• The Korean Journal of Pain
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• v.30 no.3
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• pp.220-228
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• 2017

Background: The transforaminal (TF) epidural steroid injection (ESI) is suggested as more effective than the interlaminar (IL) route due to higher delivery of medication at the anterior epidural space. However, serious complications such as spinal cord injury and permanent neural injury have been reported. The purpose of this study is to evaluate and compare the clinical effectiveness, technical ease, and safety of the TF and parasagittal IL (PIL) ESI. Methods: A total of 72 patients were randomized to either the PIL group (n = 41) or the TF group (n = 31) under fluoroscopic guidance. Patients were evaluated for effective pain relief by the numerical rating scale (NRS) and Oswestry Disability Index (ODI) (%) before and 2 weeks after the ESI. The presence of concordant paresthesia, anterior epidural spread, total procedure time, and exposed radiation dose were also evaluated. Results: Both the PIL and TF approach produced similar clinically significant improvements in pain and level of disability. Among the 72 patients, 27 PIL (66%) and 20 TF (64%) patients showed concordant paresthesia while 14 (34%) and 11 (36%) patients in the same respective order showed disconcordant or no paresthesia. Radiation dose and total procedure time required were compared; the PIL group showed a significantly lower radiation dose ($30.2{\pm}12$ vs. $80.8{\pm}26.8$ [$Cgy/cm^2$]) and shorter procedure time ($96.2{\pm}31$ vs. $141.6{\pm}30$ seconds). Conclusions: ESI under fluoroscopic guidance with PIL or TF approach were effective in reducing the NRS and ODI. PIL ESI was a technically easier and simple method compared to TF ESI.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.143-155
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• 1998

This study was performed to investigate the factor that might affect mandibualr body rotation. For the study, 115 patients with temporomandibular disorders and 35 dental students without angy signs and symptoms of temporomandibular disorders were randomly selected as the patient group and the contreol group, respectively. Preferred chewing side, Angle' classification, lateral guidance pattern, and affected side were clinically recorded, and the amount of Mandibular body rotational torque movement was measured in wide opening and closure, in right and left excursion with vertical and lateral distance in frontal plane, right and left rotational angel in horizontal and in frontal plane. Masticatory muscle activity of anteriorocclusal contact pattern on maximal hard biting were also observed synchronously with BioEMG and T-Scan , respectively. The observed items were muscle activity of anterior temporalis and superficial masseter, and tooth contact status related to contact number, force, duration, and occlusal unbalance between right and left arch. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Mean value of vertical distance in frontal plane in wide opening and closure was more in control subjects than in patients, but there was no difference for rotational angle. In right excursion, rotational angles were greater in patient group than in control group. 2. Comparison among the subjects by preferred chewing side did not reveal any significant difference, but comparison among patients by affected side showed more rotational amount in bilaterally affected patients than in unilaterally affected patients. 3. Comparison among the subjects by Angle's classification or lateral guidance pattern revealed no difference. There was also no difference between preferred chewing side and contralateral side, and between affected side and contralateral side. 4. Positive correlation in madibular rotational torque movements were observed among vertical distance, total horizontal rotation angle, electromyographic activity of anterior temporalis, tooth contact number, and tooth contact force but total frontal rotation angle almost did not show any correlation with other variables except vertical distance.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.4
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• pp.377-391
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• 2015

Inter-dental arch discrepancy between maxilla and mandible could cause three dimensional occlusal problems, and collapse of occlusal plane, multiple teeth loss and decrease of masticatory efficiency could be observed in patient having unstable occlusal contact. Patient showing posterior bite collapse, unstable occlusal contact and improper anterior guidance should be treated to recover stable centric occlusion, occlusal contact, and anterior guidance in conjunction between prosthodontics and orthodontic treatment. This clinical report describes the favorable results of orthodontic and prosthodontics rehabilitation of patient with above mentioned problems.

• The Journal of Korean Academy of Prosthodontics
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• v.27 no.2
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• pp.189-200
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• 1989

The purpose of this study was to investigate the muscle activity of the group function occlusion and the changed canine guided occlusion using EM2. In this study, 13 subjects with group function occlusion and without temporomandibular disorders were selected, each subject was changed to the canine guided occlusion by forming the lingual ramps in the upper canines with light curing composite resin. The muscle activities of the anterior temporal and masseter muscle were recorded in the group function occlusion and immediately, one week, and two weeks after changing to the canine guided occlusion under the condition of maximum voluntary clenching in centric occlusion, lateral excursion, and during gum chewing. The results were as follows: 1. In case of maximum voluntary clenching in centric occlusion, the muscle activities of the anterior temporal and masseter muscle of working and balancing side didn't show any difference immediately after changing to the canine guided occlusion, one week after changing to the canine guided occlusion, one week after changing to it the muscle activities of the anterior temporal masseter muscle of working and balancing side were increased significantly, and two weeks after changing to it the muscle activities of the masseter muscle were increased significantly in comparison with the group function occlusion. 2. In case of maximum voluntary clenching in lateral excursion, the muscle activities of the anterior temporal and masseter muscle of working and balancing side were reduced significantly immediately after changing to the canine guided occlusion, one week after changing to it the muscle activities of the anterior temporal muscle of balancing side and of the anterior temporal and masseter muscle of working side were reduced significantly, and 2 weeks after changing to it the muscle activities of the anterior temporal and masseter muscle of working side were reduced significantly in comparison with the .group function occlusion. 3. During gum chewing, the muscle activities of the anterior temporal and masseter muscle of working and balancing side didn't show any difference immediately after changing to the canine guided occlusion, one week after changing to it the muscle activities of the masseter muscle of working and balancing side were increased significantly, and two weeks after changing to it only the muscle activities of masseter muscle of working side were increased significantly.

• Physical Therapy Korea
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• v.13 no.4
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• pp.39-46
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• 2006

The purpose of this study was to determine the effects of slump sitting postures on the masticatory, neck, shoulder, and trunk muscles associated with work-related musculoskeletal disorders (WRMD). Eleven healthy adults (age, $23.3{\pm}2.7$ yrs; height, $174.0{\pm}4.1$ cm; weight, $61.4{\pm}6.6$ kg) participated in this study. The participants were free of injury history and neurologic deficits in the masticatory, neck muscles and upper extremities at the time of participation. The subjects were asked to perform erect and slump sitting postures under the guidance of physical therapists. The surface electromyography (EMG) was recorded from the anterior temporalis, masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique, gluteus maximus muscles of 11 adults as they performed visual terminal display work, which are known as the weakened and tightened muscles owing to WRMD. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. The results of study were as follows: The masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique muscles significantly differed in the slump sitting posture (p<.05). The muscle activities of the serratus anterior, middle trapezius muscle, and external abdominal oblique were significantly lower and that of the masseter, upper trapezius, L3 paraspinal muscles were significantly higher. Further research is needed to assess the motor control problems and the function of the deep muscles in posture stability of patients with WRMD.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.2
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• pp.281-295
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• 1994

It is very important for the ideal restorations of anterior openbite patients to record the mandibular movement and to harmonize mandibular movement with other organs in stomatognathic systems. This study was designed to compare the mandibular movement of anterior openbite patients with that of normal bite(Angle Class I) patients, to ascertain which components of mandibular movement have differences between two groups, and to use for occlusal treatment of mandibular movement. Saphon Visi-trainer Model 3(Tokyo Shizaisha Co. Japan) and Denar Pantronic(Denar Corp.,U.S.A.) were used to record mandibular movement. Pantronic survey was peformed by using an arbitrary hinge axis according to manufacturer's direction. Twenty-eight adult who have physiologically normal occlusion(Angle Class I) and are free of TM dysfunction were selected as a control group(Group 1). Fifteen adult who are anterior openbite patient and have not anterior guidance function and have posterior interference at protrusion were selected as a experimental group(Group 2). The results are as follows : 1. There was no statistically significant difference between the average immediate and progressive side shift of anterior openbite patients(0.54mm, $7.57^{\circ}$) and those of normal group(0.49mm, $5.96^{\circ}$). 2. The average protrusive and orbiting condylar inclination of anterior openbite patient$(30.87^{\circ},\;32.27^{\circ})$ were significantly lower than those of normal group$(36.11^{\circ},\;39.04^{\circ})$ (P<0.05). 3. In the results of Visi-trainer recordings, the mean for the maximum protrusion, the maximum laterotrusion, the angle of laterotrusion and the angle of protrusion in the horizontal trajectory between group 1 and 2 did not differ significantly. 4. The mean for the angle of protrusion, the maximum opening in the frontal trajectory, the ICP-RCP(A-P) distance and the angle of protrusion in the sagittal trajectory differ significantly(P<0.05). 5. The significant correlation was found between orbiting condylar inclination and protrusive condylar inclination.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.183-187
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• 2012

The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.254-257
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• 1997

Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.34-40
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• 2004

Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

• The Journal of Korean Academy of Prosthodontics
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• v.27 no.2
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• pp.11-36
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• 1989

Mandibular movements are guided mainly by three determinants, namely the two posterior controls (the Temporomandibular joints) and the anterior control (the incisal guidance). The aim of this study was to evaluate the incisal guide angle in effort to reconcile a patient's condylar guide angle and incisu guide angle, to develop criteria for incisal guidance in clinical practice. 48 subjects (male 33, female 15) with intact intercuspation, without past history and symptoms of stomatognathic system, were selected for this study. All of the subjects had not anterior prostheses. The sagittal condylar guide angles and incisal guide angles were measured and estimated statistically by cephalogram and articulator (Whip-Mix 8500A). The results of this study were as follows: 1. Average of condylar guide angle was 43.33 degree by cephalogram, and was 35.18 degree by articulator. 95% confidence interval was from 40.43 to 46.23 degrees in cephalogram and was from 32.98 to 37.38 degrees in articulator. 2. Average of incisal guide angle was 51.51 degree by cephalogram, and was 44.11 degree by articulator. 95% confidence interval was from 49.12 to 54.95 degrees in cephalogram and was from 40.67 to 47.56 douses in articulator. 3. Difference between condylar and incisal guide angle was 8.18 degree by cephalogram, and was 8.94 degree by articulator. 95% confidence interval was from 4.61 to 11.74 degrees in cephalogram and was from 4.90 to 12.98 degrees in articulator. 4. In case of the incisal guide angle steeper than condylar guide angle, subjects were 69% (33 of 48) in cephatogram and 75% (36 of 48) in articulator. 5. By the multiple regression equation, condylar guide angle was more influenced by the anterior teeth. 6. When the mandible protrudes from the intercuspal position to the edge to edge position the incisal linear movement was 4.18mm (S.D.:1.30mm) and the condylar linear movement was 4.38mm (S.D.:1.26mm).