The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, symptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were : Implant treatment, 14 cases ; Tooth extraction, 3 cases and others. 2. TMD symptoms were : pain on TMJ, 12cases : Sound on TMJ, 3cases ; Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were : Synovitis and/or capsulitis, 10 cases ; 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were : Improvement, 6cases ; sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD, prior explanation and knowledge TMJ treatment are very important in these cases.
Seo, Bo-Myung;Lim, Seong-Chul;Jung, Tae-Young;Han, Sang-Won;Seo, Jung-Chul
Journal of Pharmacopuncture
/
v.8
no.3
/
pp.99-105
/
2005
Objectives : The purpose of this study is to analyze the functional and clinical improvement effect on temporomandibular disorder by additional Hominis Placenta and bee venom herbal acupuncture treatment. Methods : A patient was treated with Hominis Placenta, bee venom herbal acupuncture, simple acupuncture, chiropractic therapy, and herbal medicine. We evaluated the improvement by visual analogue scale(VAS) score, mouth opening range, and X-ray image. Results : The VAS score was significantly decreased and mouth opening range was increased after treatment. X-ray image showed improved change after treatments. Conclusions : We think Hominis Placenta and bee venom herbal acupuncture treatment mainly contributed to the improvement of temporomandibular disorders. Further study is needed for the confirmation of this effect of on temporomandibular disorders.
Most patients with temporomandibular disorder can be treated conservatively. However, open TMJ surgery can be needed in some patients. We analysed the patients with TMD which open surgery has performed since 1998. Open surgery was carried out in 8 patients. Age ranged from 22 to 61 years, with a mean of 42.8years. All patients were male. Final diagnosis was obtained based upon clinical, radiographic and operative finding as follows; habitual luxation, bony ankylosis, traumatic arthritis, disc displacement with destructive change, disc displacement and adhesion. Etiologic factors included trauma(4), infection(2), and unknown(2). Open surgery included arthroplasty with either of condylectomy, eminectomy, meniscoplasty, capsurrohaphy. All patients were recovered uneventfully without severe complications. Some mouth opening limitation and mouth opening deviation remained. Postoperative aggressive physical therapy and careful follow up were performed. In conclusion, open TMJ surgery must be considered in organic disease such as ankylosis, tumor and TMD without favorable recovery after long-term conservative therapy.
Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.
Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.
The management of mandibular condyle fractures continues to be a subject of much debate. It is suggested that, if not properly managed, these fractures may give rise to serious problems, such as malocclusion, mouth opening limitation, temporomandibular joint disorders. Treatment planing of mandibular condyle fractures is very important. The aim of this present study was to evaluate the long-term results according to treatment methods in condylar fractures. Also, it was to evaluate results of treatment according to condylar fracture level. We conducted a retrospective analysis of 43 mandibular condyle fractures. 43 patients followed for average period of 9.00 years(mini. 7yr, max. 12yr). All patients underwent a clinical and radiologic evaluation focusing on mouth opening, mandibular movements, TMJ function, change of ramal height, condylar remodelling. If the level of fracture was positioned in high, especially in level II, mandibular movement disability and ramus length loss was more prominent. This results were similar to the cases of treatment of fragment removal. In high level fracture and fragment removal cases, It is thought that more intensive and long term management are needed than other treatment cases using different operation methods. Also, direct fixation by each approach showed good results in mandibular movement, ramal height change and condylar shape. Through this results, accurate reduction of the mandibular condyle fractures was a very important factor in postoperative prognosis.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.17
no.1
/
pp.151-162
/
1987
The author obtained the computed tomograms around the condylar head from 10 normal subjects and 5 patients having clicking condylar head from 10 normal subjects and 5 patients having clicking sound or limitation of mouth opening by using a Hitachi-W 500. And then. the author had the axial analysis of condyle position and sagittal analysis of that after sagittal reformation on centric occlusion and 18㎜ interincisal opening. Transcranial view and submentovertex view were taken and compared with computed tomographic view. The obtained results were as follows: 1. Median angle of long axis of condylar head was 17 degrees on centric occlusion and the angles of long axis of both condylar heads were reduced symmetrically on 18㎜ interincisal opening in normal group. however. in the patient group, the affected side of condyle heads showed greater change in the angle on 18㎜ interincisal opening. 2. In the patient group, the condyle head of affected side was located superiorly to that of normal side on centric occlusion and the discrepancy of condular positional height was increased after 18㎜ interincisal opening. 3. The distances from medial pole of condylar head to triangular fossa of temporal bone were same on both right and left side in normal group, however, in the patient group, the distance of affected side was wider than that of opposite side on centric occusion and became narrower than the opposite side on 18㎜ interincisal opening. 4. The distances of posterior joint space were same on both right and left side. The distance t lateral pole 1/3 of condyle head was similar to that on transcranial view on centric occlusion in normal group. 5. The distances of posterior joint space were narrower in patient group than in normal group. 6. Conclusively, the affected condylar head of patient showed postero-latero-superior displacement on centric occlusion and larger range of rotational movement on 18㎜ interincisal opening.
A 69-year-old male pateint was admitted for discomfort on right temporomandibular joint during opening, closing and chewing that started few months ago. The patient had no special medical history except for lung tuberculosis approximately 30 years ago and nothing specific appeared on a physical exam taken 2 months ago. Clinical tests show that mouth opening of 53mm which was normal and no joint sound, deviation, pain during opening. But tenderness to palpation on Rt masseter muscle and pain existed on Rt temporomandibular joint during loading test on the right joint. No pain existed during resistance test and protrusion and range of lateral movement was normal. Rt temporomandibular joint was not swollen and no palpable mass was observed. No previous trauma history to the face existed. On X-ray calcific material existed in the joint cavity and on CT image, approximately 2mm sized calcific material appeared on the Rt temporomandibular joint but no change in bone appeared on the condyle nor the temporal bone. The patient was diagnosed as loose body, and the symptoms were relived after 2 physical therapies and is under regular check ups. The purpose of this case is to review disease that cause loose bodies.
Journal of the Korean Society of Fisheries and Ocean Technology
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v.23
no.1
/
pp.1-5
/
1987
The authors carried out an experiment to determine the vertical opening of the midwater trawl, which is the same used in the former experiment in this series of studies. To determine the vertical opening of otter board and front weight, three fish finders were used. A 200 KHz fish finder set on board the research vessel was used to sound the depth of water. A transmitter of 50 KHz fish finder was set through the shoe plate of otter board to determine the height of otter board from the sea bed, and a transmitter of another 50 KHz fish finder was set downwardly on the net pendant right before the front weight to determine the height of weight from the sea bed. The depth of otter board and weight were calculated by subtract the height of those from the depth of water, respectively. To determine the vertical opening of mouth, a transmitter of net recorder was set on the head rope and the vertical opening of that to ground rope was directly read on the recording paper. The results obtained can be summarized as follows: 1. The rate of the depth of otter board to the length of warp was in the range of 0.44 to 0.25, and the depth was linearly shoaled about 5m per 0.1m/sec of the towing speed or per 20rpm of the main engine. The rate of the observed depth to the calculated depth of otter board was in the range of 0.92 to 0.080 with a decreasing tendancy in accordance with the increase of towing speed. 2. The depth of head rope was 2 to 3m deeper than that of otter board, and the vertical opening of net mouth was in the range of 22 to 19m, with a decreasing tendancy in accordance with the increase of towing speed, 3. The difference of depth between front weight and otter board was about 20m and 22m respectively in the length of warp 100m and 150m without distinct change in accordance with the towing speed. The depth of front weight was 2 to 3m shallower than that of ground rope. 4. The changing range of depth of head rope according to the revolution of main engine was about 4m per 20rpm.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.11
no.1
/
pp.79-87
/
1981
The author analysed the interrelation between the morphologic changes of bone Structures and the position of condylar head from the routine radiographs of 134 cases of the temporomandibular joint arthrosis. The frequencies of coincidence between the site of bone defrmity and condylar head positional change were examined. Also, the positional changes of condylar head and the direction of condylar movement in relation to the kind of bone deformities were observed. The results obtained were as follows; 1. In 52.65 per cent of total cases, the site, of positional change of condylar head was coincided with the site of bone deformans. The frequencies of the coincidence between these in the five items among seven items examined were above 53 per cent. From the results, it seems that the positional changes of condylar head were related with the morphological change of bone structure. 2. Eburnation and erosion. revealed frequently positional changes in the opening and closing position of the mouth, although in the early stages of the TMJ arthrosis. 3. In the bone deformans, during opene position of the mough 44.81 per cent of total cases revealed backword movement and 37.74 per cent showed forward movement. In closed position of the mouth, downward movement was revealed in 35.23 per cent of total cases and upward movement 28.41 per ,cent of total cases. 4. In the cases showing eburnation, the frequencies of coincidence between the site of positional change and bone deformans were 58.57 per cent of the total cases. that means it was high in the early stages of the TMJ arthrosis.
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