• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.211-218
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• 2007

The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.377-383
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• 1995

이 연구의 목적은 측두하악관절통에 있어서 인도메타신 포노포레시스의 동통완화효과를 평가하기 위한 것이다. 측두하악관절통을 가진 20명의 환자들이 이 연구에 참여했다. 10명은 인도메타신을 이용하여 초음파치료를 받았고 다른 10명은 순수 초음파 치료용 젤을 이용하여 초음파 치료를 받았다. 동통완화효과를 평가하기 위하여 치료전과 치료후에 유추지수와 압력통각역치를 이중맹검법으로 평가하였다. 실험결과는 다음과 같다. 인도메다신을 이용하여 초음파 치료를 받은 군은 유추지수와 압력통각역치에서 다 유의한 동통의 감소를 보였다. 반면에 대조군에서는 치료후에 유추지수와 압력통각역치에서 동통의 감소를 보였지만 통계적으로 유의하지 않았다. 이 결과는 측두하악관절통에 있어서 단순한 초음파 치료보다 포노포레시스가 더 효과적이라는 것을 의미한다.

• The korean journal of orthodontics
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• v.35 no.5 s.112
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• pp.398-407
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• 2005

The present study was conducted to examine the morphometrics and function of the disk on both sides among patients with facial asymmetry (FA) and to elucidate plausible correlations between internal derangement (ID) and FA. The sample was composed of 10 males and 27 females with FA. The disk status of all subjects was evaluated by bilateral high resolution magnetic resonance scans in the sagittal (closed and open) and coronal (closed) planes. Five types of disk displacement were identified accordingly. The disk function was diagnosed as normal disk function, disk displacement with reduction, and disk displacement without reduction. The disk shape on sagittal MRI in closed position was classified as bi-concave, biplanar, funnel/hemiconvex, and deformed. The disk position, translation and rotation were also measured. The difference between the shifted side and non-shifted side was analyzed by statistical analysis. Approximately $70\%$ of the patients in the present study showed unilateral or bilateral ID. It was found that anterior disk displacements (ADD), especially rotational ADD, occurred more frequently in the shifted side, while normal disk position was observed mainly in the non-shifted side (p<0.01). The disk of the shifted side showed significantly deformed configuration and inferior-anterior disk position. However, the disk of the non-deviated side showed hyper-mobility during jaw opening movement. These results demonstrate that in FA patients, the disks status of the shifted side is different from that of the non-shifted side, a phenomenon that could be correlated to facial asymmetry.

• Journal of Oral Medicine and Pain
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• v.25 no.3
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• pp.293-303
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• 2000

앵글씨 분류에 따른 최대개구시 하악의 수직 변위에 대한 차이를 확인하고, 수직 하악운동에 영향을 주는 골격요소를 확인하기 위하여, 측두하악관절 및 저작계 이상에 대한 증상 및 병력이 없으며 발치 및 교정치료의 경험이 없는 광주지역 대학에 재학중인 학생들을 대상으로, 앵글씨 구치부 관계에 근거하여 1급군(남:30명, 여:49명), 2급군(남:18명, 여:24명)과 3급군(남:18명, 여:33명)으로 분류하여 총 172명(연령 범주:20-30세)의 학생을 선택하였다. 전남대학교 병원 구강내과에서 사용하는 계측용자를 이용하여 최대 개구시 상하악 중절치 절단면간의 거리를 측정하였다. 대상자들의 진단모형을 만들어 상하악궁 길이와 폭경를 측정하였다. 대상자들에 대한 두부 규격방사선 사진을 촬영, 작도하고 방사선학적 지표를 계측, 비교분석하였다. 앵글씨 분류 1급군, 2급군 그리고 3급군 절치간 최대개구량은 3급군이 가장 컸으며 모든 군에서 남자가 여자보다 컸다. 구치간 최대개구량은 앵글씨 분류 1급군, 2급군 그리고 3급군에서 각 군간의 유의한 차이는 없었으나, 모든 군에서 남자가 더 컸다. 앵글씨 분류 1급군과 2급군의 하악운동에서 총 하악골 길이, 하악지 길이, 하악 하연부 길이 그리고 상악궁 폭경이 변수로 나타났으며, 상하악궁 길이와는 역상관관계를 나타내었다. 앵글씨 분류 3급군의 하악운동에서 상하악궁 길이와 안면 부길이가 1급군과 2급군과는 다른 중요한 변수로 나타났으며, 상악궁의 폭경과는 역상관관계를 나타내었다. 이상의 결과로 보아 앵글씨 분류 각 군에서 하악개구운동은 안면 골격구조의 영향을 받으며, 각 군간에 영향을 주는 안면 골격 요소들은 차이가 있었다. 따라서 이러한 골격적 요소들은 개구량 개선을 위한 진단과 치료시 고려되어야 할 것으로 사료된다.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.125-134
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• 2023

When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient's occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient's chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.275-289
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• 2013

This study was conducted to investigate and analyze the dental patients' awareness and understanding about TMDs. Among the total number of 243 patients who had visited the department of dentistry of Busan Paik Hospital, Inje University or Hanvit dental hospital in Ulsan metropolitan city and participated in the survey, 195 patients who filled in all parts of the questionnaire were selected as the subjects. The results were as follows. 1. The subjects who were aware of the term, "TMDs" were 17.4%. The group with total education period of 12 years and over was significantly more aware of "TMD"(82.4%, p<0.01) than the other group. The subjects who were aware of the term, "jaw joint disease" were 81.0%. 30 to 49 age group(45.6%, p<0.05) and the group with total education period of 12 years and over(60.1%, p<0.01) were significantly more aware of "jaw joint disease" than other groups. 2. More than half of the subjects chose "overuse of the jaws" as the concept of jaw joint disease(50.6%). 3. TV, radio(41.4%) was the most frequent source of awareness about jaw joint disease followed by family and friends(20.2%), hospitals and health professionals(18.2%), internet(15.7%) and newspapers, magazines(4.5%). Among the respondents who were aware of jaw joint disease through TV, radio, 30 to 49 age group showed significantly higher percentage(52.4%, p<0.05) than other age groups. Among the respondents who were aware of jaw joint disease through internet, 18 to 29 age group showed significantly higher percentage(61.3%, p<0.01) than other age groups. Among the respondents who were aware of jaw joint disease from hospitals and health professionals, the group with total education period of 12 years and over showed significantly higher percentage(75.0%, p<0.05) than the other group. 4. Noise during mouth opening and closing(26.9%), mouth opening difficulty(25.1%) and jaw pain(13.7%) were the most frequently responded sign and symptoms of jaw joint disease. For the causes of jaw joint disease, enjoying hard food chewing(19.5%), occlusal discrepancy(19.0%) and chewing with one side only(18.5%) were responded in sequence. TMJ surgery(28%) was the most frequently responded treatment method for jaw joint disease, followed by occlusal appliance therapy(23.9%) and physical therapy(14.6%). For preventive method of jaw joint disease, avoid eating hard food(21.1%), avoid opening mouth wide(17.0%) and simultaneous using of molar of both side when chewing food(15.4%) were chosen frequently.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.175-185
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• 2013

Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.421-427
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• 1995

두개하악장애는 저작근, 측두하악관절 및 그와 관련된 구조물의 많은 임상적인 문제를 포함하는 포괄적인 용어이다. 두개하악장애의 원인은 다양하고 종종 다인성이며 위험을 증가시키는 여러가지 소인들이 존재한다. 이갈이나 이악물기 같은 이상기능습관은 흔하며 또한 임상적으로 많은 관련이 있는 것으로 사료된다. 그러나 이전의 연구에서는 연령증가에 따른 기능적 마모를 고려한 치아교모에 관한 연구가 시행되지 않고 단순한 교모도의 평가비교만이 시행되었다. 본 연구는 법치의학적 연령감정에서 널리 사용되고 있느 치아교모도를 이용한 연령감정법을 이용하여 두개하악장애환자의 치아교모도에 관한 연구를 시행하였다. 연령은 기능적마모에 따른 정도를 평가하기 위해서 고려되었다. 단국대학교 치과병원 구강내과에서 두개하악장애로 진단된 환자18명과 대조군으로 외래환자 14명을 대상으로 하였다. 연령차는 연령감정법의 추정연령과 환자의 실제나이의 차이를 구해서 비교분석하였다. 이상의 결과로 두개하악장애환자의 중절치, 측절치, 제1소구치, 제2소구치의 치아교모도가 정상군보다 유의성 있게 높았다.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.241-250
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• 2007

We examined 104 patients(primary group, controlled group) who had visited PNUH from 1994 to 2002, having been diagnosed as temporomandibular disorders(TMDs) and treated in conservative ways such as Behavior modification, medications, physical therapies and splint therapies. We also examined 54 patients(recurred group, experimental group) who had visited PNUH from 1991 to 2001, having been diagnosed as TMDs and experienced recurrence after conservatively treated. To find out the symptoms of Recurred TMD patients and their results of conservative treatments, we compared these two groups mentioned above. The obtained results were as follows: 1. Both primary and recurred groups have showed great improvements with conservative treatments. 2. Both primary and recurred groups have showed no differences in pain, LOM, MCO in their first visits but the noise were louder in primary group. 3. Both primary and recurred groups have showed no differences in pain, LOM, MCO when the treatments were over but the noise were louder in recurred group. 4. Treatments modalities, diagnosis, sex, kind of disease had not affected the results of treatment in either of groups. 5. It has come out that much better results were achieved when the patients in primary group had treated for over 6 months and for more than 10 times.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.257-268
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• 2005

It is recently suggested in Korea that Resource-Based Relative Value Scale (RBRVS) is an alternative plan of Korean Dental Fee Schedule which has been operated on a fee-for-service basis since the introduction of the national health insurance program in 1977. RBRVS applicable to diagnosis and treatment for temporomandibular disorders (TMD), a common cause of orofacial pain, is needed to be estimated in Korea and the establishment of the standard terminology of dental procedures for TMD should be preceded. The purposes of this study were to develop a new classification system of health care service items for TMD and to investigate time needed for each item, which enables RBRVS to be estimated prior to establishment the payment system of health care services for TMD. The dental service items for TMD in this study were categorized through Delphi process which 10 TMD specialists were participated in and the time needed for each service item was investigated by work sampling and time study method with a stopwatch. The results of this study demonstrated the new classification system of dental services for TMD comprising 151 service items and exhibited the average time for each items ranging from 7.22 min for cold laser therapy to 171.71 min for direct fabrication of anterior repositioning splint. Conclusively, it is suggested that the classification system for TMD developed in this study, considering specific characteristics on basis of resources for health care service of dental procedures, should be helpful to estimate payment level for each service item.