Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.
Seo, Min-Gyung;Chi, Seung-Seok;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
The Journal of Korean Academy of Prosthodontics
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v.60
no.4
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pp.420-430
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2022
Open bite is accompanied by decrease in tooth contact and overbite, and causes collapse of occlusal plane, mastication difficulties, speech disorders, changes in appearance, and lower occlusal force than normal. Open bite caused by temporomandibular joint disorder in adults with complete occlusion must be corrected after removal or stabilization of the causative factors. Orthodontic treatment, occlusal adjustment, prosthetic treatment, and surgical treatment can be the option of occlusal correction. This report describes about estimating the cause of occlusion change in two patients who developed an open bite due to mandibular displacement in adults with complete occlusion and different treatment approaches accordingly. In one patient, satisfactory result was obtained in functional and esthetic aspects through occlusal adjustment after stabilization of the temporomandibular joint.
Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.
The Journal of Korea Institute of Information, Electronics, and Communication Technology
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v.8
no.5
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pp.359-366
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2015
TMJ(TemporoMandibular Joint) is considered as the most important articulation in human body for maintaining the balance. Thus it is one of the main treatment areas in Chiropractic. Instead of Chiropractic treatment, NOSICK, a TMJ balancing device, can be used. As there is no such device to quantify the effect of NOSICK, a system was developed to measure the effect of NOSICK. This system is composed of stereo vision, infrared lights, and infrared through filter, etc. It requires optical markers for the measurement. 8 land markers were selected from the face which will show different displacement as NOSICK is applied. 11 test subjects were measured with the system developed with and without NOSICK applied. Quantifiable displacement of markers before and after applying NOSICK was successfully measured with the system developed.
The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.
In this study, the objective masticatory efficiency of two groups of temporomandibular disorder patients, pain and sound groups, was compared with that in a normal group using the MAI (mixing ability Index). The subjective chewing ability was evaluated using questionnaires, such as the Food Intake Ability Index (FIA) and Visual Analogue Scale (VAS). The Oral Health Impact Profile (OHIP)-49K of the patients was also examined to measure the oral health-related quality of life. The results were as follows: 1. The MAI, FIA and VAS in the pain group were significantly lower than in the normal and sound groups. This shows that the chewing efficiency of the pain group was lower than the normal and sound groups (P<0.05). However, there was no significant difference between the sound and normal groups. 2. The OHIP-49K for the oral health-related quality of life showed a significant increase in both the pain and sound groups compared with normal group. This means that the oral health-related quality of life was lower in both the pain and sound groups. 3. There was a correlation between the MAI, FIA and VAS (P<0.01) in all subjects (71 persons). The OHIP-49K was associated with the FIA and VAS. 4. There was a correlation between the FIA and VAS (P<0.05) in the sound group but no correlation in the other groups. 5. There was a correlation between the FIA and VAS in all groups. 6. The VAS was increased significantly in the pain group according to the level of pain reduction after treatment (P<0.05). However, there was no significant increase in the MAI, even though there was an improvement in masticatory efficiency. In addition, there was no difference in the FIA and OHIP-49K according to the level of pain reduction after treatment. In this study, it is believed that pain is a main factor decreasing the masticatory efficiency in patients with temporomandibular disorders. Moreover, TMJ sounds decrease the quality of life but do not decrease the masticatory efficiency. Therefore, it is important to control the pain in order to improve the masticatory efficiency in temporomandibular disorder patients. Moreover, managing both pain and sound can improve the quality of life.
In order to evaluate the effect of conservative treatment for Temporomandibular Disorders(TMD), 137 patients were subjected at the Department of Oral Medicine, Pusan National University Dental Hospital from June 2012 to Sept. 2012. They were treated conservatively with behavioral therapy, physical therapy, medication and occlusal stabilizing splint therapy. Subjective symptoms and clinical findings were investigated to evaluate and compare the patients' status after 3 months treatment. The results were as follows; 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurements of TMD were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender and chronicity. 3. Conservative treatment including stabilization splint produced better results than physical therapy with medication. 4. After 3 months of treatment, pain and LOM were significantly improved in the MD(Muscle disorder) group. Pain, LOM and noise were significantly improved in the DD(Disc displacements) group. In the OA(Osteoarthritis) group, pain, noise, LOM and MCO were significantly improved.
Journal of Dental Rehabilitation and Applied Science
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v.31
no.2
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pp.86-95
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2015
Purpose: The aim of the study was to evaluate the subjective symptoms and clinical signs through the TMD-questionnaire, clinical examination and radiography against the many instrumental performers and to investigate the association between playing instruments and TMDs. Materials and Methods: A total of 803 instrumental performers received TMD-related questionnaire and evaluations of prevalence and disease distribution were performed. Among those who reported at least one symptom of TMD, 70 volunteers visited in clinic then received clinical examination and radiography for diagnosis and evaluations of prevalence and disease distribution were performed. 70 subjects were divided into three groups as woodwind, brass wind, string. Comparative analysis of disease distribution was performed. Results: Among 803 instrumental performers, 610 people (75.97%) were reported to one or more symptoms of TMD. The most frequent symptom was click (29.68%).70 subjects underwent a clinical examination and radiography survey results, the most frequent symptom was a click (29.75%). Most commonly diagnosed disease was a myofacial pain (30.53%).Comparison of the three groups, a significant difference was not observed in the clinical sign. But among subject symptom, muscle pains howed significant differences in accordance with the Group (P = 0.024). During the 70 people who underwent clinical examination, 66 people (94.3%) showed moderate to severe attrition, mild to severe tongue ridging, mild to severe cheek ridging assigns of parafunction. Conclusion: Instrumental performers showed a high prevalence of TMD and the most of the musicians with temporomandibular disorder had bruxism or clenching habits.
Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
Journal of Oral Medicine and Pain
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v.32
no.3
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pp.305-318
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2007
To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.
Kim, Hee-Jin;Park, June-Sang;Ko, Myung-Yun;Ahn, Yong-Woo
Journal of Oral Medicine and Pain
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v.31
no.2
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pp.185-197
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2006
The aim of this study was to investigate the beneficial effect of a daily dose of 300 mg of ASU taken for more than 3 months on the subjects diagnosed as osteoarthritis of temporomandibular joint by RDC/TMD. Total 68 outpatients(15-54y) of female except menopause in Orofacial Pain Clinics of the Pusan National University Hospital were randomly assigned to either an ASU group(n=36) or a placebo group(n=32). The pain, noise and limited mouth opening(LOM) were evaluated by numerical analogue scale(NAS, range 0-10) and maximum comfortable opening(MCO) were measured by milimeter scale. The difference of simple uptake rate(SUR) on bone scan, hot spot(HS) on coronal SPECT, condylar bony changes on CT between the ASU and placebo groups were compared to investigate the objective effect. The obtained results were as follows. 1. Comparison of the NAS of pain, noise, LOM and MCO before treatment and 3, 6 and 9 months after treatment showed no significant difference between the ASU and placebo groups. 2. Comparison of the NAS of pain, noise, LOM and MCO before treatment and 3, 6 and 9 months after treatment showed no significant difference between the ASU and placebo groups without splint treatment, but showed more increased MCO in the ASU group than the placebo group with splint treatment at 6, 9 months after treatment. 3. Comparison of the NAS of pain before treatment and 3, 6 and 9 months after treatment that the NAS of pain at first visit divided into two groups(above or below 6) showed more decreased the NAS of pain in the ASU group than the placebo group that the NAS of pain at first visit was above 6. 4. Comparison of the NAS of pain, noise, LOM and MCO during 6 months period showed improvement of clinical symptoms within group, but no significant difference between subjects. 5. The simple uptake ratio(SUR) on bone scan and hot spot(HS) on coronal SPECT showed more increased SUR and HS in affected side than non-affected side of the ASU and placebo groups. 6. Comparing of condylar bony changes, osseous remodeling were observed highest, osteophyte lowest in the affected and non-affected side of the two groups. After treatment, comparison of condylar bony changes were observed more decreased erosive features in the ASU group than the placebo group.
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