• Title/Summary/Keyword: Disc opening

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Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

OSTEOCHONDROMA OF THE MANDIBULAR CONDYLE: A CASE REPORT (하악 과두부에 발생한 골연골종의 치험례)

  • Kim, Min-Chul;Min, Sung-Yoon;Joo, Bum-Ki;Huh, Jong-Ki;Kim, Hyung-Gon;Park, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.3
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    • pp.283-287
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    • 2005
  • Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. Osteochondroma shows an irregular radiopaque lesion and chondromatic area surrounded by osteoma. It may appear different findings as calcification levels. When it develops in the long bone, it has a marked tendency in the ages from 10 to 20 years and ceases with the end of pubertal growth. However, when it develops in the condyle, it is prevalent in the third decades (average 39.2 years) and continues to develop. Lesions developed in the long bone have a predilection for men (M:F = 2:1), but for women in the mandible. Osteochondroma is differentiated from chondroma, osteochondromatosis and osteoma. Mandibular condyle osteochondroma presents asymptomatic facial swelling, rarely posterior openbite, pain during mouth opening and internal derangement of the temporomandibular joint disc due to condylar lengthening and condylar hyperplasia. The first choice of treatment of the massive osteochondroma is the surgical removal. We report osteochondroma of the mandibular condyle showing good result to treat the lesion.

A CLINICAL STUDY ON TEMPORALIS MYOFASCIAL FLAP FOR ADULT TEMPOROMANDIBULAR JOINT ANKYLOSIS (측두근 근막 피판을 이용한 성인 악관절 강직증의 외과적 재건에 관한 임상적 연구)

  • Park, Bong-Wook;Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.143-153
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    • 2006
  • Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

Effect of simultaneous therapy of arthrocentesis and occlusal splints on temporomandibular disorders: anterior disc displacement without reduction

  • Lee, Hye-Sung;Baek, Hyun-Su;Song, Dong-Suk;Kim, Hee-Chul;Kim, Hyo-Geun;Kim, Bok-Joo;Kim, Myung-Soo;Shin, Sang-Hoon;Jung, Sung-Hee;Kim, Chul-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.14-20
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    • 2013
  • Objectives: This study sought to evaluate the effect of simultaneous application of arthrocentesis and occlusal splint. Materials and Methods: A retrospective study of 43 patients (3 males, 40 females) whose symptoms had improved was conducted at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital between 2008 and 2010. Subjects were divided into three groups: Group A (17 patients with arthrocentesis and occlusal splints simultaneously applied), Group B (13 patients whose symptoms did not improve with occlusal splints, undergoing arthrocentesis after occlusal splint use for 8 weeks), and Group C (13 patients that only used occlusal splints). We compared these groups in maximum comfortable opening (MCO) and the visual analogue scale of pain and noise. Follow-up was performed at 1 week, 1 month, 3 months, and 6 months. Results: The improvement of symptoms was noted in all three groups, but Group A had a quicker improvement than the other groups, in terms of pain reduction and MCO increases. Conclusion: The simultaneous application of arthrocentesis and occlusal splints can reduce patient discomfort more quickly.

SURGICAL TREATMENT OF RECURRENT TMJ DISLOCATION BY EMINECTOMY WITH DISCOPLASTY (하악관절융기 절제술과 악관절원판 성형술을 이용한 악관절 탈구의 외과적 치료)

  • Kim, Hyung-Gon;Choi, Hee-Soo;Huh, Jong-Ki;Park, Kwang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.141-146
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    • 2002
  • Purpose: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. Materials and Methods: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. Results: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. Conclusion: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.

Study on Temporomandibular Disorder Patients with Conservative Treatment (보존적 치료를 이용한 TMD 환자에 관한 연구)

  • Ko, Myung-Yun;Kim, Jin-Hwa;Heo, Jun-Young;Ok, Soo-Min;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.77-86
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    • 2013
  • In order to evaluate the effect of conservative treatment for Temporomandibular Disorders(TMD), 137 patients were subjected at the Department of Oral Medicine, Pusan National University Dental Hospital from June 2012 to Sept. 2012. They were treated conservatively with behavioral therapy, physical therapy, medication and occlusal stabilizing splint therapy. Subjective symptoms and clinical findings were investigated to evaluate and compare the patients' status after 3 months treatment. The results were as follows; 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurements of TMD were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender and chronicity. 3. Conservative treatment including stabilization splint produced better results than physical therapy with medication. 4. After 3 months of treatment, pain and LOM were significantly improved in the MD(Muscle disorder) group. Pain, LOM and noise were significantly improved in the DD(Disc displacements) group. In the OA(Osteoarthritis) group, pain, noise, LOM and MCO were significantly improved.

Preliminary study on the effect of inflamed TMJ synovial fluid on the intracellular calcium concentration and differential expression of iNOS and COX-2 in human immortalized chondrocyte C28/I2

  • Choi, Eun-Ah;Lee, Dong-Geun;Chae, Chang-Hoon;Chang, Young-Il;Park, Young-Ju;Kim, Young-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.1
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    • pp.36-41
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    • 2006
  • Objective. The objective of this study was to examine the hypothesis that inflammatory synovial fluid from TMJ internal derangement initiates a transient increase in intracellular calcium concentration ([$Ca^{2+}$]i) in chondrocytes and the induced Ca2+ signaling affects iNOS/COX-2 gene expression patterns following exposure to inflamed synovial fluid. Materials and Methods. Two female adult patients with symptoms of TMD who agreed to participate in the study were selected for this study. Immortalized human juvenile costal chondrocyte C-28/I2 was grown to 80% confluency and synovial fluids from two patients were added respectively to culture media for 24 hours at the concentration of 100ng/10ml. Confocal laser scanning microscope (CLSM) was used to examine changes of intracellular calcium concentration ([$Ca^{2+}$]i). RT-PCR was performed to identify the expression profile of IL-1${\alpha}$, iNOS, COX-2. Results. Increased [$Ca^{2+}$]i was observed in chondrocytes subjected to inflamed synovial fluid compared to control cultures and in respective cultures exposed to inflamed synovial fluids from each patient, IL-1${\beta}$, COX-2 mRNA were detected. However, in neither case iNOS mRNA was expressed. IL-1${\alpha}$, COX-2, and iNOS mRNA were expressed in control culture. Conclusion. Our results show that immortalized chondrocytes cultured with inflamed synovial fluids from patients diagnosed as disc displacement without reduction and limitation in mouth opening showed increased calcium concentration and expression of COX-2 while inhibiting the production of iNOS, which in turn could adversely affect the chondrocytes in at least short term by hindering physiologic role of NO against inflammatory cascades. These findings suggest that inflamed synovial fluid may differentially regulate the transcriptomes of relevant inflammatory mediators, especially iNOS/COX-2 axis in chondrocytes through adjusting calcium transients.

The Study of the Origin and Transformation of the Arts of the Dao in The Canonical Scripture (《典經》中的道術思想來源與轉化運用研究)

  • Hsieh, Tsung-hui
    • Journal of the Daesoon Academy of Sciences
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    • v.36
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    • pp.267-298
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    • 2020
  • The purpose of the paper is to analyze the developmental background and practical approaches to the arts of the Dao (道術 dosul) in Daesoon Jinrihoe (大巡真理會) by tracing this concept back to its source and comparing and contrasting Daesoon Jinrihoe's usage of 'arts of the Dao' with the usage found in traditional Daoism. The paper is divided into a preface, conclusion, and two body sections. Especially significant discoveries appear in the second and third sections. In the second section, the Daoist concept of Alterable and Unalterable Degree Numbers (運度定數 yundudingshu, 'degree numbers' suggesting 'fate' or 'destiny') allows for a comparison between the Reordering Works of Heaven and Earth (天地公事 cheonjigongsa) from Daesoon Jinrihoe's The Canonical Scripture (典經 jeon-gyeong) and the Opening of Calamities to Save Humanity (開劫度人 kaijieduren) in Daoism. Here discourse can be provided regarding the cause of calamities (劫 'jie' in Chinese and 'geop' in Sino-Korean). Additionally examined are the deep grievances between divine beings and humans and the cosmic cycles of growth and decay as both of these relate to the reason for calamities. As for the resolving of calamities, there are two differing perspectives proposed by Daesoon Jinrihoe and traditional Daoism. Daesoon Jinrihoe believes that Kang Jeungsan (姜甑山) led changes and renewal through the Reordering Works of Heaven and Earth. In this context, clergy and laity play roles as assistants. However, Daoism emphasizes gaining merit from the recitation of scriptures and the collective participation of immortals rather than relying completely upon divine intervention from the Celestial Worthy of the Primordial State (元始天尊 yuanshi tianzun). In the third section, 'The Origin and Application of the Arts of the Dao (道術 daoshu),' analysis is provided regarding the origin and connotation of five directional generals (五方將 wufangjiang), the twenty-four generals (二十四將 ershijiang), the twenty-eight generals (二十八將 ershibajiang), and the forty-eight generals (四十八將 sishibajiang). Likewise examined is the relationship between the arts of the Dao in The Canonical Scripture and Thunder Rites in the Shen Xiao Lineage (道教神霄雷法 daojiao shenxiao leifa) of Daoism. Lastly, some points are made about the operation of two ceremonies: The Ceremony of Transformation and Pacing (遁甲步罡儀式 dunjiabugangyishi) and Divination through the Formula Disc of the Six Ren Gods (六壬式盤占卜 liuren shipanzhanbu).