• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.69-77
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• 2006

Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.1-11
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• 2007

Purpose: The purpose of this study was to determine the effect of continuous wave ultrasound and pulsed wave ultrasound that influence changes in pain and range of motion when applied to patients with temporomandibular joint disability. Methods: The subjects of the study were 40 selected patients who had been diagnosed with temporomandibular joint movement restriction and had endured pain for more than two weeks. These patients had visited K orthopedic surgery in Deagu measured from October 1, 2004 to March 31, 2005. The subjects were divided into two groups with 20 patients each. The one group was applied to continuous wave ultrasound and the other group was applied to pulsed wave ultrasound at a dosage of 1.5 W/$cm^2$ for a duration of 5 minutes and eight times for two weeks. The pain perception degree were measured by using Visual Analogue Scale(VAS) and the range of motion was measured by using a rule for each group. Results: The results obtained were as follows The change in the pain perception degree were statistically significant in both group(p<0.05) ; however, the continuous wave ultrasound group showed more difference in the average decrease in the pain perception degree than did the pulsed wave ultrasound group. Both groups showed significant results regarding changed in the range of motion(p<0.05) ; Comparing the difference in the average of the range of motion between the two groups, came back from normal the range of motion of temporomandibular joint at the both groups. Conclusion : Based on the results of this study, we found that both groups showed decreased pain and increased the range of motion, but the continuous wave ultrasound method had a higher therapy effect pain and the range of motion than the pulsed wave ultrasound method to patients with temporomandibular joint disability. With such finding, we expect that according to ultrasound therapy applicant method can be helped usable accurately to patients with variety symptoms temporomandibular joint disability.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.39-46
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• 2013

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.133-141
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• 2009

We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.439-447
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• 2019

The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.315-321
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• 2022

Objectives: Although the number of clinics offering temporomandibular joint (TMJ) physical therapy has been increasing to help with its treatment, the scope of dental physiotherapy reflected in the dental hygienist curriculum is very limited. This study aims to survey the status of dental physiotherapy work and the need for educating dental hygienists. Methods: An online community platform was used to survey 140 dental hygienists working in clinical dental hospitals. The survey included questions about general characteristics, the experience of dental physiotherapy work, the importance of physiotherapy work performance, and the need for physical therapy education for dental hygienists. Results: Half of the study participants had prior experience working in dental physiotherapy. Out of 140 participants, 88.6% agreed with the opinion that 'physical therapy work is important or that it will become important'. Furthermore, 84.3% agreed that 'physical therapy education is necessary for dental hygienists'. Even dental hygienists without physical therapy experience (50.7%) believed that related education would be necessary because of the importance of physical therapy work in dentistry. Conclusions: This study suggests the need for education in dental physiotherapy to help dental hygienists effectively perform clinical tasks.

• Journal of Oral Medicine and Pain
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• v.23 no.1
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• pp.21-36
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• 1998

The purpose of this study was analyse the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified patients with internal derangement of the temporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandibular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandibular movements, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group. The results were as follows : 1. Pain was more frequently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle's classifications had not significant correlations between the experimental groups. 2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experiment groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was no significant difference in the range of the maximum lateral movement between toward affected side and toward unaffected side. 3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to control group. There was no significant difference in maximum opening velocity and maximum velocity of Terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other. 4. In the frontal plane of the MKG, the frequency of complex deviation type(F-2)pattern was significantly increased in the anterior disc displacement with out reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type(S-1)was decreased in the same group. 5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3)in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement with out reduction group, but the frequency of no-peak type (OV-3)was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group. Compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.63-79
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• 2009

While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.