Science
• /
• v.31 no.3
• /
• pp.262-272
• /
• 2015

Loss of molar support and abnormal jaw relationship lead to occlusal disharmony and cause pathologic signs. Full mouth rehabilitations with reestablishment of occlusal schemes are needed. In this case, the 75 year-old female patient showed posterior bite collapse, irregular occlusal plane and Class II jaw relationship. By observing her profile and interocclusal distance, she was diagnosed as loss of occlusal vertical dimension. Treatment plan is to restore maxillay class I removable partial denture and mandibular fixed prosthesis and to establish vertical dimension and harmonious occlusal plane. Occlusal vertical dimension of 19 mm, which is obtained by 7.5 mm increase between maxillary right lateral incisor and mandibular canine, was established using temporary prosthesis via diagnostic wax-up. Patient adaptation with newly formed vertical dimension was verified during 8 week follow-up period. Within the information of interim prostheses, final restoration was constructed and delivered. The patient showed sound occlusal scheme and esthetic profile.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.4
• /
• pp.426-433
• /
• 2013

When restoring edentulous patients with lower complete denture, the smaller supportive and retentive area of mandible can lead to poor support and stability, denture dislodgement and pain resulting discomfort. In this situation, implant prosthesis can improve esthetics, stability and occlusal force. Whereas, patients with a upper complete denture can adjust more easier because of palate. Therefore, it is suggested to rehabilitate fully edentulous patients with lower implant-supported, upper complete denture as one of the treatment options. So, we are going to report the case and literature review about how the lower implant prosthesis opposing to upper complete denture affects the bone resorption of maxillary residual ridge.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.3
• /
• pp.300-304
• /
• 1991

This is case report of open reduction of condylar fractures with or without discal injury. Many articles described open reduction and internal fixation of condylar fractures emphasize the method of bony reduction and fixation without mention of the position of the disc. So we like to present our cases of open reduction of condylar fractures in conjunction with reconstruction of the disc and associated structures. The pupose of this presentation is to emphasize several well - established principles of trauma management and management of temporomandibular joint injuries, such as 1) in situations of traumatic injury, anatomic restoration is the goal of treatment and, 2) anatomic alignment of the TMJ disc over the condyle is preferable to disc subluxation because the latter may lead to chronic pain, limitation of opening and degenerative arthritis. Although our case is small with short term follow up, we believe that open reduction and internal fixation of condylar fractures in conjunction with disc repair is a biologically sound approach to those fractures indicated for open surgery. Long term follow up will allow better judge the validity of this treatment approach to us.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.1
• /
• pp.43-50
• /
• 2000

The purpose of this study was to investigate the interrelationship between temporomandibular joint disorders, and the condyle size and angle of the posterior slope of the articular eminence. The subjects used in this study were 100 patients with temporomandibular joint disorders and 100 volunteers with normal temporomandibular joints. All the patients and the volunteers were subjected to take panoramic and temporomandibular radiographs for the morphologic evaluation. The films were traced, measured, and analyzed. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows; 1. The posterior slope of the articular eminence in the group of temporomandibular joint disorders was larger than that in the normal group (p<0.05). The mean articular eminence angle was $31.6^{\circ}\;{\pm}\;6.3$ in the group of temporomandibular joint disorder, and $29.9^{\circ}\;{\pm}\;8.4$ in the normal group. 2. There were no statistically significant differences in the discrepancies of the left and right articular eminence angular measurements between the group (p>0.05). 3. There were no statistically significant differences in the condylar ratio between the groups (p>0.05). 4. There were no statistically significant differences in the discrepancies of the left and right ramus length measurements between the groups (p>0.05). 5. The relative size of condyle to fossa in the group of temporomandibular disorders was smaller than that in the normal group (p<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.1
• /
• pp.1-7
• /
• 2009

Purpose: The purpose of this study is to investigate the therapeutic use of Hepatocyte growth factor(Adv.CMV.HGF) in temporomandibular joint disc defect. Materials and methods: Twelve New Zealand white rabbits, weighing 2.5 - 3.0 kg, were used in this experiment. Defects(2 mm in diameter) were created in their TMJ discs. Recombinant Adv.CMV.HGF with gelatin sponge($Gelfoam^{(R)}$) as carrier was implanted in the defects. We divided the rabbits into four batches according to the duration of the implantation - of 1, 4, 8, 12 weeks - and both left and right TMJ of each rabbit in all groups were used in the research : left joints were used as experiment group and right were control group. Each batch of rabbits was killed one, four, eight and twelve weeks after the experimentation respectively, and called Group A, B, C, and D. (Group A = 1 wk, B = 4 wks, C = 8 wks, and D = 12 wks) Results: The experimental group showed a significant increase in the number of chondroblasts and active cell differentiation at the margin of the defects. Compared to the control group, in the experiment group chondroblasts increased and chondrocytes showed a columnar arrangement, which is witnessed at the time of cell differentiation. Conclusion: This study supports the case that Avd.CMV.HGF may be useful in the repair of articular disc of the rabbit TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.5
• /
• pp.375-380
• /
• 2009

Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.11 no.1
• /
• pp.23-32
• /
• 1981

The purpose of this study was to assess temporomandibular joint subluxation by means of cephalometry using two lateral cephalograms from each person with in centric occlusion and wide-open mouth position, and to compare patient group with subluxation to normal control group in the measurements and correlation coefficient. The 200 cephalograms of 100 Korean adults, patient group consisted of 24 females and 26 males ranged from 17 to 63 years age and the normal control group consisted of 20 females and 30 males ranged from 18 to 56 years age, were studied and analyzed statistically. The results were as follows; 1. In the comparison of patient group vs normal control group in the measurements, statistically significant differences were found in C-C', C'-PTM, K-FH, K-PTM, Gn-Gn', C-S-C', Gn-S-Gn', Gn-K-Gn', GoGn-SN, and GoGn-Go'Gn'. K-point* of patient group was located antero - superiorly than of normal control group, and the significance level was higher in K-PTM than in K-FH. There was no statistically significant difference found in local relationship of C-point between patient group and normal control group. The values of correlation coefficient among all measurements were in 0.958≥r≥-0.760, and the highest value was in Gn-Gn' to GoGn-Go'Gn' and Gn-K-Gn' to Gn-Gn', and the lowest value was in C'-PTM to Gn-K-Gn' of normal control group. K was determined as a point of intersection by a perpendicular bisector of Gn-Gn' and a perpendicular bisector of C-C'.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.11 no.1
• /
• pp.79-87
• /
• 1981

The author analysed the interrelation between the morphologic changes of bone Structures and the position of condylar head from the routine radiographs of 134 cases of the temporomandibular joint arthrosis. The frequencies of coincidence between the site of bone defrmity and condylar head positional change were examined. Also, the positional changes of condylar head and the direction of condylar movement in relation to the kind of bone deformities were observed. The results obtained were as follows; 1. In 52.65 per cent of total cases, the site, of positional change of condylar head was coincided with the site of bone deformans. The frequencies of the coincidence between these in the five items among seven items examined were above 53 per cent. From the results, it seems that the positional changes of condylar head were related with the morphological change of bone structure. 2. Eburnation and erosion. revealed frequently positional changes in the opening and closing position of the mouth, although in the early stages of the TMJ arthrosis. 3. In the bone deformans, during opene position of the mough 44.81 per cent of total cases revealed backword movement and 37.74 per cent showed forward movement. In closed position of the mouth, downward movement was revealed in 35.23 per cent of total cases and upward movement 28.41 per ,cent of total cases. 4. In the cases showing eburnation, the frequencies of coincidence between the site of positional change and bone deformans were 58.57 per cent of the total cases. that means it was high in the early stages of the TMJ arthrosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.1
• /
• pp.35-42
• /
• 2003

Purpose: This study was aimed to investigate the relationship between the mandibular asymmetry and the internal derangement of temporomandibular joint. Materials and methods: One hundred and sixty eight patients had been assessed through clinical examinations, panoramic radiographs and magnetic resonance imagings (MRIs), were selected. The samples were classified into three subgroups according to the severity of the mandibular asymmetries in the panoramic radiographs and the status of TMJ discs on the MRI were compared among each groups. Results: In an apparent asymmetry group, there was a significant difference in the number of temporomandibular disk displacement without reduction between the long and short side (66.7%, 18/27 joints on the short side) when the ratio of condylar process and coronoid process was used (p<0.05), but there was no statistically significant difference when the ratio of condyle and ramus was used. Conclusion: The probability of the disc displacement without reduction was higher at the side with relatively shorter condylar process on the panoramic radiograph, and also it might be more effective to use ratio of condylar process and coronoid process in the assessment of mandibular asymmetry. Therefore, a careful assessment on the temporomandibular disorders is necessary to diagnose and establish the treatment plans for the patients with a mandibular asymmetry and the panoramic radiograph can be used effectively on that way.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.16 no.2
• /
• pp.123-132
• /
• 2000

The field of maxillofacial prosthetics is concerned with the prosthetic reconstruction of missing head and neck tissue. Currently, facial prostheses are usually applied in cases of defects caused by the surgical removal of tumors or congenital defects. While silicone has been most widely used for the reconstruction of missing maxillofacial defects, it does not have ideal physical properties. Therefore, bonding a thin polyurethane sheet to silicone prostheses was recommended. In this case skin adhesives were used for the retention of maxillofacial prostheses. But retention of devices has always been problematic. The contributions of implants can be made to solve these problems. Implants have reduced the need for adhesive use, simplifying cleaning procedures and thus extending the life of the prostheses. For implant-retained prostheses, retentive matrix is necessary to hold attachments and/or magnets. The retentive matrix is usually fabricated with autopolymerizing acrylic resin or visible light- polymerized resin. The purpose of this study was to compare the adhesion-in-peel force of silicone adhesive to autopolymerizing acrylic resin and polyurethane sheet with two different surface textures : pumice polish only or retention groove, and three surface primers : Dow corning 1205 primer or Dow corning S-2260 primer or FactorII A-304 primer, and two polymerization methods : room temperature or dry heat oven. The t-peel bond strength of specimens was determined as described in ASTM Standard D1876-72. The results were statistically analyzed using the ANOVA test, multiple range test and t-test The results were as follows. 1. The t-peel bond strength of A-304 primer was the highest and statistically higher than that of S-2260(p<0.05). 2. The t-peel bond strength of specimens with retention groove was statistically higher than that of specimens polished with pumice(p<0.05). 3. The t-peel bond strength of specimens polymerized in dry heat oven was statistically higher than that of specimens in room temperature(p<0.01).