• 구강회복응용과학지
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• 제39권4호
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• pp.237-249
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• 2023

구강안면 근긴장이상(Orofacial dystonia)은 자신의 의지와 상관없이 불수의적으로 얼굴, 입술, 혀 및 턱 주변을 불규칙적이거나 반복적으로 움직이는 신경운동학적 장애로 틱장애로 불리기도 한다. 이러한 증상을 갖는 무치악 환자는 총의치 사용의 어려움과 더불어 언어 장애 및 연하곤란, 구강안면의 통증까지 기능적이고 심미적인 문제점들을 겪게 된다. 본 증례에서는 비교적 젊은 나이에 완전 무치악 상태를 경험하게 된 구강안면 근긴장이상 환자를 위해, 양측 구치부 지르코니아 교합면을 갖는 상악 총의치와 하악 임플란트 지지 고정성 보철물의 수복치료를 시행하고 지속적인 미소훈련을 시행하여 안면근육의 심미적인 개선을 도모하고자 하였다. 치료의 결과, 환자는 저작기능과 심미성이 향상된 것 뿐만 아니라, 심리적 안정감을 회복하여 정상적인 일상생활이 가능해진 것에 대해 매우 만족하였기에 이를 보고하고자 한다.

• Journal of Oral Medicine and Pain
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• 제37권3호
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• pp.183-188
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• 2012

노인층에서의 턱관절장애의 증상과 징후에 관한 이전 연구에서 일관된 결론을 제시하지 못하고 있다. 본 연구의 목적은 연령에 따른 턱관절의 증상과 징후의 유병률을 분석하는 것이다. 젊은층을 대조군으로 평가하였다. 40명의 노인층 환자 (28명 여자, 12명 남자, 평균연령: $65.2{\pm}2.5$)와 40명의 젊은층 환자 (30명 여자, 10명 남자, 평균연령: $23.3{\pm}2.6$)로서 턱관절장애(temporomandibular disorders, TMD)로 진단받은 질환자를 대상으로 하였다. 실험 대상자는 다음과 같은 평가기준을 적용하였다. 주관적 평가인 주소에서 구강안면 통증의 정도(VAS), 객관적인 평가에서 하악 개구 시 운동량, TMJ 관절잡음 (관절음, 염발음), TMJ 촉진 시 통증, 저작과 관련된 근육(교근, 측두근)과 목 근육, 견부근의 촉진 시 통증에 관한 것을 포함한다. 두 그룹 간 차이점 분석은 t 검정과 카이제곱 검정 방법을 사용하였다. (SPSS v. 17) P 값이 0.05 이하인 것을 통계적으로 유의성 있게 보았다. 주관적인 평가에서 주소에 나타난 구강안면 통증 정도에서는 두 그룹 간 유의한 차이는 발견되지 않았다. 객관적인 평가에서 노인층 환자에서 개구 시 염발음이 25%에서 관찰되었고 저작근 촉진 시 통증은 82.5%에서 관찰되었으며 측두근 촉진시에 60%에서 통증을 보였다. 반대로, 젊은층에서 62.5%에서 관절잡음이 관찰되었고 개구 시 좀 더 큰 운동량을 보였다. (p=0.043) 관절잡음과 촉진 시 근육 통증, 하악 운동량에서 두 그룹 간 차이는 현저했다. 노인층에서 TMD에 대한 개구 시염발음, 근육 촉진 시 통증이 자주 관찰되는 반면 젊은 층에서는 하악 운동 시 관절잡음, 운동 시 개구량의 증가가 보다 많이 관찰되었다.

• 구강회복응용과학지
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• 제17권4호
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• pp.217-224
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• 2001

A prevalence of temporomandibular disorders(TMD) based on the clinical sign and symptom in 155 patients were investigated. History taking with interview chart and clinical examination were performed. Age and gender of the patients, duration of TMD, location of pain, joint sound, limitation of mouth opening and more detailed diagnostic name were identified. The results of this study were as follows: 1. TMD was more prevalent in female than in male. TMD was the most prevalent at the age of 20s and decreased with age. 2. Acute TMD was more prevalent than chronic one. 3. About ninety percent of TMD patients had pain. Pain had mainly a unilateral origin. Muscle pain was mainly related with the masseter muscle. 4. Joint sound was identified in about fifty-six percent of the TMD patients and unilateral joint sound was more prevalent than bilateral one. 5. Limitation of mouth opening was observed in about forty percent of the TMD patients. 6. In TMD patients, muscle dysfunction was the most prevalent one. In muscle disorders local muscle soreness was the most prevalent one. In joint disorders, capsulitis was the most prevalent one. In muscle-joint disorders, trigger point pain with retrodiscitis was the most prevalent one.

• 구강회복응용과학지
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• 제33권2호
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• pp.127-134
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• 2017

전신적 혹은 국소적 원인에 의해 발생하는 치아맹출지연은 대부분 소아기에 발견되어 교정적 정출을 이용한 치료를 진행한다. 하지만 소아기때 치료를 받지 못하고 성인기로 될 경우, 교정에 의한 치아이동이 어려워지기 때문에 보철수복으로 치료를 변경할 수 있다. 보철계획을 결정하기 전 고려사항으로는 치아상실이 나타난 범위, 치아사이 근원심공간 및 악간공간, 환자의 연령대 등이 있다. 이 논문에서는 상하악 구치부 맹출지연환자를 지르코니아 부분 고정성 보철물을 통해 구강회복한 증례를 소개하고자 한다.

• 척추신경추나의학회지
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• 제6권2호
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• pp.45-52
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• 2011

Objective : We had good effects on two patients who had problem with temporomandibular joint by using upper cervical manipulation combined with acupuncture therapy. Methods : Two temporomandibular disorder cases were managed by using upper cervical manipulation, combined with acupuncture therapy. We used Toggle-recoil technique for the purpose of upper cervical manipulation. Results :Even though symptoms of two patients were not same, each cases showed clinical changes by using upper cervical manipulation. Two cases had effects on decreasing pain of temporomandibular joint, and at the first case, the range of motion of temporomandibular joint was increased. Conclusion : We could treat temporomandibular disorder patients by using upper cervical manipulation combined with acupuncture therapy.

• 대한통합의학회지
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• 제7권4호
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• pp.1-11
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• 2019

Purpose : This study was aimed at investgating the effect of McKenzie exercise on temporomandibular joint disorder (TMJD) and body balance. Methods : Thirty subjects with TMJD were selected. They were randomly assigned to one of two groups (15 in each group) : namely the conservative treatment group and McKenzie exercise group. The conservative treatment group were treated physical therapy for 6 weeks (3 times a week). The McKenzie exercise group performed McKenzie exercise for 6 weeks (3 times a week). We measured mouth opening, pain, muscle activation and body balance before and after exercise by using the maximum mouth opening MMO), visual analog scale (VAS), electromyography and Biodex Balance System, respectively. Results : We found statistically significant differences in pain and mouth opening in the conservative treatment group and McKenzie exercise group before and after (p<.05). Conclusion : We confirmed the effect of McKenzie exercise on TMJD. Thus we thought these results could be used as basic data and reference for TMJD. But we need more study effect of McKenzie exercise on TMJD and body balance.

• 구강회복응용과학지
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• 제28권2호
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• pp.171-178
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• 2012

보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 구강 악안면 분야에서는 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애(temporomandibular disorders, TMD)의 치료 등에 사용되어 왔다. 최근 보툴리눔 독소 주사가 운동신경에서 마비효과 뿐만 아니라 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 따라서 본 연구는 쥐, 토끼 등 동물 신경 손상 모델에 대한 실험과 치과 치료 후 발생한 신경 손상 환자에서 보툴리눔 독소의 진통 효과 및 작용 기전을 살펴보고자 한다.

• 대한치과기공학회지
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• 제42권3호
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• pp.254-261
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• 2020

Purpose: This study aimed to investigate the effect of stress and oral parafunctional habits on temporomandibular joint disorders (TMD) in college students. Methods: An online survey comprising 354 questionnaires was conducted from May 23, 2020, to June 21, 2020. The collected data were analyzed using Student's t-test, one-way analysis of variance, correlation tests, and multiple regression analysis. Results: The stress symptom score was higher in females than in males. The symptoms of physical stress were significantly higher among students from the Department of Public Health, whereas those of psychological stress were higher among students from the Department of Physical Education. Both TMDs and oral parafunctional habits were higher among females, students of the Departments of Arts and Physical Education, and seniors. The higher the stress symptom level, the higher the scores for TMD and oral parafunctional habits. TMD and oral parafunctional habits were found to be most affected by physical stress. Conclusion: These findings indicate that a reduction in physical stress is required to decrease the prevalence of oral parafunctional habits and TMDs among college students. This can be achieved by the incorporation of physical activity programs, which may aid in reducing the symptoms of physical stress.

• 대한장애인치과학회지
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• 제11권2호
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• pp.62-66
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• 2015

Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

• 대한치과마취과학회지
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• 제14권2호
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• pp.119-126
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• 2014

Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.