• 한방재활의학과학회지
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• 제33권4호
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• pp.185-193
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• 2023

Objectives This study was conducted to find out the correlation between lumbar malposition and lumbar disc herniation. Methods Among the patients who visited Gwangju Jaseng Hospital of Korean Medicine from January 2019 to January 2021, taking 92 patients under age 60 who had the records of X-rays and magnetic resonance imaging (MRI) images as the research subjects, Cobb's angle was measured in anterior-posterior (AP) view and lateral (LAT) view, the number of displacements was scored by listing categories defined by The Korean Society of Chuna Manual Medicine for Spine and Nerves. The degree of lumbar intervertebral disc herniation was expressed as a percentage according to the method of Kato, etc., and the correlation between each factor was analyzed. Results AP curvature and MRI herniation index showed significant positive correlation in L4-L5 level but there was no significant difference in L5-S1 level. LAT curvature and MRI herniation index had no correlation in L4-L5 level, but there was a significant negative correlation in L5-S1 level. Malposition score and MRI herniation index had a significant positive correlation in L5-S1 level, whereas there was no correlation in L4-L5. Conclusions As a result of the study, AP curvature and MRI herniation index showed a significant positive tendency in L4-L5 lumbar spine, and LAT curvature and MRI herniation index showed a significant negative tendency in L5-S1 lumbar spine. Malposition score and MRI herniation index were found to have a significant positive tendency in L5-S1 lumbar spine.

• 대한의용생체공학회:의공학회지
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• 제21권3호
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• pp.295-301
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• 2000

뼈의 성장에 미치는 많은 요소들 중에서 implant의 상대적인 미세운동(relative micromotion)은 뼈의 implant와의 접합을 방해하는 것으로 알려져 왔다. 그런데 이러한 상대적인 운동 및 spinal stability에 직접적으로 영향을 주는 하중조건, spinal material의 물성치, spinal geometry 및 뼈와 implant의 접촉면에서의 마찰계수를 고려하기 위하여, 하나의 titanium interbody cage 가 삽입된 human lumbar segments (L4-L5)의 유한요소 모델이 개발되었다. 이러한 유한요소 모델의 해석을 통하여 상대적인 미세운동, Posterior의 수직적인 변위, von Mises 응력 및 마찰력이 예측되었다. Cancellous bone. annulus fibers 및 ligaments의 기계적인 물성치의 감소 또는 접촉면에서의 마찰계수의 감소는 상대적인 미세운동 (relative micromotion or slip distance)을 증가 시켰다. 접촉면에서의 normal force는 뼈의 밀도 (cancellous bone density) 가 감소하거나 접촉마찰계수가 증가하면 감소했다. 특히 하중조건에 있어서, compressive preload에 대한 torsion의 추가는 접촉면의 anterior부위에서 상대적인 미세운동을 증가 시켰다. 하지만 디스크면적이 증가할수록 상대적인 미세운동은 감소했다. 결론적으로, 접촉면의 기계공학적 거동 (Relative micromotion, stress response, posterior axial displacement and contact normal force)은 접촉면의 마찰계수 뼈의 밀도, 하중조건 및 노화에 따른 형상/물성의 변화에 매우 민감함을 보이고있다.

• 대한치과교정학회지
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• 제30권2호
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• pp.235-243
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• 2000

측두하악관절의 자기공명영상(MRI)은 하악과두와 관절원판(disc)의 관계를 잘 보여주기 때문에 관절내장증(internal derangement)의 진단을 위해 매우 유용하다. 이번 연구의 목적은 서울대학교 치과병원 교정과에 내원한 측두하악관절 장애가 의심되는 환자들의 MRI 자료를 평가하여 관절 내장증의 유무, 발생빈도 및 심도를 파악하는 것이다. MRI를 촬영한 표본은 남자 10명, 여자 40명으로 총 50명이었고 평균 나이는 22.9세였다. 전체 50명 중에 43명에서 positive finding이 관찰되었다. Positive finding을 나타낸 환자 중에서 전방관절원판변위(anterior disc displacement : ADD)는 비정복성이 $56\%$로 가장 많았으며, 양쪽 관절에서 동시에 일어난 경우가 $65\%$로 가장 많았다. Positive finding을 나타낸 환자를 Angle 분류 시, II급 1류 부정교합 환자가 $39.6\%$, II급 2류 부정교합 환자가 $2.3\%$로 II급 부정교합이 $41.9\%$로 가장 많았고, I급 부정교합 환자는 $37.2\%$, III급 부정교합 환자가 $18.6\%$, 확인 안된 경우가 $2.3\%$였다. Positive finding을 나타낸 환자 중에서 안면 비대칭 환자는 $8.6\%$, 개교 환자는 $55.8\%$였다. 결론적으로 측두하악관절의 관절 내장증을 가진 환자에서는 II급 부정교합이 차지하는 비율이 매우 크다고 할 수 있다. 개교나 안면 비대칭은 측두하악관절 장애로 인한 보상적 또는 비보상적인 변형에 의해 나타날 수 있으며 퇴행성 관절 질환으로 진행되는 과정중 안면 골격 개조의 결과로 보인다. 그러므로 개교 및 안면 비대칭이 있는 환자는 교정 치료 시작 전에 측두하악관절의 이상 유무를 MRI로 확인(screening)할 것이 권장된다. 측두하악관절 장애가 있는 경우 교정 치료 후에도 재발의 경향이 크고 측두하악관절에 대한 계속적인 관찰이 필요하므로 감별진단이 필수적이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권5호
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• pp.370-378
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• 2005

The purpose of this study is that evaluate the distribution and biological roles of TNF-a, interleukin-1${\beta}$(IL-1${\beta}$), interleukin-6(IL-6) and tissue inhibitors of metalloproteinase-1(TIMP-1) in the synovial fliud of patients with non-inflammatory chronic temporomandibular joint(TMJ) disorders in relation to pain during joint movements and magnetic resonance imaging(MRI) findings. TMJ synovial fluids aspirates were obtained from 36 patients (36 joints) with chronic TMJ disorders and from 8 controls(8 joints). Patients were divided to four groups. The control group was from healthy volunteers(8 joints), group I(18 joints) was patients with anterior disc displacement with reduction, group II(5 joints) was patients with disc displacement without reduction and group III (5 joints) was osteoarthritis. The TNF-${\alpha}$, IL-1${\beta}$ and IL-6 levels in the aspirates were determined by using an enzyme-linked immunosorbent assay and the TIMP-1 level was measured by an enzyme immunoassay. Following examinations for pain during joint movements and MRI observations, these cytokines' level and frequencies of detection were compared. The level of IL-1${\beta}$was not significant different in all groups. but the level of TNF-${\alpha}$, IL-6 and TIMP-1 were significant different among groups. The level of IL-6 and TIMP-1 were correlated to pain during movement(p<0.01) and the level of TNF-a(p<0.05). Also, the level of IL-6 was correlated to the level of TIMP-1(p<0.01). Especially, The level of the TIMP-1 level was significantly correlated to the pain during movement and showed very high levle of Pearson's correlation coefficient (r=0.833)(p<0.001). The results indicated that the TNF-${\alpha}$, IL-6 and TIMP-1 levels in the TMJ aspirates of patients with chronic TMJ disorders have been raised. Especially, IL-6 and TIMP-1 were very high levels in the patients who were degraded in the TMJ. Also, TNF-${\alpha}$, IL-6 and TIMP-1 showed the significant correlation in the chronic temporomandibular joint disorders. Therefore I suggest that these cytokines were also correlated to the pain during movement in the chronic temporomandibular joint disorders.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권1호
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• pp.14-20
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• 2013

Objectives: This study sought to evaluate the effect of simultaneous application of arthrocentesis and occlusal splint. Materials and Methods: A retrospective study of 43 patients (3 males, 40 females) whose symptoms had improved was conducted at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital between 2008 and 2010. Subjects were divided into three groups: Group A (17 patients with arthrocentesis and occlusal splints simultaneously applied), Group B (13 patients whose symptoms did not improve with occlusal splints, undergoing arthrocentesis after occlusal splint use for 8 weeks), and Group C (13 patients that only used occlusal splints). We compared these groups in maximum comfortable opening (MCO) and the visual analogue scale of pain and noise. Follow-up was performed at 1 week, 1 month, 3 months, and 6 months. Results: The improvement of symptoms was noted in all three groups, but Group A had a quicker improvement than the other groups, in terms of pain reduction and MCO increases. Conclusion: The simultaneous application of arthrocentesis and occlusal splints can reduce patient discomfort more quickly.

• The Journal of Advanced Prosthodontics
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• 제1권1호
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• pp.26-30
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• 2009

STATEMENT OF PROBLEM. Qualitative and semi-quantitative methods have been developed for TMJ sound classification, but the criteria presented are completely inhomogeneous. Thus, to develop more objective criteria for defining TMJ sounds, electroacoustical systems have been developed. We used Joint vibration analysis in the BioPAK system(Bioresearch Inc., Milwaukee, USA) as the electrovibratography. PURPOSE. The aim of this study was to examine the TMJ sounds with repect to frequency spectra patterns and the integral > 300 Hz /< 300 Hz ratios via six-months follow-up. MATERIAL AND METHODS. This study was done before and after the six-months recordings with 20 dental school students showed anterior disk displacement with reduction. Joint vibrations were analyzed using a mathematical technique known as the Fast Fourier Transform. RESULTS. In this study Group I and Group II showed varied integral > 300 /< 300 ratios before and after the six-months recordings. Also, by the comparative study between the integral > 300 /< 300 ratios and the frequency spectrums, it was conceivable that the frequency spectrums showed similar patterns at the same location that the joint sound occurred before and after the six-months recordings. while the frequency spectrums showed varied patterns at the different locations that the joint sound occurred before and after six-month recordings, it would possibly be due to the differences in the degree of internal derangement and/or in the shape of the disc. CONCLUSIONS. It is suggested that clinicians consider the integral > 300 /< 300 ratios as well as the frequency spectrums to decide the starting-point of the treatment for TMJ sounds.

• 치과방사선
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• 제18권1호
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• pp.81-136
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• 1988

The aim of this study was to determine whether T.M.J. tomographic examination yielded significant differences in condyle positions among asymptomatic, myalgia, derangement, and arthrosis groups of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows. 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substantial range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P<.05). Also that of left central section existed between derangement and myalgia groups, and that of left medial section existed between derangement and myalgia groups (P<.05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main- symptom sides, and only between derangement and myalgia groups in central section of contra-lateral sides (P<.05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia groups (P<.05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P<.05).