• Title/Summary/Keyword: 악관절

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ORAL REHABILITATION OF UNSTABLE OCCLUSION DUE TO SEVERELY DESTRUCTED FIRST PERMANENT MOLARS (제1대구치의 광범위 치관파괴로 인한 불안정한 교합의 재건)

  • Baik, Byeong-Ju;Lee, Sun-Young;Kim, Jae-Gon;Jeon, So-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.204-209
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    • 2003
  • A 9-year old boy visited Department of Pediatric dentistry, Chonbuk National University Hospital due to unstable occlusion. He had permanent 1st molars destructed severely by dental caries and lost vertical stop. He could not occlude in the same position on closing of the jaw since he could not find his centric occlusion. The treatment plan was made, which was oral rehabilitation with crown restorations on permanent 1st molars based on clinical and radiographic examinations and centric relation of the jaw. Treatment plan consisted of endodontic treatment, crown lengthening and restoration of the occlusal vertical dimension (OVD) with gold crown by 3mm-increase of OVD. After endodontic and periodontal treatments, temporary crowns made of acrylic resin were set for assessment of tolerance to an increased OVD. After a month for tolerance, final prosthetics were made and set temporarily. In a month, gold crowns were set finally. Immediately after setting, the patient showed anterior open bite, but at the appointment after 4 months, he showed normal overjet, overbite and stable occlusion.

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Improvement of Articulation Disorder Using Flexible Partial Denture in Intellectural Disability Patient with Missing Lower Incisors (하악 전치부 상실로 인한 조음장애를 보이는 경도 지적장애 환아에서 탄성의치를 통한 조음능력의 향상)

  • Choi, Haein;Choi, Byungjai;Choi, Hyungjun;Song, Jeseon;Lee, Jaeho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.306-313
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    • 2013
  • Speech is complex psycho-physiological mutual process which includes many orofacial organs. Especially, teeth play an especially important role as an articulation organ in conjunction with the lips and tongue. When teeth are missing, the position of tongue and mandible is adjusted to produce correct sound. If a patient's adaptive function is inadequate for modification of malocclusion, prosthodontic and orthodontic interventions are necessary. Missing teeth of young patients should be reconstructed bacause it can cause malocclusion, decreased masticatory efficiency, articulation disorders, esthetic problem, and temporomandibular disorder. Valplast$^{(R)}$(Valplast International Corp, New York, USA) flexible denture is useful for rehabilitation due to its excellent physical properties, esthetics, and small volume. This case is regardingan intellecturally disabled patient with anarticulation disorder caused by missing lower incisors due to trauma. The patient showed improvement in articulation by using flexible partial denture. The purpose of this report is to figure out the influence of missing lower anterior teeth on articulation.

Personality Type Test(MBTI) of Korean College Students with Symptoms of Temporomandibular Disorders (측두하악장애증상자의 성격유형검사(MBTI))

  • Park, Hye-Sook
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.25-37
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    • 2011
  • The purpose of this study is to investigate the relationship between personality type and symptoms and contributing factors of temporomandibular disorders. 199 college students completed the MBTI(Myers-Briggs Type Indicator) and a questionnaire and collected data were analyzed by SAS 9.2 program. The obtained results were as follows : 1. The prevalence of symptoms of temporomandibular disorders and mean scales of positive answers of contributing factors appeared to be higher in I type, S type, T type, P type than in E type, N type, F type, J type. 2. ISTP and ISFP among 16 types of personality seemed to have higher prevalence of symptoms and contributing factors of temporomandibular disorders than other types of personality. 3. Symptom of TMJ pain during mouth opening seemed to occur more frequently in I type, S type, F type, J type than in E type, N type, T type, P type. 4. Contributing factors including clenching and stressful state occurred significantly more frequently in I type than E type. Gum chewing habit occurred significantly more frequently in E type than in I type. 5. Unilateral chewing habit occurred significantly more frequently in J type than in P type. 6. Nervous or sensitive persons had significantly higher mean scales of positive answers of subjective symptoms than relaxed or general persons. 7. General persons had significantly lower mean scales of positive answers of contributing factors than nervous, sensitive and relaxed persons. In conclusion, these results show that there is the relationship between personality and temporomandibular disorders and patient education and counselling considering personality type may contribute to treating patients with temporomandibular disorders.

A COMPARATIVE STUDY ONMAGNETIC RESONANCE IMAGE AND SECTOGRAPH OF HUMAN TNJ (악관절의 자기공명영상과 시상단층 방사선촬영상에 관한 비교연구)

  • Lee, Sung-Bok;Choi, Dae-Gyun;Choi, Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.2
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    • pp.249-270
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    • 1993
  • For understanding of anatomy, physiology, and diseases of human TMJ, it is required to evaluate quantitatively the movement of the disc and condyle head of mandible. The histologic section of cadaver TMJ were examined, and the magnification of the MR image and its details of anatomy were evaluated. And then a quantitative analytic method, by comparing the Sectograph and the MR image of vital human TMJ, was proposed. For this study, 15 subjects(Male, 24~35years) were selected from a prosthodontic examination randomly, and each subject’s five interocclusal rubber registration records were made on the ICP, and 5, 10, 15, and 20mmjaw opening positions. All subjects were radiographed with a Denar Quint Sectograph Image System(Denar Corp., USA), and imaged with a MRP-20EX MR Image System(0.2T, Permanent Magnet Type, Hitachi Medical Corp., Japan) using an 100mm diameter bilateral type surface coil. These images were traced on the acetate tracing paper, and analyzed In this study, the findings led to the following conclusions. 1. In comparison of the histologic section of autopsy specimen with the MR image at the same section, the size(dimension) of MR image was 70% of the real one. It was possible to recognize the shape of articular disc, anterior and posterior attachments, and adjacent soft tissues, because of the excellent reproducibility of anatomical structure. 2. When we compared the amount of joint space on MR image with that of joint space on sectograph, the amount of joint space on sectograph was significantly greater than that of joint space on MR image, except at the top of condylar head. 3. The position of minimum joint space on sectograph at intercuspal position didn't coincide with the middle position of articular disc on MR image, and was approximately in the anterior third of posterior band of articular disc. 4. The amount of condylar movement on MR image at opening movement was greater than that of articular disc movement. From Intercuspal position to 5mm jaw-opening movement, the condylar movement showed hinge one, and over the range 5mm jaw-opening it suggested hinge & translatory one. 5. In terms of area variation of articular disc measured on MR image in sagittal plane, the area of posterior band increased with increasing the amount of Jaw opening, but the area of anterior band decreased conversely.

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RADIOGRAPHIC ANALYSIS OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증 X선사진분석에 관한 연구)

  • You Dong Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.14 no.1
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    • pp.141-152
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    • 1984
  • The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36.90%(217 case), sclerosis 34.18% (20 cases), errosive chang 25.85% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent(36.90%), of which frequency was signifiantly higher than forward positioning (11.22%) and backward positioning(4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restricted movement of condylar head within articular fossa was most frequent(35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erossive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33.33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of normal positioning, forward positioning and downward positioning of condylar head was 38.38%, 36.96% and 44.64% respectively. 4. Bone changes of condylar head was 47.11%, articular eminence 41.50% and articular fossa 11.39% respectively. This revealed that the frequencies of bone changes. were higher in the projected portion of bony structures of temporomandibular joint than their depressed portions. On the otherhand, in the bone changes of condylar head, deformity was 59.57% which was the most frequent. In the bone changes of articular eminence and articular fossa, however, sclersis was 41.39% and 65.67% respectively, which was the most frequent in those portions.

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THE DEVELOPMENT OF INTERPRETATION FOR TEMPOROMANDIBULAR JOINT ROENTGENOGRAMS (악관절증 환자의 X선사진 판독법 개발에 관한 연구)

  • You Dong-Soo;Ahn Hyung-Kyu;Park Tae-Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.14 no.1
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    • pp.121-134
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    • 1984
  • The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms, duration of the diseases were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases, 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%). sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The condylar positional changes and bone changes according to the region were as follows: a) In the condylar head the most frequent bone change was erosion (30.45%) and the most frequent condylar positional change was downward position (37.40%) in closed state, restricted movement of condyle (33.2%) in open state. b) In the articular eminence the most frequent bone change was eburnation (39.91%) and the most frequent condylar positional change was downward position (39.79%) in closed state, restricted movement of condyle (27.22%) in open state. c) In the articular fossa the most frequent bone change was eburnation (53.94%) and the most frequent condylar positional change was downward position (42.57%) in closed state, restricted movement of condyle (30.32%) in open state.

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RADIOGRAPHIC STUDY OF BONE CHANGES ON TMJ ARTHROSIS (악관절증에서의 골변화양상에 관한 방사선학적 연구)

  • You Dong Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.12 no.1
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    • pp.69-80
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    • 1982
  • The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandi.bular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthorsis was eburnation of cortical bone (35. 64%) of total cases). Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed !tate, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relatioships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movenent in 332 cases (28.55%), bone on bone relation- ships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). bone on bone relationships in 243 cases (21.32%) and downward positioning of condyle in 217 cases (18.66%). 5. In the TMJ arthrosis patients with bone changes, 1249 cases of abnormal condylar position in the mouth closed state and 1163 cases of abnormal condylar position in the mouth open state could be interpreted. so, for the radiographic interpretation of TMJ arthrosis, the reading of condylar positional changes as well as that of bond changes should be performed and their interrelations should be profoundly considered.

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Evaluation of Tightness of Proximal tooth Contact on Implant Prostheses (임프란트 보철수복물에서의 인접치간 접촉강도의 평가)

  • Kim, Sang-Pil;Jung, J-Hyun;Kang, Dong-Wan;Oh, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.371-379
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    • 2008
  • The aim of this study was to evaluate the tightness of proximal tooth contact(TPTC) using a novel device at rest state on implant prostheses. Ten healthy young adults with class I normal occlusion consented to participate in the study and twenty patients were restored with a total 20 single-implant crowns in the left maxillary and mandibular second molars for 10 single-implant crowns, respectively. Test area were divided by 4 groups. UM describes the contact between the upper natural left first molar and natural second molar; LM the contact between the lower natural left first molar and natural second molar; IUM the contact between the upper natural left first molar and implant second molar and ILM the contact between the lower natural left first molar and implant second molar. The TPTC was measured at rest state in each area. The mean TPTC of the UM, LM, IUM and ILM was 1.48(${\pm}0.44$) N, 1.78(${\pm}0.40$) N, 1.14(${\pm}0.37$) N and 1.30(${\pm}0.32$) N respectively. These results indicate that the TPTC was less between natural tooth and implant prosthesis than between natural teeth.

Full Mouth Rehabilitation with a Overlay Denture (피개의치를 이용한 지적장애인의 완전구강회복)

  • Ko, Kyung-Ho;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.385-395
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    • 2012
  • This clinical report presents the case using overlay dentures to treat a patient with cleft lip and palate and malocclusion. This patient requires vigorous treatment such as orthodontic treatment and combined orthodontic/oral surgery procedures. Overlay denture can be used as an alternative treatment option. Intraoral and radiographic examinations were done. The vertical dimension of occlusion was evaluated for proper prosthetic procedures and the surveying in the diagnostic cast was done. Considering the tissue and teeth undercut, the alterations of teeth shape were done. Final preparation and impression was performed. After the evaluation of vertical dimension and occlusion with wax-denture, the dentures were polymerized. Clinical remounting and occlusal adjustment were done on the articulator. Overlay dentures were delivered and the patient was recalled for relining. The overlay dentures satisfied patient's esthetic and functional requirements and provided a stable occlusion. Overlay dentures in this case were a reversible and relatively inexpensive treatment for this patient, however the potential possibilities of caries and periodontal disease as a result of poor oral hygiene should be prevented with periodic recall.

Full mouth rehabilitation of a partially edentulous patient with crossed occlusion using implant-retained RPD with zirconia occlusal table (엇갈린 교합을 가진 부분 무치악 환자에서 지르코니아 교합면을 가지는 Implant-Retained RPD 이용한 전악 수복 증례)

  • Kwon, Tae-Min;Seo, Chi-Won;Kim, Kyung-A;Ahn, Seung-Geun;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.314-321
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    • 2016
  • Conventional removable partial dentures (RPDs) with distal extensions are associated with some problems, including lack of stability that calls for frequent relining, and cantilever actions of claps that can produce excessive loading to abutment teeth, and the need for unesthetic retentive arm clasps. Therefore, IARPDs (Implant-assisted RPD) that use implants to support or retain RPDs has been reported to improve stability, esthetics and masticatory performance of RPDs. Also, an IARPD that has zirconia occlusal table can prevent the incongruity of occlusal plane and the extrusion of antagonistic tooth. In this case of partially edentulous patient with crossed occlusion, each edentulous area was restored with implant fixed prosthesis and implant retained partial denture to suit each situation. Through the procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.