• 대한치과교정학회지
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• 제36권2호
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• pp.136-144
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• 2006

본 연구는 표준 경두개 방사선사진에서 나타나는 하악두/관절와의 위치 관계 및 형태 특징과 MRI에서 관찰되는 관절원판의 변위 여부를 비교함으로써 측두하악관절 내장증 평가 시 경두개 방사선사진의 임상적 이용 가능성을 알아보고자 하였다. 연구는 성인 환자 76명(남자 26명, 여자 50명)의 113개 악관절을 대상으로 하였다 MRI 자료를 기초로 하여 각 악관절을 정상군, 정복성 관절원판 변위군, 비정복성 관절원판 변위군으로 분류하였으며 최대 감합시의 경두개 방사선사진에서 관절와와 하악두 간의 전방, 후방 및 상방 직선 거리를 계측하여 상대적 위치 평가를 하고 형태적 특징을 판별하기 위해 악관절 경부와 두부간의 각도를 계측하였다. 또한 각 군에 따라 경두개 방사선 계측항목 간에 유의성 있는 차이가 있는지 알아보기 위해 일원분산분석과 다중비교분석을 시행하였다. 표준 경두개 방사선사진에서 나타나는 관절와와 하악두의 위치 관계는 관절원판 변위 여부 및 진행 정도와 상관성을 보이지 않았다. 또한 하악측두관절 경부와 하악두가 이루는 각도는 비정복성 관절원판 변위군에서 유의성 있게 증가하였다. 이는 하악두각이 악관절 내장증의 진행에 따른 악관절의 구조적인 경조직 변화를 반영한다고 볼 수 있으나 이것에만 근거하여 관절원판 변위 여부를 판단하기에는 근거가 미약하다.

• Journal of Oral Medicine and Pain
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• 제41권3호
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• pp.110-117
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• 2016

Purpose: The purpose of this study is to determine factors influencing the duration of occlusal appliance (OA) treatment for patients with temporomandibular joint (TMJ) internal derangement. Methods: Ninety patients were included for this study, who satisfied the following including criteria: (i) those who were diagnosed as disc displacement of TMJ by taking magnetic resonance imaging (MRI) and (ii) those who were finished OA treatment. The subjects were classified into three groups according to the period of OA treatment: (i) early response group (<6 months), (ii) moderate response group (6 months-1 year), and (iii) delayed response group (>1 year). Demographic data, data from chief complaints and past history of temporomandibular disorder, data from clinical examination and diagnostic imaging including panoramic view and TMJ MRI were compared among groups. One-way ANOVA and chi-square analysis were used to test statistical significance. Results: There were no significant differences in demographic data, data from chief complaints and TMJ imaging. However, only the prevalence of oral parafunctional habits including bruxism, clenching, and unilateral chewing showed significant differences among groups. Conclusions: Oral parafunctional habits could be factors to influence the duration of OA treatment in the patients with TMJ internal derangement.

• Imaging Science in Dentistry
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• 제31권3호
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• pp.159-164
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• 2001

Purpose: To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. Materials and Methods: MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes, 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. Results: The most frequent Stage in internal derangement of TMJ was Stage I. And 28 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage II (1.8%) and III (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. Conclusion: MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle.

• 대한치과교정학회지
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• 제22권2호
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• pp.345-372
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• 1992

The purpose of this experiment was to study the effects of changes of mandibular position on temporomandibular joint in internal derangement patients Twenty-four female New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study . Bilateral temporomandibular joint surgery was performed in twenty-one of the rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc, thus inducing internal derangement. They were divided into three groups nine were left untreated after surgery, six were fitted with functional protrusive appliances 4 weeks after surgery, and six wore collar appliances to apply 4 ounces of mandibular refractive force per side 4 weeks after surgery. The remaining three served as the control group. Histologic examinations were performed after sacrificing them by threes at 4-week intervals. The results were as follows. 1. Histologic findings similar to internal derangement were observed in the rabbits whose retrodiscal tissues had been incised. 2. In the rabbits untreated after surgery, articular surface on condylar process and articular eminence showed severe erosion and deformation, and displaced disc manifested changes in both shape and internal architecture. 3. Functional protrusion after surgery resulted in progressive remodeling on postero-superior portion of condyle and glenoid fossa, while it also brought about erosion on articular eminence and anterior portion of condyle. 4. Mandibular retraction after surgery resulted in compression of retrodiscal tissue and regressive remodeling of posterior portion of condyle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.189-197
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• 1993

Tempormandibular Joint pain and dysfunction is a common and important clinical problem. With the recent advances in imaging technology, radiologists have made major contribution to the understanding of TMJ disease. The MRI has several advantages over the conventional imaging methods. It is possible to obtain surprisingly precise images of internal hard and soft tissues with MRI. It is not invasive without ionizing radiation. The abnormal disk position has been thought as the cause of TMJ internal derangement. But there are few methods to relate disk position to TMJ internal derangement quantatively. The object of our study is to determine the amount of anterior displacement fo articular disk in symptomatic patients related each symptoms. Using the method of Dr. Drace, we studied the 38 joints of 22 persons with susceptable TMJ internal derangement. 1. In determining the anterior displacement of TMJ articular disk, the junction between the posterior band and bilaminar zone was useful. 2. The mean anterior displacement of disk in reduction group and without reduction group were $51.0^{\circ}C$ and $81.1^{\circ}C$ respectively. The difference was significant. 3. In the mean anterior displacement of disk, the pain without clicking group showed $84.8^{\circ}C$ and the clicking and pain group $70.8^{\circ}C$, the clicking group respectively.

• 한방재활의학과학회지
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• 제21권4호
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• pp.257-267
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• 2011

Objectives: The purpose of this study is to evaluate the effect of the burning acupuncture therapy and exercise therapy on the internal derangement of knee with patella tendon and posterior cruciate ligament injury. Methods: Burning acupuncture therapy was administered three times and exercise therapy was administered during 4 weeks. The improvement of clinical symptom was evaluated by VAS(visual analogue scale) and KOOS(knee injury and osteoarthritis outcome score). Results: After treatment, the patient's VAS score was reduced to 0 pant. The KOOS score of pain, symptom, ADL, sport/rec, QOL(quality of life) improved from 28 to 75, from 36 to 71, from 22 to 65, from 0 to 15, from 25 to 38 respectively. Conclusions: Burning acupuncture therapy and exercise therapy fer internal derangement of knee with patella tendon and posterior cruciate ligament injury was effective. Although this case presented valuable result, further research is encouraged to confirm the effectiveness of this treatment with large number of patient.

• Journal of Oral Medicine and Pain
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• 제20권1호
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• pp.133-139
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• 1995

The aim of this study was to investigate the state of anterior tooth contacts in patient with internal derangement of TMJ. We have investigated the change of the number of tooth contacts after conservative treatment including stabilization spint in 83 patients with TMJ internal derangemnet who visited the Orofacial Pain Clinic, Dept of Oral Diagnosis, Seoul National University Dental Hospital. The obtained results were as follows : 1. The gender ratio of patients was 1:3.7(M:F) 2. The number of patients with bony changes in TMJ was 17(20.5%) 3. The number of patients with absence of incisor tooth contacts was 73(88%) 4. The number of Tooth contacts after treatment was decreased compared with that before treatment in both groups. However there was no significant difference between groups 5. There was the decrease in the number of tooth contacts in 12(76%) of 17 patients with bony changes in TMJ and in 23(34.8%) of 66 patients without bony changes in TMJ. 6. The ratio of patients who showed the decrease of the number of tooth contacts was higher in patients with bony changes in TMJ than patients without bony changes in TMJ. 7. After conservative treatments with stabilization splints in patients with TMJ internal derangement, the possibility of the decrease in the number of tooth contacts had no relationship with the presence of incisor tooth contacts. However, the incidence was higher in patients with bony changes in TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.458-463
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• 1994

A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

• 치과방사선
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• 제28권1호
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• pp.205-213
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• 1998

This study was designed to reveal the correlationship between the internal derangement state of TMJ and clinical characteristics including pain and mandibular dysfunction. One hundred and twenty five subjects with TMJ signs and symptoms were chosen for two years. The level of pain and madibular dysfunction were evaluated by Visual Analog Scale(VAS) and Craniomandibular Index(CMI). The diagnostic categories of TMJ internal derangement were determined by arthrography and they included normal disc position, anterior disc displacement with reduction(ADDR), rotational disc displacement with reduction (RDDR), anterior disc displacement without reduction(ADDNR), and rotational disc displacement without reduction(RDDNR). Also disc perforation was used as a criteria to divide the diagnostic subgroups. The obtained results were as follows; 1. The patient distribution of each group was 5 in normal disc position(4％), 40 in ADDR(32％), 30 in RDDR(24％), 34 in ADDNR(27％), and 16 in RDDNR(13％). 2. Perforation was observed in 8％ of ADDR, 10％ of RDDR, 32％ of ADDNR, and 19％ of RDDNR. 3. CMI of non-reduction group was higher than that of reduction or normal group(p<0.05), but V AS showed no significant difference.4. CMI of perforation group was higher than that of non-perforation group in reduction group (p<0.05). 5. There were no significant differences of CMI and VAS between anterior disc displacement group and rotational disc displacement group in both reduction and non-reduction group. 6. CMI of RDDNR group was higher than that of RDDR group(p<0.05). 7. There were no significant difference of CMI and VAS between bilateral involvement group and unilateral involvement group(p<0.05).

• 치과방사선
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• 제21권2호
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• pp.225-234
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• 1991

This study was designed to investigate the effects of the posterior slope of the articular eminence and the condylar angulation to the posterior slope of the articular eminence on internal derangement of TMJ. The materials consisted of 78 transcranial oblique lateral projections of 31 normal subjects and 47 internal derangement patients. The results were as follows: 1. The posterior slope of the articular eminences in normal group were larger than that in abnormal group, but there were not significant differences between each group about the condylar angulation to the posterior slope of the articular eminences. 2. The differences between in the right and left sides in patients who were affected unilaterally and bilaterally were larger than that in normal groups. 3, In patients affected unilaterally, there were not significant differences between affected joints and unaffected joints about the posterior slope of the articular eminence and the condylar angulation to the posterior slope of the articular eminence. 4. In abnormal group, there were significant differences between each group about condylar angulation to the post, slope of the articular eminence (ant. disk displacement without reduction > fibrous adhesion > ant. disk displacement with reduction), but not about the post, slope of the articular eminence.