• 제목/요약/키워드: Articular disc of TMJ

검색결과 40건 처리시간 0.029초

악관절 관절원판 위치변화가 관절원판 형태 및 골변화에 미치는 영향 (Effect of disc displacement on the bony change and disc configuration of TMJ)

  • 김진화;이완;이병도
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.17-24
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    • 2006
  • Purpose : The objective of this study was to investigate the effect of TMJ disc displacement on the TMJ disc configuration and surrounding osseous structure. Materials and Methods : The proton density and 72-weighted MR images of 57 TMJs were retrospectively studied. These TMJs were divided into three groups according to the anterior disc displacement status on MR sagittal images, those were the normal, anterior disc displacement with reduction (ADWR), anterior disc displacement without reduction (ADWOR). The frequency of disc configuration and surrounding bony change, the border status between articular disc and retrodiscal tissue were investigated according to the positional change of articular disc. Results : There were significant statistical differences of chi-square statistics of TMJ disc configurational type between normal and ADWR/ADWOR group, respectively. Surrounding bony change frequently appeared in ADWOR and a statistically significant difference of chi-square statistics of bony change frequency between normal and ADWOR group was observed. Conclusion : These results suggested that the disc configuration and bony change of TMJ are strongly related to TMJ disc displacement.

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MRI를 이용한 악관절 원판 또는 그 주위조직의 천공에 대한 진단 (MRI FINDINGS FOR DIAGNOSIS OF THE TEMPOROMANDIBULAR JOINT DISC PERFORATION)

  • 김형곤;김일수;박광호;허종기;윤현중;조나리야
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권2호
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    • pp.191-196
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    • 2000
  • Purpose This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. Patients and Methods The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. Results The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. Conclusion The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.

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악관절 내장증 치료를 위한 악관절 세정술 후 관절강내 Hyaluronic Acid 주입 효과 (THE EFFECT OF INTRA-ARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROCENTESIS IN TREATMENT OF INTERNAL DERANGEMENTS OF THE TMJ)

  • 김재진
    • 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.

턱관절 관절원판 변위의 진단 및 치료 (Diagnosis and Treatment of TMJ Disc Displacement)

  • 권정승
    • 대한치과의사협회지
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    • 제58권6호
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    • pp.364-376
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    • 2020
  • Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

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측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 대한물리치료과학회지
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    • 제5권4호
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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측두하악관절에 대한 cone beam형 전산화단층영상과 자기공명영상의 비교 (Comparison between cone beam computed tomography and magnetic resonance imaging of the temporomandibular joint)

  • 김규태;최용석;황의환
    • Imaging Science in Dentistry
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    • 제38권3호
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    • pp.153-161
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    • 2008
  • Purpose : To compare and evaluate the diagnostic ability of cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Materials and Methods : CBCT and MRI of 46 TMJs of 23 patients with TMJ disorders were evaluated. They were divided into 3 groups according to the position of the articular disc of the TMJ at closed mouth position and the reduction of the disc during open mouth position on MRI: no disc displacement group (NDD), disc displacement with reduction group (DDR), and disc displacement without reduction group (DDWR). With PACS viewing soft-wares, position of mandibular condyle in the articular fossa, osseous change of mandibular condyle, shape of articular fossa, and mediolateral and anteroposterior dimensions of mandibular condyle were evaluated on CBCT and MRI. Each value was tested statistically. Results : The position of mandibular condyle in the articular fossa were concentric in the NDD, DDR, and DDWR of CBCT and NDD of MRI. However, condyle was positioned posteriorly in DDR and DDWR of MRI. Flattening, sclerosis and osteophyte of the mandibular condyle were much more apparent on DDR of CBCT than MRI. And the erosion of the condyle was much more apparent on DDWR of MRI than CBCT. Box and Sigmoid types of articular fossa were found most frequently in DDR of MRI. Flattened type was found most frequently in DDR of CBCT and deformed type was found most frequently in DDWR of CBCT. No significant difference in mediolateral and anteroposterior dimensions were shown on CBCT and MRI. Conclusion : Since MRI and CBCT has unique diagnostic imaging ability, both modalities should be used together to supplement each other to evaluate TMJ.

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Change of Glycosaminoglycan Distribution and Collagen Fibers Arrangement on Temporomandibular Joint Following Anterior Disc Displacement of the Rabbits

  • Kim, Uk-Kyu;Chung, In-Kyo;Kim, Kyu-Cheon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권3호
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    • pp.173-179
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    • 2012
  • Purpose: This study was to determine the effects of surgical induction of anterior disc displacement (ADD) on the distribution of glycosaminoglycan (GAG) and collagen fiber arrangement in the rabbit temporomandibular joint (TMJ) tissues including articular cartilage of condyle, disc, retrodiscal tissue, and articular eminence. Methods: We used van Gieson staining and Alcian blue critical electrolyte concentration (CEC) method to observe change of collagen fibers on disc and to measure GAG up to 10 weeks in TMJ tissues after surgical induction of ADD on 25 rabbits. Results: CEC measurements for GAG showed 0.3 M, 0.4 M, 0.6 M, and 0.8 M at 1 week, 2 weeks, 3, 4, and 8 weeks, 10 weeks, respectively. This result indicated that GAGs shifted to highly sulphated ones as time passed. Disruption of collagen fiber arrangement in the disk occurred at 10 days and aggravated at 3 weeks. Conclusion: Our study showed degenerative osteoarthritis changes in rabbit TMJ following surgical induction of ADD up to 10-week period.

가토에서 하악골 신장술이 악관절에 미치는 영향 (THE CHANGE OF THE TEMPOROMANDIBULAR JOINT AFTER EXPERIMENTAL DISTRACTION OF MANDIBULAR RAMUS IN RABBIT)

  • 임승규;김철환;김경욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권5호
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    • pp.543-549
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    • 2008
  • Distraction osteogenesis is a commonly used technique for mandibular lengthening, but changes in the temporomandibular joint(TMJ) have not been well documented. The TMJ is one of the most complex joint in the body and is composed of a fibrous surface layer, a proliferative zone, hypertrophic cartilage, and bone. The shape and role of the TMJ change and modify during a person's life-time. Possible complications that can arise after mandibular distraction include failure of the formation, failure of callus, infection, disturbance of TMJ and of occlusion. However, there are only a few reports on changes in the TMJ as a result of distraction osteogenesis. Hence, the goal of this study was to evaluate the change of the TMJ after experimental distraction of mandibular ramus in rabbit. We studied histological changes of mandibular condyle, articular disk and retrodiscal tissue, and also examined the collagen I gene expression and MMP-1 gene expression. The results were as follows. 1. In the histological staining, experimental condylar surface showed more thick fibrous articular layer and proliferative layer, compared with the control condyle and experimental articular disc showed thick and dense collagen fibers compared with the control disc. 2. In the collagen I and MMP-1 gene RT-PCR analysis, experimental discs showed increased collagen I expression compared with the control disc, while MMP-1 gene expression was decreased compared with the control disc. The retrodiscal tissue was almost equal expressions of the collagen I and MMP-1 genes compared with the control retrodiscal tissue. These findings suggest that histological and biomolecular changes occur in condyles and discs after unilateral mandibular distraction osteogenesis.

Cone-Beam Computed Tomographic Assessment of Temporomandibular Joint Morphology in Patients with Temporomandibular Joint Disc Displacement and in Healthy Subjects: A Pilot Study

  • Choi, Hang-Moon;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • 제41권2호
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    • pp.41-47
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    • 2016
  • Purpose: The purpose of this study was to analyze the size and morphology of mandibular condyle and mandibular fossa between temporomandibular joint (TMJ) disc displacement (DD) patients and healthy subjects using cone-beam computed tomography (CBCT). Methods: Twenty healthy subjects and twenty TMJ DD patients participated in this study respectively. We made five measurements in mandibular condyle (medio-lateral dimension, antero-posterior dimension, condyle height, intercondylar distance and intercondylar angle) and two measurements in mandibular fossa (mandibular fossa depth and articular eminence angle) using CBCT image. Results: There was no difference between two groups in medio-lateral dimension. In case of antero-posterior dimension, average of healthy controls was larger than that of TMJ DD patients, but that was not significant statistically. There were no significant differences between two groups in condyle height. Comparing intercondylar distance and intercondylar angle between two groups, there was no significant difference between two groups. In comparison of mandibular fossa depth and articular eminence angle, there was no significant difference between two groups. Conclusions: We couldn't find any definite relationship between TMJ morphology and TMJ DD.

Management of Disc Displacement with Retrodiscitis after Macrotrauma: A Case Report

  • Tae-Seok Kim;Yeon-Hee Lee
    • Journal of Oral Medicine and Pain
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    • 제48권1호
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    • pp.25-30
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    • 2023
  • We present the case of a 60-year-old male with post-macrotrauma disc displacement and retrodiscitis, in which temporomandibular joint (TMJ) injection and manual therapy were used to alleviate his symptoms. He visited our clinic with complaints of pain and swelling in his right facial area and malocclusion of his right side teeth after being hit on the right side of his face five days earlier. During clinical and radiological examinations, the inflammatory state of the joint and disc displacement on the right side, which led to malocclusion, were noted. At the initial visit, we performed TMJ intracapsular injection and prescribed medications to control pain and inflammation. Simultaneously, manual manipulation was performed to relocate the disc. The same treatments were employed two days later. However, 10 days after the first visit, his symptoms did not mitigate substantially. We also performed magnetic resonance imaging (MRI), prescribed nortriptyline, and created a stabilization splint. MRI images depicted inflammatory disc displacement and joint effusion in the right TMJ. Based on the accurate diagnosis, we kept administering a stabilization splint, intra-articular injection, and medication. His signs and symptoms were alleviated 20 days after the initial visit and did not reoccur for the next 40 days.