• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.18 no.1
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• pp.67-73
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• 1988

This study was performed to clarify the mechanism of clicking sound and locking on temporomandibular joint and to determine the radiographic findings of them by using computed tomogram. Through the preliminary study with cadavers, the proper scanning condition and the correlatonship between the anatomy of cadaver and computed tomogram had been determined. The subjects were consisted of 10 controls and 16 patients having clicking sound or locking on temporomandibular joint. By using Hitachi-W500 as computed tomographic device, direct axial views and sagittal views reformed according to the changes in window setting and using the non-linear fraction were taken and analyzed by visual method and measuring the attenuation numbers. The obtained results were as follows: 1. The density of the anterior band of meniscus showed isodense to the surrounding muscles in normal. 2. In patient group, affected side showed increased radiopaque area anterior to condyle and underneath articular eminence as the feature of anteriorly displaced meniscus on axial and sagittal views. 3. In patient group, the condyle was rotated postero-laterally in affected side. 4. Non-linear fraction highlightened the feature of anteriorly displaced meniscus.

• The Journal of the Korean dental association
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• v.38 no.6 s.373
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• pp.549-557
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• 2000

ㆍPurpose: This study was performed to investigate the initial conservative treatment for TMD patients using careful counselling and medication prospectively. ㆍMaterials and Methods: Careful counselling and medication were performed in 51 TMD patients and 27 patients had follow-up check 2 months or more. Diagnosis of TMD was based on medical history and, physical and radiographic examination. TMD included masticatory disorder, internal derangement, degenerative joint disease, inflammatory joint disorder. and problems resulting from extrinsic trauma. All patients had chief complaints of TMJ pain, mouth-opening limitation. joint noise, and/or referred pain. We counselled and explained to the patient about the pathogenesis, etiologic factors, diagnosis and treatment plan for abut 10 minutes. We prescribed nonsteroidal anti-inflammatorv analgesic(Somalgen) and amitriptyline 10mg per day for 2 weeks. We informed the patient of the attention sheet and taught self-exercise of jaw. The patient were assessed by answering the questionnaire of subjective evaluation of TMD & maxillofacial pain. Questionnaire of an activity limitation. Questionnaire of a jaw function, and Questionnaire for the evaluation of TMD. ㆍResults: In questionnaire for the evaluation of TMD, 88.5% of 26 patients answered that the treatment was efficacious. 71.4% of 21 patients answered no problem in everyday life. There were significant differences between pretreatment and final follow-up in the evaluation of the subjective pain in the following sections: opening widely, chewing, resting, morning, masticatory muscle, and temporal portion(SAS program, paired T-test, P = 0.05). ㆍConclusions: Considerate counselling and proper medication could be significantly effectve in the initial treatment of TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.211-216
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• 2007

Temporomandibular joint disorders (TMD) often show muscular disorder, internal derangement and degenerative change of articular surface of the condyle. It is important to choose adequate diagnostic method for obtaining data for the diagnosis and treatment. Magnetic Resonance Imaging (MRI) has some advantages, because it shows good resolution image for the soft tissue and it is not invasive to the human body. We have performed serial research about the retrodiscal tissue of the TMJ according to the progress of the disease, using T2 weighted image, since 2002. In this study, we applicated resized observation area to compare signal intensity between the retrodiscal tissue of the TMJ and cerebral gray matter, using T2 weighted image.

• Journal of Korean Physical Therapy Science
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• v.5 no.4
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• pp.717-728
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• 1998

The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.1-4
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• 2003

Purpose : The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. Materials and Methods: On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Results: Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1 %) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Conclusion: Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.237-244
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• 1992

The author has studied retrospectively the meniscectomy with temporary silastic implant. The study material used was 4 joints that were possible to be followed up in 9 joints of out of all 145 joints who were diagnosed as internal derangement and have been operated in Yongdong Severance hospital from March 1988 to February 1990. We concluded that the use of temporary silastic implant would prevent the complication which would be arised after meniscectomy alone. And we could obtain the results of the relief of clinical symptoms and maintenance or improvement of joint space when preoperative and postoperative clinical and radiographic findings were compared. The larger number of patients and long term follow-up will be needed for further the investigation.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.141-148
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• 1995

The Magnetic resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.157-162
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• 2023

Elongated styloid syndrome (ESS) can present with myriad symptoms that mimic common features of orofacial pain, such as temporomandibular joint disorders (TMJDs), often causing a challenge and delay in diagnosis. We report the case of a 52-year-old male with a three-year history of non-painful clicking during jaw movement initially diagnosed as TMJD-related internal derangement. The patient presented with a history of annoying jaw sounds for three years, described as a popping sound without bilateral clicking or crepitation. Tinnitus and progressive hearing loss were observed in the right ear, and a hearing aid was recommended by an otolaryngologist. The patient was initially diagnosed with TMJD and managed accordingly; nevertheless, his symptoms persisted. Imaging revealed prominent bilateral styloid process elongation that exceeded the recognized cut-off level of >30 mm for elongation. The patient was informed of his diagnosis and its treatment but opted only for further swallowing and auditory assessments of his ear and nose symptoms. Clinicians should consider including ESS as a differential diagnosis in patients presenting with non-specific chronic orofacial symptoms for timely diagnosis and favorable clinical outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.11-18
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• 1989

Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

• Journal of Korean Medical classics
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• v.13 no.2 s.17
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• pp.21-21
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• 2000

All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exegenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usuable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki)穀氣) 내 that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Maridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily froms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and connot fulfil their own functions. Because the meridian symtem unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.