• The Journal of Korean Academy of Prosthodontics
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• v.31 no.1
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• pp.63-76
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• 1993

The purpose of this study was to investigate the disclusion time and occlusal pattern during lateral movement in normal group and temporomandibular dysfunction (TMD) group. Twenty dental college students of Chosun University without the abnormal occlusion and temporomandibular dysfunction were selected as a normal group, and twenty slight temporomandibular dysfunction (TMD) group and the ten moderate temporomandibular dysfunction (TMD) group classified according to Helkimo's dysfunction index were selected. Occlusal pattern was classified as canine guided occlusion, group functioned occlusion and the other group during lateral movement and disclusion time in lateral movement was measured using T-Scan system. The result were as follows: 1. The disclusion time according to each group were $1.24{\pm}0.58$ sec in normal $1.60{\pm}0.79$ sec in slight TMD group and $2.29{\pm}0.80$ sec in moderate TMD group. There was statistically significant between normal group and moderate TMD group(P<0.01), slight TMD group and moderate TMD group(P<0.05). 2. The distribution of occlusal pattern in normal group was 62.5% (25 side) in canine guided occlusion, 27.5% (15 side) in group functioned occlusion. 3. The distribution of occlusal pattern in slight TMD group was 45% (18side) in canine guided occlusion, 35% (14 side) in group functioned occlusion and 20% (8side) in others and that in moderate TMD group was 15% (3 side) in canine guided occlusion, 35% (7 side) in group funcconed occlusion and 50% (10 side) in other 4. The disclusion time in normal group was $1.05{\pm}0.59$ sec at canine guided occlusion and $1.53{\pm}0.72$ sec at group functioned occlusion. 5. The disclusion time in slight TMD group was $1.23{\pm}0.75$ sec in canine guided occlusion, $1.50{\pm}0.88$ sec in group functioned occlusion, and $2.61{\pm}0.57$ sec, in the other. There was staistically significant between canine guided occlusion and other(P<0.001)and group functioned occlusion and the other (P<0.05). 6. The disclusion time in moderate TMD group was $1.28{\pm}0.84$ sec in canine guided occlusion, $1.75{\pm}0.58$ sec in group functioned occlusion, and $2.98{\pm}0.08$ sec in the other(P<0.01).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.367-374
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• 2007

Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

• 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.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 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 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.33 no.3
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• pp.279-294
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• 2008

This study aimed to make an analysis of the occlusion in the state of muscle fatigue produced by excessive mouth opening and clenching during the dental treatment to control the dental pain and to evaluate the sensory nerve in the muscle pain state. Most of the reasons why patients visit the dental office result in pain-either conceivably the dental origin pain or the non-dental origin pain. The dental offices have many therapeutic actions to produce the masticatory muscle fatigue for the treatment. Dental treatment with long minutes of mouth opening can cause some headaches, masticatory muscle pain and mouth opening difficulties. Patients with mastication problems who visits a dental office to alleviate pain run against another unexpected pain with other aspects. This study uses T-scan II system(Tekscan Co., USA) for the evaluation on the occlusal pattern in the experimental muscle fatigue after clenching, opening the mouth excessively and chewing gum. The occlusal contact pattern is analyzed by the contact timing, namely first, intercuspal, maximum and end point of contact. This inspection was performed at frequencies of 2000Hz, 250 Hz and 5 Hz before and after each experimental muscle pain was produced to 24 subjects who had normal occlusion without the orthodontic treatment or a wide range of the prosthesis by using $neurometer^{\circledR}$ CPT/C(Neurotron, Inc. Baltimore, Maryland, USA). The measuring sites were mandibular nerve experimental muscle fatigue respectively. This study could obtain the following results after the assessment of occlusion and sensory nerve of the experimental muscle fatigue. 1. There were the fastest expression after the excessive mouth opening in muscle fatigue and after tooth clenching in muscle pain. In the visual analog scale that records the subjective level, there was the highest scale after the clenching in the muscle fatigue in jumping off the point of pain. 2. Tooth contact time, contact force, relative contact force on the point of the first contact had no difference, and there were decreases in the contact force after the excessive mouth opening on intercuspal position point, after the excessive mouth opening and the gum chewing on the point of the maximum, and in the contact time after all the experimental muscle fatigue state on the point of the end contact. 3. There was no statistic significance in the current perception threshold before and after the experimental muscle fatigue. 4. There was no significant difference in the contact number, the maximal contact number on the point of the first contact, and the contact number after the mouth opening and gum chewing on the point of the intercuspal position and the contact number after the experimental muscle fatigue on the maximum point, and showed significant decreases. In conclusion, it was found that the occlusal pattern can cause the changes on the case of the clinical muscle weakness by intra-external oral events. It was important that the sedulous attention to details is required during dental treatment in case of excessive mouth opening, mastication and clenching.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.391-400
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• 2005

Special Practitioner exists based on the need for special fields that are required to manage difficult patients with specialized skills distinguished from General practitioner. The purpose of dental specialist system is to manage patients who are not treatable by general practitioner by training doctors specializing in one specific field, thereby, enhancing health of the public. Oral Medicine deals with orofacial pain, oral soft tissue disease, forensic dentistry, oral diagnosis. In these days, living environments of city life bring about increase in stress which ultimately lead to increase in prevalence of temporomandibular disorder, oral soft tissue disease, neuropathies such as trigeminal neuralgia, and hence, the number of patients seeking help of those symptoms tend to increase. The purpose of this study was to analyze the rate of referrals and the routes of patients seeking help by investigating 3,707 patients who visited Department of Oral Medicine, College of Dentistry, Yonsei University, from August, 2004 to April, 2005. The results were as follows: 1. The types of disease referred to the Department of Oral Medicine were orofacial pain, oral soft tissue disease, forensic dentistry, oral diagnosis. 2. The rate of referrals was 58.51% which implies that more than half of the patients visiting the Department of Oral Medicine were referred. 3. The types of institution which made referrals were analyzed, and as a result, dental clinics made most of the referrals with the rate of 83.23%, while that from medical or oriental medical institutions was 16.78%. 4. Among the patients who visited the Department of Oral Medicine on their own, 30.52% gained the information about the Department of Oral Medicine from internet and mass media, and from neighbors. From the above results, most of the patients visiting the Department of Oral Medicine were found to be referred not only from the field of dentistry but also from the field of medicine. These suggest that Oral Medicine manages patients who are not treatable by general dental practitioners, and medical specialists tend to cooperate with the Department of Oral Medicine to manage diseases associated with Oral Medicine. Therefore, the role of Oral Medicine can be considered to be important as a special field, and the results of this study should be considered when working out a policy of Dental specialist system on demand and supply of residents in the future.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.339-356
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• 2013

This study was designed to evaluate the sex differences in the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group each from male (n=20) and female (n=20); saline injection group (n=5), lidocaine injection group (n=5), morphine 1.5 mg injection group (n=5) and morphine 3 mg injection group (n=5). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The male and female were significantly different statistically morphine 3 mg group in visual analogue scale evaluation. (male: p<0.05, female: p<0.05) 2. The male and female were more significantly different statistically morphine 3 mg group than morphine 1.5 mg group in McGill pain questionnaire evaluation. (male: p<0.001, female: p<0.01) 3. The male were significantly different statistically morphine 3 mg group in pain drawing evaluation and pressure pain threshold evaluation. (PD: p<0.001, PPT: p<0.05) Therefore, it was revealed that the morphine 3 mg injection for masticatory muscle pain was effective to pain control male patients and more effect than female patients in the objective pain evaluation.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.403-411
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• 2007

This investigation was carried out to evaluate the effect of Transcutaneous Electric Nerve Stimulation (TENS) to experimentally induced masticatory muscle pain and muscular fatigue. Twenty-nine healthy volunteers (18 men and 11 women, aged $26.1{\pm}4.7$ years) without past history or present symptoms of temporomandibular disorders were participated in this study. All of the subjects were randomly assigned to experimental group and control group, after at least 3 days interval, two groups were reassigned conversely. Subjects assigned to experimental group were received TENS and others assigned to control group were received sham-TENS therapy for 45 minutes, respectively. The changes of Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT), and EMG power spectrum were measured on the masseter muscle both before and after sustained fatiguing contraction in each group. The major findings of this study are as follows : 1. PPTs and median frequencies of masseter muscles were significantly decreased after sustained isometric contraction resulting in muscular fatigue. 2. In experimental group received TENS therapy, PPTs measured both before and after occurrence of experimentally induced muscular fatigue were significantly increased. 3. In experimental group received TENS therapy, the changes of PPTs during sustained isometric contraction resulting in muscular fatigue were significantly decreased. 4. In experimental group received TENS therapy, VAS measured after occurrence of experimentally induced muscular fatigue was significantly decreased. 5. Although there were not statistical significances, endurance time was increased in experimental group received TENS therapy and decreased in control group received sham-TENS therapy. 6. In experimental group received TENS therapy, the changes of median frequencies were the less decreased and the slope of median frequency shift was the more increased during endurance time than in control group, however, there were not statistical significances.