Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.
A retrospective study was conducted to determine the patterns of Temporomandibular Disorder(TMD) among adolescents (12-19 years) over last ten years. 174 patients who had visited the Oral medicine of Pusan National University Dental Hospital in 2000 and 491 patients in 2008 were found on chart review. The results obtained were as follows : 1. The number of adolescent patients was significantly increased in 2008 than in 2000, especially in male. 2. Bruxing, clenching, holding habits and bad sleep hygiene were highly increased more in 2008 than in 2000. 3. Osteoarthritis was significantly increased in 2008 than in 2000 and anterior disc dislocation without reduction was slightly increased. 4. The ratio of male to female adolescent patients with osteoarthritis was remarkably increased. Among the patients who had holding, bruxing, clenching habits, significantly increased osteoarthritis found to be common. This could imply holding, bruxing, clenching habits are prominently associated with increasing risk of developing osteoarthritis.
This study is conducted to confirm a correlation between psychological health and self-rated oral health on. 3,591 people aged from 19 to 55 were studied through the Korean National Health and Nutrition Survey. Self-rated oral health risk in relation to psychological health and 95% confidence interval are calculated through multi-variate regression analysis, and the results were as in the following. Self-rated oral health OR was the most when subjects had felt stressed. Toothache experience, OR was the most when subjects had suffered depression more than 2-weeks straight. In terms of mastication problem, OR was the most when subjects had had psychological consultation experience. In terms of TMJ symptom experience, OR was the most when subjects had suffered depression more than 2-weeks straight. In terms of talk problem, OR level was particularly high when subjects had had psychological consultation experience. Therefore, daily stress, depressed conditions, and psychological consultation experience have a correlation with self-rated oral health. developing a oral health promotion program considering psychological health would help those two domains.
Cho, Young Eun;Leesungbok, Richard;Lee, Suk Won;Choi, Joseph June Sirk
The Journal of Korean Academy of Prosthodontics
/
v.60
no.3
/
pp.263-275
/
2022
The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.3
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pp.327-336
/
2011
Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.27
no.3
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pp.239-249
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2001
The purpose of this study is to evaluate the relationship of the factors which could be influenced by orthognathic surgery especillay SSRO. We measured the amounts of the maximum opening, lateral movements, maximum velocity and pattern of mandibular path during the opening and closing of mandible at the following times ; preoperative, 1 month after operation, 6 months after operation respectively using MKG. And the results were compared according to the categorized subgroups. Following results were obtained : 1. The change of the amounts of mandibular lateral movement and maximum opening velocity were statistically different between male and female (p<0.05), but the others were not. 2. According to the method of operation, there was no difference in the change of the mandibular movements between the group of SSRO and SSRO plus LeFort I osteotomy (p>0.05). 3. According to the amounts of mandibular movement, the recovery of left lateral movement of the group of $6{\sim}10mm$ was better than the other groups (p<0.05). 4. In the frontal pattern of the opening and closing of the mandible, the complex deflected type (F5), simple deflected type (F4), complex deviated type (F3), simple deviated type (F2), straight type (F1) were obtained in order at the time of preoperative, simple deflected type, simple deviated type, complex deviated type, straight type, complex deflected type in order at the time of 1 month after surgery, and the result at the time of 6 months after surgery was the same with that of the time of preoperative. In the sagittal pattern, non-coincident type (S2) was predominant at the time of preoperative, and coincident type (S1) was predominant at the time of 1 month after surgery. After 6 months, the result was also the same with that of the preoperative in sagittal pattern. 5. There was not a statistical difference in the change of the mandibular movement between group of presence of the preoperative TMJ symptoms and non-presence group (p>0.05). 6. There was not a statistical difference in the change of the mandibular movement between repositioning device applied group and non-applied group (p>0.05). 7. Sixty three percents of the patients who had preoperative TMJ symptoms were improved after surgery and preoperative TMJ symptoms were more improved after operation in the repositioning device non-applied group statistically (p<0.05).
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.19
no.1
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pp.7-18
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1989
The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.
Objectives : Therapeutic effect of Balance Appliance of functional crebrospinal technique (FCST for meridian and neurologic yinyang balance was observed in two refractory torticollis cases. Methods : A unidentified severe torticollis two cases with several months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after $3{\sim}5$ months of therapy, which effect was reported to maintain for 6 months. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.
Journal of the korean academy of Pediatric Dentistry
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v.30
no.2
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pp.204-209
/
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.
This study was undertaken to investigate the distribution of the chewing side preference and variations in the maximum bite force and facial morphology according to chewing side preference since unilateral chewing may cause morphologic and functional anomalies. 50 dental students who had no signs or symptoms of masticatory system and Angle's Class I relationship in posterior segments were selected, and divided into two groups, that is, 25 in bilateral chewing group(19 male and 6 female) and 25 in unilateral chewing group(10 male and 15 female). Maximum bite force was estimated ana posteroanterior cephalogram were measured ana statistically analyzed. The results were as follows : 1. Their were more students with bilateral chewing side preference($68\%$) and unilateral chewing side group consisted of right side preference($68\%$) and left side preference($32\%$). 2. There was no significant difference in the strength of max. bite force between the right and left side in bilateral chewing group. The bite force of the chewing side nab greater in the unilateral chewing group but less in the non-chewing side compared to those of bilateral chewing group with Bo significant difference. Max. bite force of chewing side was greater than that of non-chewing side in the unilateral chewing group(Female p<0.05). Max. bite force of males was about twice in that of females in both groups(p<0.05). Max. bite force of chewing side of the unilateral chewing group was similar to that of the bilateral chewing group, but that of non-chewing side was less than that of the bilateral chewing group. 3. In comparison of the facial morphology, there was no statistically significant difference in the size between the right and left side of the bilateral chewing group and between chewing and non-chewing side of the unilateral chewing group.
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