• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.96-106
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• 2016

Purpose: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

• The Journal of Korean Physical Therapy
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• v.34 no.6
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• pp.321-325
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• 2022

Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p<0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p<0.05), but ankle sways were not different between group. Conclusion: We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.185-189
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• 2023

Purpose: This study investigated the immediate biomechanical effects of unilateral mastication for 10 minutes on the temporomandibular joint (TMJ) with 21 healthy adult participants. Methods: The gum group chewed gum on the right side for 10 minutes, and the control group rested for 10 minutes. Biomechanical data were obtained using a three-dimensional infrared camera before and after intervention. An independent t-test assessed the variation of kinematic data to identify differences between before and after intervention. Results: Among biomechanical variables, the gum group's length of the left forehead middle region and the temporomandibular joint angle decreased compared to the control group (p<0.05). Conclusion: Caution with unilateral masticatory activity is recommended, as unilateral mastication causes biomechanical changes due to excessive load on the soft tissues of the contralateral TMJ.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.24 no.1
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• pp.117-124
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• 1986

Numerous studies have been reported on the movement of the jaw during chewing. However, there is still much controversy. The purposes of this study were to observe the jaw movement during mastication and to provide the information in prosthodontic treatment and diagnosis of temporomandibular disorder. The author analyzed the time and characteristics of the masticatory movement during chewing using mandibular kinesiograph in 24 subjects, 17 males 7 females, age of 22-27 without orofacial problems. The obtained results were as follows: The duration of single chewing cycle was $515{\pm}87msec.$. Comparing the three phases of the chewing cycle (opening, closing, centric pause), the closing phase had the longest duration, and the centric pause had the shortest duration. The maximal laterotrusive movement of the mandible druing chewing was $3.5{\pm}1mm$. The maximal mediotrusive movement of the mandible during chewing was $1.0{\pm}0.7mm$. The maximal vertical velocity of the mandible during chewing was $120{\pm}28mm/sec.$ in opening phase, and $109{\pm}21mm/sec.$ in closing phase.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.369-382
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• 1996

The author performed this study to investige the relationship between condylar movements recorded with Pantronicⓡ and mandibular rotational torque movements with BioEGNⓡ. For this study 56 patients with Temporomandibular disorders(TMD) and 30 dental students without any masticatory signs and symptoms were selected as patients group and control group, respectively. The items recorded with Pantronicⓡ(Denar Corp., USA) were immediate side-shift, progressive side-shift, angle of orbiting path, protrusive path and PRI. BioEGNⓡ(Bioelectric gnathography, Bioresearch Inc., USA) were used to measure the amounts of mandibular rotational torque movements in frontal and horizontal plane, and the distance of mandibular translation at incisal area. Amount of mandibular rotational torque movement depicted between the condyles was automatically analysed by angle and difference in frontal and horizontal plane. The obtained data were processed with SAS program and the conclusion of this study were as follows : 1. Mean values of items between patients group and control group in Pantronic measurements were not significantly different except in left protrusive path and in Pantronic Reproducibility Index(PRI). There were no significant difference of condylar paths by preferred chewing side and affected side between the two groups. 2. The amount of mandibular rotational torque movements were differed in frontal angle and difference on protrusion, and in frontal and in horizontal difference on left excursion between the two groups. But the amounts of translatory movements were actually same on all eccentric movements. 3. The amount of mandibular rotational torque movements with splint mere almost not changed from those without splint, with the exception of in horizontal measurements on protrusion. 4. The correlations of items between in Pantronic measurements and in BioEGN measurements wert not consistently, significant, however, generally the ISS related significantly with horizontal torque movement positively, and with frontal torque movement negatively on the contrary, the PSS showed positive correlation with frontal torque movement, and negative correlation with horizontal torque movement.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.421-429
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• 2007

Some researchers suggested that tactile sensor system would be useful in evaluating masticatory muscles of TMD patients, but there were few studies on the effects of chewing with time. The aim of this study was to investigate the change of elasticity and stiffness for masseter and temporal muscles of normal subjects before, during and after gum chewing and to obtain the baseline data for further researches on the elasticity and stiffness for masticatory muscles of TMD patients. Stiffness and elasticity of their anterior temporalis and inferior masseter muscle were measured bilaterally by a tactile sensor system. Each subject was instructed to sit on a chair for evaluation of masticatory muscles. Before operating the sensor, the thickest skin area over anterior temporalis and inferior masseter muscles were selected as the points to be pressed by a tactile sensor, and marked with a pen. While the teeth of subjects were lightly contacted, the probe of the tactile sensor was placed perpendicularly over the marked point over the skin, followed by computer-controlled movement including gently pressing straight down on the muscle for a second and retracting. All subjects were instructed to chew gum (Excellent Breath, Taiyo Co., Japan) bilaterally with a velocity of 2 times per second for 40 minutes after the first measurement had been performed for the baseline data of all subjects. The measurements had been repeated during chewing with 10 minutes of interval and continued for 40 minutes with same interval after chewing. Resultantly, the decrease of elasticity and the increase of stiffness in masticatory muscles can be seen significantly within 10 minutes after chewing and those were maintained during chewing without significant change with chewing time. The elasticity of muscles was recovered within 10 minutes after stopping chewing, but the stiffness was recovered more lately than elasticity by about 10 minutes. Based on these results, it can be concluded that elasticity and stiffness of muscles would be good indicators to evaluate the masticatory muscles objectively, when more supported by further researches.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.348-356
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• 2001

The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.13-19
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• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.475-478
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• 2012

The purpose of this study is to identify the level of masseter muscle tension according to the levels of restricted movement and pain in the temporomandibular joint(TMJ), thereby verifying the fact that excessive masseter muscle tension can be a cause for restricted movement and pain in the TMJ. The subjects of this study were 81 men and women in their 20s and 30s, who feel uncomfortable with their masticatory function on the preferred chewing side. The subjects were measured in terms of the range of motion (ROM) and deviation of the TMJ and the degree of pain in the affected region. The ROM and deviation of the TMJ were measured using the Global Posture System(GPS) after instructing each subject to open his/her mouth to the fullest and taking photos of the subject with a digital camera. The tension of the masseter muscle was measured with a Pressure Threshold Meter(PTM). After the measurements, in order to compare the ROM of the TMJ, the subjects were divided into two groups based on the ROM of above 35mm and below 35mm. For the deviation and pain, based on the average of total subjects, the subjects were divided into two groups of above and below average. Thereafter, the levels of masseter muscle tension were compared between each pair of groups. According to the results, when each variable was compared between the respective two groups, in terms of the deviation, the pressure pain threshold(PPT) of the masseter muscle revealed a statistically significant difference(p<.05). However, the ROM and pain showed no statistically significant difference. Consequently, masseter muscle tension may cause restricted movement in the TMJ. In particular, the deviation and tension in the masseter muscle is considered to be a factor that causes deviation in the TMJ.