• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.39.1-39.6
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• 2015

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

• 대한치과의사협회지
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• 제34권3호통권322호
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• pp.163-167
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• 1996

• 한국임상수의학회지
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• 제34권6호
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• pp.434-436
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• 2017

Nine dogs with history of lameness and anorexia were presented. On physical examination, all dogs had gait abnormality and six dogs had high body temperature. Their clinical signs were mostly episodic, and only non-specific symptoms were occasionally observed. Arthrocentesis was performed in all dogs, and immune-mediated polyarthritis (IMPA) was diagnosed. Definitive rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) were diagnosed in one dogs, one each. Prednisolone (PDS) was chosen as the first-line therapy for all dogs, except for the one with RA. Most cases responded to PDS but some cases including those of SLE and RA were refractory to PDS. IMPA can be challenging to diagnose due to its vague symptom and is commonly implicated in 'fever of unknown origin'. Therefore, clinicians should consider IMPA as a differential diagnosis when the patient has fever with systemic, non-specific signs, such as anorexia and depression, but does not respond to antibiotics.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.227-230
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• 2016

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

• 대한치과의사협회지
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• 제50권5호
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• pp.244-255
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• 2012

Temporomandibular disorder(TMD) is described as a cluster of disorders characterized by pain in the preauricular area and/or the muscles of mastication; limitations or deviations in mandibular range of motion; and noises in the TMJ during mandibular function. The most common symptom in TMD patients is pain that is aggravated by chewing or other jaw function. These symptoms are appeared when the stimuli loaded in TMJ are over the physiologic tolerance. The primary goal in treatment of TMD is to alleviate pain and lor mandibular dysfunction. TMD treatment can be divided into 2 categories: reversible and irreversible methods. Reversible methods include medication, thermal therapy, habit modification, physical therapy, appliance therpy and arthrocentesis and lavage and irreversible methods include arthroscopic lysis, surgery, occlusal adjustment et al. It is widely accepted that reversible methods are ther first choice of treatments. However if reversible ones are not effective, irreversible methods are considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.299-299
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• 2019

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.453-457
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• 2006

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients' complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 ㏄) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.

• Journal of Korean Dental Science
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• 제11권1호
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• pp.21-31
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• 2018

Occlusion may change spontaneously but dental treatment or trauma in the patients with temporomandibular disorders (TMDs) may also alter occlusion. This report presents three cases displaying occlusal changes. Review of literature emphasizes the significance of TMD treatment. Conservative treatment modalities such as counseling, medication, physical therapy and splint therapy may be selected as initial treatment options. Irreversible or invasive treatment, such as orthodontic, prosthodontic, and occlusal adjustment should not be attempted early. In case there is no response to conservative treatment, joint injection, muscle injection, arthrocentesis or arthroscopic surgery might be performed.

• 대한치과의사협회지
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• 제41권12호통권415호
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• pp.818-824
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• 2003

Visually guided irrigation and lysis(VGIL) using temporomandibular joint(TMJ) arthroscope is useful for decreasing pain and increasing the functional mobility of TMJ. Also it demonstrated similar effectiveness comparing with arthrocentesis. Arthroscopy permits intracapsular inspection that is imperative not only for identification of morphological characteristics of joint space, but also for adequate irrigation and lysis of specific joint space. Conventional 2.3mm diameter arthroscope with 2.7mm catheter was too wide. So it was traumatic and uncomfortable to manipulate on temporomandibular joint space, especially on TMJ internal derangement patient with reduced space. We report our clinical experience on 6 TMJ closed lock patients who were treated with new 1.2mm fiberscope at Chung Hoon Dental Clinic between March 2003 and August 2003. Also we present clinical advantage & disadvantage of new system with literature review.

• 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.