• Title/Summary/Keyword: 악관절 장애

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Epidemiologic Study on the Patients Visited to Dept of Oral Medicine -In the Area of Choongnam- (구강내과 내원환자에 관한 역학조사 -충남지역에 대한-)

  • Lee, Dong-Ju;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.101-111
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    • 2006
  • Temporomandibular disorders (TMD) is a collective term embrassing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both. The prevalence of signs and symptoms associated with TMD can be best appreciated by examining epidemiologic studies. But domestic epidemiologic studies about sex, history, chief complaint, diagnosis were not sufficient comparing with foreign countries. The results obtained as follow. 1. The number of visiting patients were 6500 and mean age was 34.06 year (Male's mean age was 33.15, Female's 34.62). In the age of patients, there was no significant difference between sex. 2. There are most patients who were referred by dentist (80.07%). Most diagnostic group was arthrogenous TMD group and followed by myogenous TMD, soft tissue disease. 3. There was strong interaction between diagnostic groups and chief complaint. 4. There was little pain difference between right and left sides. Male mainly had pain onset under 6 month, but female had pain onset more than 6 month. 5. The number of patients who had joint sound history were 3445 (53.15%). There was no significant difference of pain onset between sex. Clicking sound was most among joint sounds which happened to patients. 6. In analyzing the parafunctional habit, male mainly had bruxism, but female had clenching habit.

Occlusal Adjustment

  • Kim, Yeong-Gu
    • The Journal of the Korean dental association
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    • v.25 no.10 s.221
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    • pp.927-930
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    • 1987
  • 하기 내용은 네델란드 Amsterdam치대의 Hansson교수와 스웨덴 Karolinska의 Riise교수의 ‘악관절 기능장애환자의 진단 및 처치’에 관한 course work의 내용중 일부이며 최근에 유럽제국에서는 시술이 간편하여 임상가에게 널리 이용되는 방법중에 하나이다. 현금에는 TMJ를 전공하는 학자들도 그 분야의 광범위성에 비추어 전공을 세분화하는 경향이 있어 Dr. Hansson은 splint therapy에 의한 muscle activity를 Dr. Riise는 occlusal adjustment를 주로 연구하고 있다.

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EVALUATION OF INTERNAL DERANGEMENT OF TMJ BY ANALYZING TMJ SOUNDS (측두하악관절잡음을 이용한 악관절내장증 진단)

  • Kim, Tae-Woo;Yang, Won-Sik;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.26 no.4
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    • pp.423-439
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    • 1996
  • The purpose of this study was to evaluate the diagnostic value of $SONOPAK^*$ in internal derangement of TMJ by comparing the spectral analysis data of TMJ sounds recorded by SONOPAK with the results of MRI. From the patients who came to Department of Orthodontics, Seoul National University Dental Hospital for treatment of malocclusion, eighteen adult patients (five males and thirteen females) with TMD symptoms were selected. After joint sounds were checked by a pediatric stethoscope, they were recorded and analyzed by the SONOPAK. The spectral analysis of the SONOPAK provided SONOPAK INTERPRETATION data about the stage of internal derangement, which were compared with the results of MRI. Among the patients whose disc positions were diagnosed as 'normar by MRI, there were no false positive diagnosis by the SONOPAK INTERPRETATION, But in the cases of anterior disc displacements (reducible and/or nonreducible), most of SONOPAK INTERPRETATION data did not coincide with MRI results. In conclusion, it is not adequate to try to differentiate reducible and non-reducible anterior disc displacements on the basis of joint sounds. And it is recommended not to determine the stage of internal derangement according to the nature of sounds. We suggest that the diagnostic value of the SONOPAK will be enhanced when clinicians combine some other informations such as clinical signs/symptoms and other supplementary diagnostic tools), and that more data be incoporated into the SONOPAK INTERPRETATION software.

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Vibration Analysis of the Temporomandibular Joint Sounds (측두하악 관절잡음의 진동 분석)

  • Jeong, Da-Un;Jeong, Jae-Hyeon;Gang, Dong-Wan
    • The Journal of the Korean dental association
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    • v.46 no.4
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    • pp.232-242
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    • 2008
  • 관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral>300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절 잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰 되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.

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Skeletal Factors Related to Open Lock of the Temporomandibular Joint (측두하악관절의 개구성 과두걸림 환자의 골격적 특성에 관한 연구)

  • Nam, Ji-Na;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.267-274
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    • 2013
  • This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

The Reliability of the Conventional Tomographic Interpretation for the Patients with Temporomandibular Disorders (턱관절장애환자의 일반단층촬영 판독에 대한 신뢰도)

  • Kim, Sung-Won;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.291-300
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    • 2001
  • 본 연구는 측두하악관절장애의 증상이 있는 악관절의 통상적인 방사선 단층촬영술에 대한 해석과 관절강 측정에 대한 조사자내, 조사자간 신뢰도를 조사하였다. 신뢰도 검사는 조사자들 간에 판독의 일관성이 있는지와 일정 시간이 지난 후 반복 측정 시 판독의 정확성이 있는지를 알아보기 위하여 시행하였다. 조사자내 상관계수는 과두 형태에 대해서는 각각 0.812와 0.619, 골변화 형태에 대해서는 모두1.00, 골변화에 대해서는 0.846과 0.991, 전방관절강에 대해서는 0.919와 0.966, 상방관절강에 대해서는 0.864와 0.955, 그리고 후방관절강에 대해서는 0.718과 0.672였다. 통상적인 방사선 단층촬영술이 신뢰도가 있음을 보여주는 이 연구의 결과로 보아, 측두하악 관절을 평가하는데 있어서 통상적인 방사선 단층촬영술은 높은 진단학적 정확성과 조사자간 일치성을 가진다고 할 수 있다.

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Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.