• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.39-51
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• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.163-173
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• 2013

When the mandible performs opening movement, the condyle-disk complex conducts sliding movement along the articular eminence. Thus, anatomic configuration of articular eminence is very important to normal movement of TMJ. The purpose of this study was to measure the posterior slope of the articular eminence and evaluate the effect of a pathologic bone change in the condylar head on the stiffness of articular eminence, and compare the differences of the articular eminence slope by gender and age using dental cone-beam CT. As using i-CAT Cone-Beam Computed Tomography, the CT images of 204 TMJs of 102 patients(43 men and 59 women, mean age: 37.7 years) who were diagnosed at Wonkwang University Sanbon Dental Hospital were evaluated. All images were converted into a TMJ analysis mode to observe the continuous sagittal section images and coronal section images of the joints. To observe and assess bone changes in the condyle, three dentists measured the stiffness of the articular eminence on the same images, and when two of the three dentists agreed on their reading, these results were adopted and recorded. The articular eminence slope, considering the condylar anatomic configuration, was measured in three regions, namely, lateral part, central part, and medial part of the condyle. In the cases of a normal condyle(NCBC) and a condyle(CBC) with bone change, the articular eminence slopes were $57.0^{\circ}$(NCBC) and $51.8^{\circ}$(CBC) at the medial part, $57.9^{\circ}$(NCBC) and $52.4^{\circ}$(CBC) at the central part, and $55.1^{\circ}$(NCBC) and $49.5^{\circ}$(CBC) at the lateral part of the condyle. And the articular eminence slope of the condyle with bone change demonstrated less steepness than that of normal condyle (p<0.05). The articular eminence slope showed mediolaterally that it was the steepest at the central, followed by at the medial, and at the lateral (p<0.05). There were no significant differences by the gender and the age (p.0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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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.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.4
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• pp.275-282
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• 2001

Centric relation is defined the horizontal position between maxilla and mandible when condylar head of mandible is positioned adequately in mandibular fossa. The most recent concept of centric relation position is defined as the mandibular position in which the condyles are in their most superoanterior position in the articular fossa, resting against the posterior slope of the articular eminences, with the articular disk properly interposed. To be suitable as a reference point during occlusal management, a mandibular position of centric relation has to be functionally acceptable to the patient and clinically reproducible and achievable during everyday practice. There are numerous methods for determination of centric relation, and in this study we used three of them, Gothic arch tracing(Group I), leaf gauge(Group II), and anterior jig(Group III). The subjects were 10, 8 men and 2 women, age-ranged from 23 to 26 years old, had no prosthetics in thier mouth, and had no sign and symptom of temporomandibular disorders. We gained three occlusal records using each method, and then the degree of the reproducibility was examined with split cast technique. In this study the reproducibility of centric relation using split cast technique was greater in the order of Group I(mean 1.6), Group II(mean 1.4), and Group III(mean 1.3), but there was no significant differences among them statistically(p>0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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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.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.141-148
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• 1995

The Magnetic resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.

• Imaging Science in Dentistry
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• v.31 no.4
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• pp.185-192
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• 2001

Purpose: To evaluate the condylar movement at maximal mouth opening on MRI in patients with internal derangement. Materials and Methods: MR images and transcranial views for 102 TMJ s in 51 patients were taken in closed and maximal opening positions, and the amount of condylar movement was analyzed quantitatively and qualitatively. Results: For MR images, the mean condylar movements were 9.4 mm horizontally, 4.6 mm vertically and 10.9 mm totally, while those for transcranial views were 12.5 mm, 4.6 mm, and 13.7 mm respectively. The condyle moved forward beyond the summit of the articular eminence in 41 TMJs (40.2%) for MR images and 56 TMJs (54.9%) for transcranial views. Conclusion: The horizontal and total condylar movements were smaller in MR images than in transcranial views.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.284-287
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• 2001

Three dogs referred to Veterinary Medical Teaching Hospital, Seoul National University were diagnosed as intervertebral disc disease. Physical examination, neurologic examination, survey radiograph, and myelography were performed in patients. Case 1 showed narrowing intervertebral space and calcified intervertebral disc material in survey radiograph. Case 2 showed increased opacity in the intervertebral opacity in survey radiograph. All of 3 cases showed extradural pattern during myelography. In survey radiography, radiographic signs consistent with intervertebral disc herniations include narrowing of the disc space and the dorsal intervertebral articular process joint space, small intervertebral foramen, increase opacity in the intervertebral foramen and extruded, mineralized disc material within the vertebral canal. Myelography is useful for evaluating the spinal cord and the cauda equina. Indication for myelography includes confirming a spinal lesion seen or suspected on survey radiograph, defining the extent of a survey lesion, finding a lesion not observed on survey radiograph, and distinguishing between surgical and nonsurgical lesion. In presentcases, two of three cases show radiographic signs of IVDD with survey radiograph and all of three case show extradural pattern during myelography. It is observed that intervertebral disc disease is one of the most important indication for radiographic examination and myelography of the vertebral column of small animals.

• The korean journal of orthodontics
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• v.19 no.3
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• pp.15-33
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• 1989

The purpose of this study was to investigate changes of the mandible of a growing rat when they are subjected to a retractive force and those after removal of the retractive force. The experimental animals were Sprague-Dawley male rats of four weeks of age. A mandible was retracted with 50 grams of force on each side in the posterior and superior direction for 8 hours per day. The animals were sacrificed after 1 week, 2-week and 4-week force application, and after 4-week force application-4-week force removal period. The changes of rat mandibular growth following retractive force on the growing rat mandible were observed histologically and biometrically. The findings were as follows ; 1. Histologically, the thickness of the condylar cartilage was slightly reduced in the anterosuperior region with the retractive force. However, in the group of 4-week force application-4-week force removal, there was no significant difference in the thickness of the condylar cartilage. 2. There were no significant histological changes in the articular disk and glenoid fossa through the experimental period. 3. The length and anterior height of the mandible subjected to the retractive force were significantly smaller and greater than those of the control group. 4. There were no significant differences in the mandibular length between 4-week force application - 4-week force removal and the control group. 5. It was concluded that a mandibular retractive force produced inhibitory effects in the growth of the mandible, but that these effects were not sustained during mandibular growth in this experimental model.

• Tribology and Lubricants
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• v.29 no.1
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• pp.46-50
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• 2013

In this study, the frictional behaviors of articular cartilage against a Co-Cr alloy in two types of kinematic motions were compared. Cartilage pins were punched from the femoral condyles of porcine knee joints, and Co-Cr alloy disks were machined from orthopedic-grade rods and polished to a surface roughness ($R_a$) of 0.002. Friction tests were conducted by using a pin-on-disk-type tribotester in phosphate buffered saline (PBS) under pressures of 0.5, 1, and 2 MPa. All tests were performed in the repeat pass rotational (ROT) and the linear reciprocal (RCP) sliding motions with the same sliding distance and speed of 50 mm/s. The coefficients of friction of the cartilage against the Co-Cr alloy increased with the sliding time in both kinematic motions for all contact pressures. The maximum coefficients of friction in RCP motion were 1.08, 2.82, and 1.96 times those in ROT motion for contact pressures of 0.5, 1, and 2 MPa, respectively. As the contact pressure increased, the coefficients of friction gradually increased in RCP motion, whereas they decrease and then increased in ROT motion. The interaction between the directional change of the shear stress and the orientation of collagen fiber in the superficial layer of the cartilage could affect the change in the frictional behaviors of the cartilage. A large difference in the coefficients of friction between the two kinematic motions could be interpreted as differences in the directional change of shear stress at the contact surface.