• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.336-342
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• 2017

Synovial chondromatosis is a rare benign lesion originating from the synovial membrane. It presents as adhesive or non-adhesive intra-articular cartilaginous loose bodies. Although the causes of synovial chondromatosis have not been fully elucidated, inflammation, external injury, or excessive use of joints have been suggested as possible causes. Synovial chondromatosis has been reported to occur most frequently at large joints that bear weights, with a rare occurrence at the temporomandibular joint (TMJ). When synovial chondromatosis develops at TMJ, clinical symptoms, including pain, joint sounds, and mouth opening may common. Moreover, synovial chondromatosis rarely spreads to the mandibular condyle, glenoid cavity, or articular eminence of TMJ. The goal of this study was to discuss the methods of surgery and other possible considerations by reviewing cases of patients who underwent surgery for synovial chondromatosis that extended to the temporal bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.202-209
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• 1990

A retrospective study of 498 patients (591 joints) who had diagnosed as having internal derangement of the temporomandibular joint by history, clinical examination, and arthrography were evaluated. 66 patients (70 joints) were diagnosed as having meniscus perforation between the joint compartments. In those patients with pain (11 joints : 15.7%), pain and crepitation (24 joints : 34.3%), pain, crepitation and LOM (31 joints : 44.3%), and painless crepitation with LOM (4 joints : 5.7%) complained clinically. All these patients who had perforation showed irregularity in outline of the contrast material, bone contour-contrast material gaps, flattening of cortical layer of articular eminence. On the 20 joints treated surgically, 17 joints were found to have meniscus perforation at the time of surgery which correlated with their pre-operative radiographic and clinical diagnosis. Three joints could not found perforation of meniscus. This study was designed to examine of the incidences of the meniscus perforation in the above patients and to assess the diagnostic accuracy of arthrography by comparing the results with the finding of direct examination at TMJ surgery.

• Journal of Oral Medicine and Pain
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• v.23 no.1
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• pp.45-55
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• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.13 no.1
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• pp.7-15
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• 1983

The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.152-155
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• 2014

Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.18 no.1
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• pp.67-73
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• 1988

This study was performed to clarify the mechanism of clicking sound and locking on temporomandibular joint and to determine the radiographic findings of them by using computed tomogram. Through the preliminary study with cadavers, the proper scanning condition and the correlatonship between the anatomy of cadaver and computed tomogram had been determined. The subjects were consisted of 10 controls and 16 patients having clicking sound or locking on temporomandibular joint. By using Hitachi-W500 as computed tomographic device, direct axial views and sagittal views reformed according to the changes in window setting and using the non-linear fraction were taken and analyzed by visual method and measuring the attenuation numbers. The obtained results were as follows: 1. The density of the anterior band of meniscus showed isodense to the surrounding muscles in normal. 2. In patient group, affected side showed increased radiopaque area anterior to condyle and underneath articular eminence as the feature of anteriorly displaced meniscus on axial and sagittal views. 3. In patient group, the condyle was rotated postero-laterally in affected side. 4. Non-linear fraction highlightened the feature of anteriorly displaced meniscus.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.21-29
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• 1993

The purpose of this study was to evaluation of temporomandibulr joint space according to increasing the occlusal force on working and non-working side during unilateral bite. For the study, 22 normal adults, age ranged from 23 to 25, who had no symptoms on TMJ area and masticatory muscles and had normal or class I molar relationship were selected. Transcranial TMJ radiograph was taken during unilateral biting with sensor of Bite force checker (Nihon Kohden Kygyo Co.Ltd., Japan) on each 1st molar teeth of right and left side which were forced each 0Kg, 10Kg, 20Kg and 30Kg by use of Accurad-200 (Denar Corperation's product). The radiographs were traced on the screen, which was magnified by 5. The size of temporomandibular joint space at anterior, superior and posterior compartment were measured with Dumas's method (reference line of between squamotympanic fissure and the most inferior point of articular eminence). On the basis of this study, the following results were obtained. 1. Size of anterior TMJ space was tend to decrease on the working side and increase on the non-working side according to increasing the occlusal force, but not significant statistically (p>0.05). 2. Size of superior TMJ space was tend to increase on the working side and decrease on the non-working side according to increasing the occlusal force (p<0.05). 3. Size of posterior TMJ space was tend to decrease on both working ad nonworking side, but non significant statistically.

• Journal of Korean Dental Science
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• v.17 no.1
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• pp.14-35
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• 2024

The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.549-564
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• 1993

The purpose of this study was to research the condylar path and the anterior angle of glenoid fossae and classify the patterns of condylar path. Thirty male and female dental students with normal occlesion and masticatory system ranging in age from 21 to 30, without present symptoms and an)r history of TM joint disturbance, were selected for this study. Transcranial radiographs of TM joints under mandibular lateral movement were obtained. By the computer analysis on the radiographs, the angle of posterior slope of articular eminance, the sagittal condylar guidance angie, condylar movement patterns and the height of glenoid fossa was measured respectively, and studied their interrelationship comparatively. The results obtained were as follows : 1. The total distance of condylar movement on balancing side during mandibular lateral movement was 4.55mm for Lt. and 4.78mm for Rt. when mandible moved from C.R. to canine to canine relation and 7.86mm for the Lt. and 8.10mm for the Rt. when mandible moved from C.R. to 7.5mm. 2. The horizontal distance of condylar movement on balancing side during mandibular lateral movements was 3.16mm for the Lt. and 3.52mm for the Rt. when mandible moved from C.R. to canine to canine relation and 6.10mm for the Lt. and 6.30mm for the Rt. when mandible moved from C.R. to 7.5mm. 3. The sagittal condylar guidance angle on balancing side during mandibular lateral movements was $45.96^{\circ}$ for the Lt. and $43.22^{\circ}$ for the Rt. when mandible moved from C.R. from canine to canine relation and $41.14^{\circ}$ for the Lt. and $39.77^{\circ}$ for the Rt. when mandible moved from C.R. to 7.5mm. 4. The height of glenoid fossa was 8.23mm for the Lt. and 7.80mm for the Rt. and the angle of posterior slope of articular eminence was $38.30^{\circ}$ for the Lt. and $38.79^{\circ}$ for the Rt. by method-A and $55.61^{\circ}$ for the Lt. and $55.64^{\circ}$ for the Rt. by method-B. 5. The sequence of the frequency of condylar movement patterns on balancing side during mandibular lateral movement were concave type(30 cases), convex type(16 cases), reverse S shape curve(9 cases) and S shape curve(5 cases) when mandible moved from C.R. to canine to canine relation and concave type(27 cases), 5 shape curve(13 cases), convex type(11 cases) and reverse S shape curve(9 cases) when mandible moved from C.R. to 7.5mm.

• The Journal of Korean Academy of Prosthodontics
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• v.25 no.1
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• pp.119-135
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• 1987

For the determination of instantaneous centre of rotation in the mandibular movement, the habitual opening path was recorded on the sagittal tracing plate by a Gnathorecorder attached on the lower anterior teeth which was designed for this study. The opening path was demonstrated mathematically and the instantaneous centre of rotation in the opening path were calculated and plotted by computer programs, and then a computer graphic movement of the mandible was obtained according to the opening path. The hinge path of posterior border movement was graphied by the Gnathorecorder as well and demonstated mathematically. This hinge path was compared with the same obtained by Visitrainer to prove a reliability of the Gnathorecorder. The results obtained from this study were as follows. 1. The habitual opening path and hinge path obtained from the Gnathorecorder movement were expressed mathematically as follows: $y=0.11x^2-0.66x+3.09$ (equation of opening path), $y=0.04x^2+0.21x+3.71$ (equation of hinge path), and a kinematic hinge axis was not shown in the equation of kings path. 2. The early habitual opening movement of the mandible demonstrated almost a straight opening path or an arc motion with the larger radius and it's centre of rotation moved parallelly in the more rear and lower position than a kinematic hinge axis. 3. Instantaneous centre of rotation occured along with the translation of the condyle, and mandible was rotated around an axis in the close to the maximum opening and then moved toward the forward and upward position. 4. There were some similarities between the articular eminence and the movement pattern of a special point which was the kinematic hinge axis.