• Title/Summary/Keyword: Diagnosis, Oral

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Differential Diagnosis and Treatment of Septic Arthritis in the Temporomandibular Joint: A Case Report and Literature Review

  • Kim, Bola;Choi, Hyo-Won;Kim, Jae-Young;Park, Kwang-Ho;Huh, Jong-Ki
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.127-132
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    • 2019
  • Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

A diagnostic dilemma in pediatric osteomyelitis: a case report

  • Mandrekar, Pooja Narendra;Gavhane, Sanket;Fernandes, Trishala Bhadauria;Dhupar, Vikas;Dhupar, Anita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.117-121
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    • 2022
  • Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis (측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성)

  • Roh, Chang-Se;Jung, Yun-Hoa;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.81-90
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    • 2009
  • This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.

Stability of the prosthetic screws of three types of craniofacial prostheses retention systems

  • Lanata-Flores, Antonio Gabriel;Sigua-Rodriguez, Eder Alberto;Goulart, Douglas Rangel;Bomfim-Azevedo, Veber Luiz;Olate, Sergio;de Albergaria-Barbosa, Jose Ricardo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.352-357
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    • 2016
  • Objectives: This study aimed to evaluate the stability of prosthetic screws from three types of craniofacial prostheses retention systems (bar-clip, ball/O-ring, and magnet) when submitted to mechanical cycling. Materials and Methods: Twelve models of acrylic resin were used with implants placed 20 mm from each other and separated into three groups: (1) bar-clip (Sistema INP, São Paulo, Brazil), (2) ball/O-ring (Sistema INP), and (3) magnet (Metalmag, São Paulo, Brazil), with four samples in each group. Each sample underwent a mechanical cycling removal and insertion test (f=0.5 Hz) to determine the torque and the detorque values of the retention screws. A servo-hydraulic MTS machine (810-Flextest 40; MTS Systems, Eden Prairie, MN, USA) was used to perform the cycling with 2.5 mm and a displacement of 10 mm/s. The screws of the retention systems received an initial torque of 30 Ncm and the torque values required for loosening the screw values were obtained in three cycles (1,080, 2,160, and 3,240). The screws were retorqued to 30 Ncm before each new cycle. Results: The sample was composed of 24 screws grouped as follows: bar-clip (n=8), ball/O-ring (n=8), and magnet (n=8). There were significant differences between the groups, with greater detorque values observed in the ball/O-ring group when compared to the bar-clip and magnet groups for the first cycle. However, the detorque value was greater in the bar-clip group for the second cycle. Conclusion: The results of this study indicate that all prosthetic screws will loosen slightly after an initial tightening torque, also the bar-clip retention system demonstrated greater loosening of the screws when compared with ball/O-ring and magnet retention systems.

Factors Related to Patients' Satisfaction Level of Treatment Outcome of Oral Malodor (구취치료 후 만족도에 영향을 미치는 예견인자)

  • Lee, Jeong-Yun;Kho, Hong-Seop;Kim, Young-Ku;Chung, Sung-Chang;Lee, Sung-Woo
    • Journal of Oral Medicine and Pain
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    • v.26 no.1
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    • pp.27-38
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    • 2001
  • 본 연구에서는 환자들에 의해 구취와 관련이 있다고 일반적으로 믿어지고 있는 여러 요인들이 치료 후의 환자의 만족도에 미치는 영향에 대해 알아봄으로써 환자의 만족도의 예후를 판단할 수 있는 자료를 마련하고자 하였다. 서울대학교 치과병원 구강진단과에 구취를 주소로 내원한 환자 194명을 대상으로 설문지를 이용하여 구취와 관련성이 있는 것으로 알려져 있는 항목들을 조사하였다. 조사 항목으로는 1) 본인확인가능여부, 2) 타인확인가능 여부, 3) 구취의 기간, 4) 구취의 빈도, 5) 축농증, 6) 비염, 7) 코수술 병력, 8) 콧물이 목뒤로 넘어감, 9) 코막힘, 10) 비호흡 곤란, 11) 구강건조감, 12) 편도선부종, 13) 가래, 14) 신물의 역류, 15) 소화불량, 16) 흡연여부가 포함되었다. 구취의 평가는 portable sulfide monitor인 $Halimeter^{(R)}$(Interscan Co., Chatsworth, CA, USA)를 이용하여 치료 전, 후에 각각 측정하였고, 혀배면의 세정, 치면 세균막 조절, 0.25% $ZnCl_2$ 양치액의 사용을 내용으로 하는 구취의 치료를 시행한 뒤 자신의 구취개선정도에 대해 %로 질문하여 치료 후 만족도를 조사하였다. 각 조사 항목과 치료 후 만족도 사이의 상관관계 및 실제 $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 상관관계를 분석하였으며, Symptom Checklist - 90 Revised(SCL-90R)의 분석결과에 따라 환자를 두 그룹으로 분류하고 두 그룹 사이의 치료 후 만족도의 차이를 조사한 결과 다음과 같은 결론을 얻었다. 1. 본인 및 타인 확인가능여부, 구취가 항상 나는지 여부, 구취의 기간, 축농증, 비염, 코수술 병력, 코막힘, 비호흡 곤란, 콧물이 목뒤로 넘어감, 흡연여부에 따른 치료 후 만족도의 유의한 차이는 없었다. 2. 신물의 역류(p=0.003), 소화불량(p=0.007), 구강건조감(p=0.016), 편도선 부종(p=0.018), 가래(p=0.033)에 따른 치료 후 만족도는 통계적으로 유의한 수준의 차이를 보였다. 3. $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 유의한 상관관계는 관찰되지 않았다(r=0.092, p=0.201).

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Mimicking Odontogenic Pain Caused by Burkitt's Lymphoma: A Case Report

  • Kim, Eui-Joo;Kim, Soung-Min;Park, Hee-Kyung
    • Journal of Oral Medicine and Pain
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    • v.42 no.3
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    • pp.85-88
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    • 2017
  • Burkitt's lymphoma is a malignant monoclonal proliferation of early B-lymphocyte. Since Burkitt's lymphoma is a highly aggressive disease, early detection is a crucial. This disease often involves jaw and mandibular mass or swelling may also be seen, but in the early phase of Burkitt's lymphoma these symptoms cannot be observed. A rare case of Burkitt's lymphoma without any mandibular mass and the general symptoms was present. The excruciating toothache led the patient to visit the dental clinic and misdiagnosis of chronic periodontal abscess was made initially. Dentists should consider the oral manifestations of systemic disease when the multiple periodontal ligament space widening is observed and the dental treatment for mimicking odontogenic pain has no effect.

Salivary Immunoglobulin A Concentrations in Patients with Oral Ulcer (구강궤양 환자의 타액내 면역 글로블린 A의 농도)

  • Geun-Chun Ryu;Chang-Lyuk Yoon
    • Journal of Oral Medicine and Pain
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    • v.19 no.1
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    • pp.117-124
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    • 1994
  • Parotid and whole saliva were collected from 27 healthy adults, from 25 years of age to 30, and from 27 patients with oral ulcer, from 23 years of age to 61. The amount of each Salivary immunoglobulin A was measured by single radial immunodiffusion (SRID) technique. Results were as follows : 1. There was no significant difference between the normal group and the disease group in the concentration of immunoglobulin A in whole saliva. 2. The concentration of immunoglobulin A in parotid saliva of the normal group was higher than the disease group and the difference was statistically significant between the two groups. (p<0.01) 3. The concentration of immunoglobulin A of the parotid saliva in both groups was higher than that of the whole saliva.

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구강악성종양 100예에 대한 임상적 고찰

  • Kim, Jong-Won
    • The Journal of the Korean dental association
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    • v.18 no.3 s.132
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    • pp.201-206
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    • 1980
  • The contents of paper are over all incidence informed from 100 case of oral cancer patients who are diagnosed histopathologically in out patient clinic, department of oral surgery, Seoul university hospital during the period of 12 months in 1979. The patients were classified for the clinical evaluation and it's assessment as like age distribution, arising regional section, and groups divided according with final histopathological diagnosis. The following are obtained results of studies 1) As regards of age distribution of oral cancer, 5th decade age group presented the highest incidence, 6th and 4th decade age groups revealed next high incidency. 2) The most common sites of oral cancer were mandible body (33%), maxillae (26%), hard palate and buccal cheek (10% each), oral floor (8%) etc. 3) According to the histopathological diagnosis, cancer of oral cavity, squamous cell carcinoma is disclosed one of the most frequently presented malignantic oral tumor (58%), and nexts are mucoepidermoid carcinoma (15%0, malignant lymphoma (10%), adenocystic carinoma (5%), osteogenic and osteolytic sarcoma were 4% each. 4) In sexual differencies of oral cancer, more prominent incidency is showed in male (68%) than in female (32%).

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A Case of Mucous Membrane Pemphigoid: From Diagnosis to Therapeutic Strategy

  • Kang, Kun-Hwa;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.63-68
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    • 2021
  • Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

Clinical and Hematologic Characteristics of Temporomandibular Disorders Patients

  • Park, Seo Eun;Kim, Ji Rak;Jo, Jung Hwan;Park, Ji Woon
    • Journal of Oral Medicine and Pain
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    • v.43 no.2
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    • pp.41-51
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    • 2018
  • Purpose: The aim of this study was to evaluate the possibility of utilizing blood tests for the diagnosis of temporomandibular disorders (TMDs) by investigating the hematologic characteristics of TMD patients according to the main source and level of TMD pain and analyzing their interrelationship. Methods: Clinical examination following the research diagnostic criteria for TMD and hematological and psychological evaluations were conducted in 357 TMD patients. Patients were divided into groups according to the main source of pain (myogenous, arthrogenous, and combined pain) and the degree of pain according to the graded chronic pain scale (GCPS). Hematological differences among the groups were statistically analyzed. Results: The C-reactive protein (CRP) level was significantly higher in the arthrogenous pain group compared to the combined pain group (p=0.032). There was no significant difference according to the GCPS classification. There were significant correlations between some of the TMD pain indices and the hematologic indices, and also between the psychological indices and the hematologic indices. Conclusions: This study suggests the possibility of applying blood tests to the diagnosis, treatment and prevention of TMD. Further research should be conducted focusing on the role of CRP in TMD pain with more refined methodology and a longitudinal study design.