• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.325-331
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• 2009

The objective of this study was to describe the prevalence of the headache attributed to Temporomandibular disorder(TMD) symptoms and to investigate the relationships of headache and TMD. 66 patients seeking care for signs and symptoms of Temporomandibular disorders(TMD) and Orofacial pain in the department of oral medicine, Dental Hospital, Chosun University, from January, 2008 to June, 2008, were recruited. The obtained results were as follows : 1. A muscle and TMJ origin combined was the most common in study populations(54.55%), grouped as TMD classification. 2. Tension type headache was the most common in study population(89.39%), grouped as headache classification. 3. 36 patients out of 66(54.55%) had headaches which related to TMD. 4. Out of 36 patients who had suffered the headache which were attributed to TMD, 19 patients(52.78%) described that their headache related to TMD was different from their own primary headaches. In conclusion, headache attributed to TMD is relatively common in the patients who had headaches and TMD symptoms together. And the new headache patterns may related to headache and TMD chronification. Larger-scale studies and more specified and controlled comparison study is needed to confirm the relationship between the headache and TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.388-394
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• 1999

To compare the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis the author investigated 22 temporomandibular joint disorder(TMD) patients with pain and limitation of mouth opening who visited at the Department of Oral and Maxillofacial Surgery. Chosun Dental Hospital and were made a diagnosis as Wilkes stage III or IV of TMJ internal derangement clinically and radiographically. The two groups consisted of 10 patients with injection of sodium hyaluronate 10mg$(Artz^{(R)})$(hyaluronate group) on the upper joint space of the affected temporomandibular joint 5 times at intervals of a week after arthrocentesis, and 12 patients with injection of dexamethasone$(Oradexon^{(R)})$ at a time(dexamethasone group). Maximum mouth opening, pain value and satisfaction value during mastication were assessed on a visual analog scale before arthrocentesis and after 6 months. Then the within-group and between-group differences were evaluated in the obtained data and the clinical success rate of each group was calculated according to our success criteria. The results were as follows. 1. the mean of maximum mouth opening before arthrocentesis and after 6 months in the hyaluronate group were 24.9mm and 39.0mm respectively, and those before arthrocentesis and after 6 months in the dexamethasone group were 25.7mm and 41.3mm respectively. 2. The mean of pain value on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 6.7 and 1.8 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 7.0 and 1.8 respectively. 3. The mean of satisfaction value during mastication on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 2.8 and 7.7 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 3.1 and 7.8 respectively. 4. There were statistically significant differences between all measurements before arthrocentesis and after 6 months(P<0.001), but no difference between all measurements in the hyaluronate group and those in the dexamethasone group. 5. The over all success rate of the hyaluronate group and the dexamethasone group were 60.0% and 63.6% respectively. In summary, there was significant difference between the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis but hyaluronate is better than corticosteroid as the injection drug in consideration of the side effect related with repeated injection.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.1
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• pp.69-75
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• 2002

A number of techniques may be employed to reduce the discomfort of syringe or needle for dental care. The use of topical anesthesia is one such method. Topical anesthetics are applied to alleviate pain during many clinical procedures, such as injection of local infiltration anesthetics, primary tooth extraction, X-ray taking of sensitive patients, reducing gag reflex prior to impression taking. In children, placement of a rubber dam clamp, however, may cause significant discomfort for purpose of pit and fissure sealant and preventive resin restoration(PRR). A topical anesthetic would be beneficial to aid in rubber dam placement for this purpose. It has been suggested that all intra-oral topical anesthetics are equally effective on reflected mucosa, however EMLA(an acronym for eutectic mixture of local anesthetics), which was developed in the 1980s and produces surface anesthesia of skin, has been shown to be more effective than conventional topical anesthetics when used on attached gingivae. This report is topical anesthesized 4 case by EMLA cream, who showed better effect in reducing the pain of infiltration anesthesia, extraction of deciduous teeth, rubber dam clamp placement and reducing the pain of preformed crown adaptation.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.61-72
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• 2021

A beautiful smile is made when it is symmetrical and gums are displayed less than 2 - 3 mm. Excessive gingival display also known as "gummy smile" is often recognized to be unaesthetic. Causes of gummy smile can be caused by delayed eruption, vertical maxillary excess, hypermobile upper lip, or a short upper lip. Meanwhile botulinum toxin which is an exotoxin produced from Clostridium botulinum, works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles. The application site and weakens the muscle tone is drawing attention as a gummy smile treatment caused by hypermobile upper lip. There have been many studies about the method of injecting botulinum toxin into muscles around the lips, but there is still no standardized research method and treatment method, so there is controversy over the therapeutic effect. The aim of this study is to review the previous studies about the predictors of indication and effects of gummy smile treatment using botulinum toxin injection. Especially we tried to propose a protocol for optimal dose and efficient injection point through the anatomical considerations for gummy smile treatment using botulinum toxin.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.388-394
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• 1997

Temporomandibular (TM) joint Pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.191-199
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• 1997

Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.38.1-38.8
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• 2019

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.617-626
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• 1992

This study was conducted for the assessment of the usefulness of masseteric silent period on electromyogram as a diagnostic method for temporomandibular disorder. Of students and dentists in Dental College of Yonsei University and patients, 36 experimental subjects with symptoms such as clicking bound, pain in the temporomandibular joint area and limitation of jaw movement, and 33 control subjects without such symptoms were selected for this study. On each subject electromyographic masseter muscle silent period followed by mention tap was recorded with surface electrodes and analysed with computerized system. The following results were obtained: 1. The mean silent period was $36.97{\pm}9.23$ msec in experimental group, and $25.62{\pm}5.24$ msec in control group respectively. 2. There were no statistically significant differences in silent period between male and female in either experimental and control group. 3. Silent periods in experimental group were more prolonged than those of control group. (P < 0.01) Taken all together, electromyographic masseter muscle silent period may be useful for diagnosis and evaluation of temporomandibular disorder.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.3
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• pp.259-272
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• 1994

The authors reviewed the etiology and essential treatment of temporomandibular disorders. The principal etiology was thought to the the myospasm of masticatory musculatures by stress (major cause) and dental irritation. Therefore, we attempted to control the myospasm by stress management, isometric exercise and regular daily physical exercises (walking, Jogging, bycycling, rope skipping, swimming & gymnastic exercise). The result was more favorable (95% success rate) without recurrence in 123 patients, who was referred to our department of dentistry(Oral & Maxillofacial surgery), Wonju Christian Hospital.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.416-421
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• 2010

Purpose: The purpose of this study was to evaluate the incidence of intra- and postoperative complications of orthognathic surgery and their relevance. Materials and Methods: The clinical records and X-rays of 418 patients who underwent surgery at Chosun University Dental Hospital, Korea, over a 12-year period between 1998 and 2009 were examined. Results: The followings are some of the most common complications which happened during the oper-ations: Inadequate osteotomy in 25 cases, excessive bleeding in 11 cases, nerve injuries in 6 cases, soft tis-sue injuries in 8 cases, and tooth injury, and insertion of foreign bodies in 4 cases respectively. The most frequent complications which happened after surgery are shown below. Paraesthesia in 262 cases, dyspnea in 78 cases, pain in cervical region in 49 cases, open bite in 14 cases, plus 62 cases where other complications occurred. Despite the great variety of complications, severe life threatening complication frequency seems to be extremely low. Conclusion: Orthognathic surgery appears to be a relatively safe procedure but complications related to orthognathic surgery do still occur. Accurate evaluation and precise surgery are needed to minimize complications.