• Journal of Oral Medicine and Pain
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• v.42 no.2
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• pp.35-43
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• 2017

Purpose: This study aims to evaluate the correlation between joint sounds and radiographic bone change patterns along with clinical symptoms of temporomandibular joint osteoarthritis (TMJ OA) patients. Methods: The patients for this study were over 19 years of age, diagnosed tentatively with TMJ OA. The patients were examined with temporomandibular disorders analysis test and all three radiographs, including panoramic radiography, transcranial radiography, and cone beam computed tomography (CBCT). Information of the patients' age, pain status, joint sound and mouth opening range were collected. And bone change pattern was examined by reviewing panoramic radiography, transcranial radiography and CBCT images. Results: The patients with crepitus had a higher average active mouth opening (AMO) range than patients without crepitus, and the group with bilateral crepitus had a higher average AMO range than the group with unilateral crepitus (p<0.001). And the patient with pain during mastication was increased in the group with clicking than the group without clicking, and the group with bilateral clicking showed a statistically significant increase in the patient with pain during mastication than the group with unilateral clicking (p<0.05). The analytical results of the relevance of crepitus showed a high correlation with bone change observed from each of the three radiographs. And the agreement in bone change findings from 3 groups of paired radiographs showed high agreement (p<0.001). Meanwhile, 77.2% of CBCT findings showed bone change of condyle without crepitus (p<0.001). Conclusions: This study presented significant results in the evaluation of the correlation with crepitus and bone change of TMJ OA patients from panoramic radiography or transcranial projection. However, the accurate assessment is required through CBCT for the patient with complains of persistent pain, limitation of mouth opening, and occlusal change even if the crepitus does not exist.

• Journal of Oral Medicine and Pain
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• v.44 no.2
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• pp.45-53
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• 2019

Purpose: To determine whether crepitus may be a clinical indication for early temporomandibular joint (TMJ) osteoarthritis (OA) and to investigate the correlation between crepitus and the occurrence of TMJ OA with respect to factors, such as patient sex, age, chewing habits, and diagnosis. Methods: This is retrospective analysis of clinical data for 162 TMJs. The criteria for a joint to be included in this study was a minimum of two cone-beam computed tomography (CBCT) scans performed with no OA observed during the initial scan. The Diagnostic Criteria for Temporomandibular Disorders was used for OA diagnosis. Crepitus was recorded when it was objectively palpated during the follow-up period. Correlations between various patient factors and progression to TMJ OA were calculated using the Pearson's chi-square test. A linear-by-linear association was used to analyze trends of OA progression with increasing age. Results: Among the 162 joints, 101 progressed to OA and 61 did not. In the joints where crepitus had been present before OA was confirmed at next or last CBCT, OA progressed at a high rate, and especially higher in female and older patients (p<0.01). Patients in the pain-related disorder group with crepitus were observed to have higher rates of OA progression compared to patients in the intra-articular disorder group (p<0.01). Conclusions: If a patient experiences pain in the TMJs and crepitus, close monitoring through regular CBCT scans is necessary even if there is no evidence of radiologically confirmed OA after the first CBCT.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.7-18
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• 1989

The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

• Journal of Korean Dental Science
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• v.8 no.1
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• pp.16-27
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• 2015

Purpose: The purpose of this study was to evaluate the correlation between the clinical symptoms of temporomandibular disorder and findings in the magnetic resonance imaging (MRI). Materials and Methods: Clinical data and MRI images were collected from a total of 240 German patients. Clinical symptoms were briefed as joint clicking, crepitus and pain. MRI findings were further defined according to the condyle position, condyle degeneration, disc positon, disc degeneration and the presence of osteophyte/sclerosis/synovitis. Hypermobility was separately recorded. Correlation analysis between parameters was performed. Result: Joint clicking had a positive correlation with unilateral disc degeneration, osteophyte, sclerosis and synovitis. Crepitus had a significant correlation with bilateral osteophyte. Pain was not correlated with any MRI findings except hypermobility. Conclusion: Selective correlations between the MRI findings and clinical symptoms were elucidated. The results of this study imply that condyle-disc deformities could be advanced without pain, and that joint clicking and crepitus could be clinical symptoms of condyle-disc degeneration.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.39-43
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• 2000

Osteochondromas, the most common tumor of the scapula, are one type of bone abnormality that may cause symptomatic scapula pseudowinging. This type of scapula winging is structural and maybe associated with significant scapula crepitus. We describe a case of a scapular solitary osteochondroma, arised from the ventral surface of the scapula in a 15-year-old boy, produced pseudowinging and scapula crepitus. The winging and scapula crepitus are alleviated with resection of the bony abnormality.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.141-158
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• 1995

This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.

• Imaging Science in Dentistry
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• v.34 no.2
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• pp.91-97
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• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• The Journal of the Korean dental association
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• v.34 no.1 s.320
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• pp.19-23
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• 1996

• The Journal of Korean Academy of Prosthodontics
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• v.26 no.1
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• pp.113-131
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• 1988

Although TMJ sound is common, its relationship to subjective and objective evaluation and the magnitude and the position of the sound during the mandibular movement is not fully understood. So, the purpose of this investigation was to provide further insight into the characteristics of the TMJ sounds. Twelve subjects (9 men and 3 women) with TMJ sounds were selected from students at Chosun University, School of Dentistry. Condylar movements and TMJ sounds of each subject were recorded and analyzed using a simplified condylar path recorder and a sound checker. Although specific conclusions were difficult to make from this study, the finding suggested the followings. 1. The position of TMJ sounds were visually observed and marked on the condylar tracings during maximum opening and closing, protrusive and retrusive and right and left lateral movements. 2. Information about the size, location and number of condylar deviations and the translation freedom of the condyle was recorded and analyzed objectively. 3. The most obvious characteristic of TMJ sounds was their variability. 4. TMJ sounds were categorized into one of four groups (soft click, hard click, soft crepitus, hard crepitus) by the quality and quantity of the duration and amplitude components.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.257-267
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• 1995

An Epidemiologic study was carried out on 77 TMD patients with degenerative joint disease who had visited the Orofacial Pain Clinic in Pusan National University Hospital. Al subjects were interviewed and examined clinically and radiologically using a standardized examination form. As related to gender and duration, subjective and objective sysmptoms in DJD patients were studied. The obtained results were as follows : 1. There were much more patients in the twenties or thirties, women and histories such as chronic duration and microtrauma. 2. Most patients responded positively more often to the questions of jaw function, unilateral chewing in habits, poot appetite and depression in behavioral response and shoulder pain in worsening prognosis 3. While the most common reasons for treatment were pain, noise, and limitation of opening, the associated symptoms such as headache, neckache, earache, jaw dysfunction, neck dysfunction, acute bite change and dizziness, ringing or fullness in the ears as secondary CNS excitatory effects were complained. 4. Opening the mouth in 25 to 40mm, soft end feel and deflective incisal pathway were seen and more tenderness to lateral or dorsal capsule of joint than intra or extra oral muscles were complained. 5. While there appeared no click, crepitus and single click in acute group, in chronic group, crepitus, single click and no click appeared in order of sequence. 6. Tomogram or bone scan revealed more bony changes than panorama and transcranial view.