• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.319-328
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• 2009

Temporomandibular disorders(TMD) have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory muscles, and associated structures. Since Dr. Costen, an otolaryngologist, published his article in 1934 claiming that pain in and around the jaw and "related ear symptoms" improved with alteration of the bite, diagnosis and treatment of temporomandibular disorders(TMD) have been within the concept of occlusion. However most of the modern descriptions for TMD no longer include occlusal disorders within their domain. Despite this trend toward the exclusion of occlusal disorders from TMD domain, the historical linkages between TMD and occlusal therapy are still strong. Currently the most popular theories regarding TMD etiology are based on the biopsychosocial model. In the future, treatment modalities should be directed at the pathophysiological processes of joint and muscle pain as well as the psychosocial aspects of chronic pain.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.225-231
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• 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 Oral Medicine and Pain
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• v.36 no.1
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• pp.65-70
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• 2011

The purpose of this study is introduce the spiral taping treatment on Temporomandibular Disorder in oral Medicine. The taping treatment is relatively simple and dosen't have any adverse effect, so it has high stability and superior effect of treatment. In this study, using the spiral taping treatment as one of the effective taping treatments, non-stretched tape was attatched to the muscles which set limit to the range of joint movement and cause pain to temporomandibular joint. With that treatment this study tried to make effective results of treatment of temporomandibular disorder. These results suggest spiral taping treatments contribute to the improvement of tempermandibular disorders. Further this study is needed for the confirmation of this effect of spiral taping treatments on temporomandibular disorders.

• 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.

• The Journal of the Korean dental association
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• v.46 no.4
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• pp.232-242
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• 2008

관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral>300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절 잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰 되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.205-218
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• 2008

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.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.2
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• pp.102-108
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• 2016

Headache disorders, one of most common disease in general population, have been developed according to many versions of international classifications. The primary headaches are those in which no consistently identified organic cause can be determined. It is divided into the following categories: (1) migraine, (2) tension-type headache, (3) cluster headache and other trigeminal autonomic cephalalgias, (4) other primary headaches. This review described a diagnosis of primary headache disorders based on International Classification of Headache Disorders (ICHD)-3 beta criteria.

• Journal of Oral Medicine and Pain
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• v.35 no.3
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• pp.213-219
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• 2010

Aim: The aims of this study were to survey the frequency of pain to palpation of the occipitofrontalis muscle in a TMD patient group, and to identify patients showing pain to palpation of the occipitofrontalis muscle that is also consistent with patients' headache symptom. Methods: A total of 218 TMD patients ($32.0{\pm}13.1$ years) participated in this study. Patients' symptoms, including headache, were surveyed by questionnaire. Temporomandibular joints, jaw muscles, and pericranial muscles including the occipitofrontalis muscle were examined with digital palpation. Pain to palpation (i.e. tenderness) was scored from 0 to 3 according to the patients' response, and frequencies were calculated of pain to palpation scores for each site of the pericranial muscles. Results: Twelve patients among 218 TMD patients (5.5%) showed pain to palpation (scores of 1, 2) on the occipitalis or frontalis sites, and seven patients (3.2%) had moderate pain (a score of 2) to palpation. Among 218 TMD patients, there was only one patient whose primary symptomatic site of headache corresponded with the result of pain to palpation of the occipitofrontalis muscle. Conclusion: It can be concluded that examination with palpation of the occipitofrontalis muscle could be considered in the evaluation of TMD patients' headache symptom when other factors have been ruled out.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.355-364
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• 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 the Korea Convergence Society
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• v.2 no.4
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• pp.39-45
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• 2011

This paper examined the relationship between stress, the most potential cause among a variety of factors causing temporomandibular joint disorder, and temporomandibular joint disorder. In particular, this paper aimed to identify the temporomandibular joint disorder of those who were in their 20s, the age when temporomandibular joint disorder possibility increased. The survey was conducted by randomly selecting 120 college students who understood the purposes of this research and agreed to the survey from July 11 to 30, 2011. For the general features of the subjects, only gender showed any statistically significant difference. In the relationship between stress and habits related to temporomandibular joint disorder, the habit which the subjects had the most was "propping up of the chin", 64.4%. Five habits were observed the most frequently in the group with the highest stress. The habit of chewing on one side of the mouth showed the highest response as 81.5% in the group with high stress. Other habits showed similar results, about 60%.