• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.4
• /
• pp.225-231
• /
• 2021

There are many studies on the indications and efficacy of splint therapy commonly used in patients with temporomandibular disorders (TMD). However, there have been no studies on the splint weaning in terms of the splint use tapering period in relation to symptom improvement of TMD. This retrospective study aims to analyze a proper splint weaning method in patients with TMD based on symptom improvement. Materials and Methods: The authors examined 130 TMD patients with TMJ disorders, masticatory muscle disorders, and clenching/bruxism who had received splint therapy (occlusion stabilization splint, anterior positioning splint) of patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital from 2015 to 2020. They were evaluated according to the method to wean splints. Results: The mean splint therapy period was 29.0 months, during which patients wore splints 7 days a week for 8.4 months, 3 - 4 days a week for 9.5 months, and finally 1 - 2 days a week for 11.1 months (a total of 29.0 months, about 2.5 years). Conclusion: It seems that TMD symptoms can be alleviated and side effects such as occlusal change can be minimized if patients wear a splint 7 days a week for the first 6 months, followed by 3 - 4 days a week for the next 6 to 18 months, and finally 1 - 2 days a week after 18 months.

• Journal of dental hygiene science
• /
• v.9 no.1
• /
• pp.9-15
• /
• 2009

Aimed at office workers at their height of Temporomandibular joint disorder(TMD), organized self-filling questionnaires were distributed from January 7 to 26, 2008 to 216 workers in the fields of service, office work, and production in D metropolitan city, to get a proper recognition about prevention and treatment of TMD by observing how strongly occupational stress influence on them. The findings of the study were as follows: 1. For subjective symptoms of joint noise as TMD, occasional was 45.8% and often 12.0%, while for joint dislocation often was 12.0%. 41.2% said they feel pains while chewing, while 24.1% said they occasionally feel pains while not chewing. 2.8% said they often experience mouth-opening disorder. 2. For joint noise, answers were significantly different according to their ages, while 30's are at their height (P < 0.05). For joint dislocation, the shorter they worked the more they have it, so less than a year worker was 37.9%, while less than 3 years 31.0%, and less than 5 years 20.7%. For work type, daytime workers have more dislocation, 58.6%, than shift-workers 34.5% (P < 0.05, P < 0.01). For pains while chewing, the shorter they worked, the more they experienced, which is the same as mouth-opening disorder (P < 0.01). 3. Workers with mouth-opening disorder have much stress on occupational autonomy (P < 0.05) and workers with dislocation and pains while chewing have much stress on relation trouble (P < 0.05, P < 0.01). Workers with highly occupational insecurity has much trouble on dislocation and pains while chewing, while workers with dislocation have significantly much stress on unproper compensation (P < 0.05). 4. For who have joint dislocation, they have much stress on relation-trouble, occupational disorder, and un-proper compensation (P < 0.01, P < 0.05). Workers with pains while not chewing showed significant difference about occupational insecurity and relation troubles (P < 0.05, P < 0.01). Who have mouth-opening disorder showed significant difference about occupational autonomy (P < 0.05).

• Journal of Oral Medicine and Pain
• /
• v.31 no.4
• /
• pp.355-364
• /
• 2006

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.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.1
• /
• pp.29-40
• /
• 2008

The purpose of this study was to evaluate the prevalence of symptoms and signs of temporomandibular joint dysfunction (TMD) and malocclusion in 10-12 year old children and to determine if a relationship exists between symptoms and signs of TMD and malocclusion. The subjects were composed of 465 school children (233 boys and 232 girls). Each subject was evaluated with simplified questionnaire and clinical examination to measure symptoms and signs of TMD and malocclusion. The results showed an elevated prevalence of headache (34.6%), which were more frequent in girls than boys. The most common cardinal sign of TMD was clicking (32.9%), which increased with age. TMJ lateral tenderness was present in 18.1% of the subjects and had a tendency to increase with age. Masseter muscle tenderness was found to be sensitive in 15.1%of the subjects and had a tendency to increase with age. Restriction of mandibular mobilitywas present in 30.3% of the subjects and had a tendency to increase with age. There was no significant difference in the prevalence of TMD signs between sex. The occlusal status showed Class I malocclusion in 73.3%, Class III in 12.9%,Class II division 1 in 11%, Class II division 2 in 2.8%. There was no significant difference in malocclusion traits between sex. There was statistically significant relationship between TMD signs and symptoms and class II division 1 and Class III malocclusion(p<0.05). The results indicate that the prevalence of TMD symptoms and signs in children is high, and the evaluation of TMD in children seems to be important.

• The korean journal of orthodontics
• /
• v.36 no.6
• /
• pp.402-411
• /
• 2006

Objective: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. Methods: Six thousand and seventy patients with TMD (temporomandibular cisorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. Results: The distribution. and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. Conclusion: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.2
• /
• pp.130-134
• /
• 1997

The sagittal split ramus osteotomy(SSRO) of the mandible has used one of the most popula methods for the correction of various dentofacial deformities, especially mandibular prognathism. In SSRO, there are produced bony gap following mandible setback because of mandibular flaring. For this reason, the condylar axis may be changed due to bony approximation both segment in three dimension more mesio-laterally. According to change of condylar position, the condition of TMJ structure are changed and change of TMJ symptoms are suggested theoretically, and the correction of malocclusion by SSRO may improve the TMJ symptoms by improvement of feeding difficulties. The pupose of this study was to determine relationship between expected alterations in condylar position and suggested TMJ symptoms produced by change of condylar position. TMJ symptoms of 15patients who had operated SSRO are checked at about postoperative 6 month ranging $5{\sim}11$ month. Anterior-posterior position of condyle which was comparison preoperative with postoperative position, was classified 5 groups. The author tried to identify relationship between positional change of condyle and TMJ discomfort.

• Journal of Oral Medicine and Pain
• /
• v.31 no.4
• /
• pp.365-373
• /
• 2006

This study suggested correction of excessive mouth opening or maximum occlusal contact to analyse occlusal contact time, occlusal contact number and force through evaluation of occlusal pattern in policemen with temporomandibular disorders. The community of policemen influence on temporomandibular disorder's development and progress due to other condition of mouth opening and maximal occlusal contact. Repeated training or changes of usual life style may cause imbalance of stomatognathic system including the masticatory muscle, then develop or aggravate pain of temporomandibular joints and associated structures. This study uses T-scan II system(Tekscan Co., USA) for evaluation on occlusal pattern may influence temporomandibular disorders, and then the subjects take a sensor at 20 mm opening for maximal occlusal contact force. The policemen with temporomandibualr disorders get more long time on maximum contact timing, more short on end contact timing, and more force on end contact force than general society's. So they get closure of mouth with more short time and more force, then transfer remaining load to temporomandibular joint. There are no statistically significances between affected side and occlusal pattern of occlusal contact time and force. There are Left -right dental arch imbalances seems on Rt. dental arch if affected side is right and Lt. dental arch if affected side is left. In above results, It's worth due consideration that policemen with temporomandibular disorders get more smooth mandibualr movement and less force on maximal occlusal contact position.

• Journal of Oral Medicine and Pain
• /
• v.24 no.1
• /
• pp.25-36
• /
• 1999

저자는 이하두정방사선사진 (願下頭頂放射線寫眞, submentovertex radiographs)을 이용하여 하악과두의 수평각과 측두하악장애와의 연관성을 평가하고자 측두하악장애의 병력 및 증상이 없고, 자연치열로 형성된 정상교합을 가진 성인 34명과 전북대학교병원 구강내과에 내원한 측두하악장애환자 38명을 대상으로, 환자군을 임상검사 및 방사선학적 검사를 통해 편측 정복성 관절원판 전방변위 환자군, 양측 정복성 관절원판 전방변위 환자군 및 편측 비정복성 관절원판 전방변위 혹은 골관절염 환자군으로 세분한 후, 좌우측 외이도의 위치를 확인할 수 있도록 소강구 (小鋼球)가 내재된 장치물을 이용하여 채득한 규격화된 이하두정방사선사진상에서 하악과두의 내측극과 외측극을 이은 선과 양측 외이공에 위치한 소강구를 이은 선으로부터 하악과두의 수평각을 측정하였다. 평가 결과 정상군에서의 좌(평균 25.3도), 우(평균 24.8도)측 하악과두의 수평각 (평균 25.0도)은 유의한 차이를 보이지 않았으며 환자군에서는 이환측 하악과두의 수평각 (평균 28.5도)이 비이환측 하악과두 (평균 26.2도)보다 유의성있게 증가된 수치를 보였다 (p<0.05). 또한 환자군 (평균 27.55도)에서의 하악과두의 수평각이 정상군 (평균 25.0도)에서 보다 유의하게 증가된 수치를 보였다 (p<0.05). 임상적으로 세군으로 구분된 환자군의 경우, 각군의 이환측 또는 비이환측, 각 군을 합한 이환측 또는 비이환측의 경우에 있어서도 정상군에서 보다 하악과두 수평각이 유의성있게 증가된 수치를 보였다 (p<0.05). 세가지로 구분된 환자군 각각의 상호 비교에 있어서는 유의성있는 차이를 나타내지 않았다. 그리고 편측으로 이환된 환자군에서의 이환된 수평각 (평균 29.1도)은 비이환측 (평균 26.2도)보다 유의성있게 증가된 수치를 보였으나 (p<0.05), 양측으로 이환된 환자군에서의 좌우측 수평각은 유의한 차이를 보이지 않았다. 이로써 측두하악장애의 진단 차원에서 측두하악장애를 유발하는 여러 요소 중외 하나로 하악과두 수평각에 대한 평가가 고려되어야 할 것으로 사료된다.

• The Journal of the Korean dental association
• /
• v.31 no.10 s.293
• /
• pp.738-743
• /
• 1993

• Journal of Dental Rehabilitation and Applied Science
• /
• v.31 no.2
• /
• pp.86-95
• /
• 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.