• Journal of Oral Medicine and Pain
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• v.26 no.3
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• pp.277-290
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• 2001

영상촬영술은 개방형 외과적 관절수술이나 관절경 검사법을 할 수 없는 상태에서 관절의 상태에 대한 시각적 정보를 확보할 수 있는 유일한 방법이다. 이것의 주된 목적은 진단과 치료계획과정을 도와주는 정보를 제공하는데 있다. 그중 방사선 촬영술은 턱관절의 구조적 질병을 진단하는데 기본적인 수단으로서 오래동안 사용되어 왔 다. 그러나 어떠한 방사선 소견이 개별 관절질환의 특징적 소견인지는 찾아내기가 어려운 실정이다. 그러나 통상적 턱관절 방사선 촬영술로서도 구조적 골변화를 찾아낼 수 있으며 특히 시상 단층촬영술은 턱관절에서 가장 유익한 정보를 보여준다고 한다. 또한 보고에 의하면 턱관절 장애는 다양한 해부학적 요인들과 관련이 있다고 한다. 따라서 본 연구에서는 통상적인 방사선 단층촬영술을 이용하여 턱관절 장애환자의 턱관절에서 나타나는 골변화를 찾아내고 이러한 골변화가 하악과두 수평각, 하악과두 형태, 과두위치 등과 같은 여러 요인들과 서로 관련이 있는 지 찾아보고저 하였다. 단국치대 구강내과 안면동통진료실에 내원한 256명의 환자 중, 턱관절장애를 편측으로만 호소하는 환자 73명을 대상으로 SCANORA를 이용하여 방사선 단층촬영을 시행하였다. 먼저 악하두정위 촬영을 통해 정중선에 대한 하악과두의 방향을 찾아내고 단층촬영 부위를 계산하였으며, 모든 촬영면은 4 mm 두께로 하고 턱관절 부위에만 국한되도록 조준하였다. 폐구 시 4개의 시상 촬영과 개구 시 한개의 시상 및 전두촬영상을 구한 후, 하악과두, 과두 형태 및 하악과두위치 등과 같은 요인들에 대한 골변화간의 관련성을 조사하고저 자료를 측정한 후 Contengency table analyses를 시행하였다. 본 연구의 결과에 따르면 결론적으로 하악과두의 형태, 하악과두의 수평각 및 하악과두의 위치 등은 턱관절의 골변화와 상호 관련이 있다는 가설을 확인할 수 있었다. 즉 하악과두상의 골변화는 과두가 후방위치되고 과두각이 25도 이상 크며, 특히 20대에서는 flat type, 40대에서는 angled type의 과두형태를 가지며 두 과두각의 차이가 9도에서 12도 정도로 큰 차이가 있는 남성환자에서 증가한다.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.267-274
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• 2013

This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.191-200
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• 1998

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

• The korean journal of orthodontics
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• v.41 no.2
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• pp.87-97
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• 2011

Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

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

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.123-136
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• 1989

The purpose of this study was to decide the diagnostic value of transmaxillary and transcranial projection in the evaluation of mandibular condyles. Five dry skulls with intact anatomic structure were selected for this study and the artificial osteophytes were attached to 9 different are as of the mandibular condyle. Ninety transcranial and forty-five transmaxillary radiographs were taken and then the radiographs were evaluated three times. The results were as follows; In transcranial radiographs, superocentral osteophyte was easily observed in closing state than in opening state (p<0.05). But there were no significant differences in other locations (p>0.05). The osteophytes on the medial and central portion easily observed at the transmaxillary projection than transcranial projection (p<0.05), but there was no significant difference on the lateral portion (p>0.05). The osteophytes on the superior (p<0.01) and posterior (p<0.01.) portion were easily observed at the transmaxillary projection than transcranial projection, but there was no significant difference on the anterior portion (p >0.05). The more laterally located osteophytes (p<0.01) at the transcranial projections were easily observed. The more posteriorly located osteophytes (p<0.05) at the transmaxillary projections were easily observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.1-10
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• 2007

악관절 잡음과 동통,과두 흡수를 동반한 퇴행성 측두하악장애는 교합 불안정과 개구장애 를 동반하기도 한다. 진단을 위해 CT나 MRI를 이용해 과두 형태 및 디스크 위치를 파악하 는 것이 유용한 접근법이다. 퇴행성 측두하악관절 환자는 CT나 MRI를 이용하여 진단하고, 과두-원판 재위치와 근 기능 개선을 위해 장기간 교합 안정장치 사용이 필요하므로 교정치료 기간에 변형된 교합 안정장치의 병용이 필요하다. 이에 본 연구에서 교합 안정장치를 병용하여 교합 재구성 증례를 CT나 MRI로 고찰해 보고자 한다.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.477-482
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• 2003

The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

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

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.570-593
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• 1996

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.