Journal of Dental Rehabilitation and Applied Science
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v.21
no.1
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pp.43-57
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2005
Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory nuscles, and associated structures. There have been many different contributing factors of TMDs which were traumatic, occlusal, pathophysiological and psychosocial. Among there factors, the effect of occlusion on TMDs have been a controversy for a long time. The purpose of this study was to investigate the effect of occlusal factors and oral habits on TMDs. In this study, 140 subjects with signs and symptoms of TMDs and diagnosed of TMD in the Orofacial Pain clinic of Yonsei University Dental Hospital though March to July 2004 were selected for the TMDs group and 50 subjects without any signs and symptoms of TMDs as the control group. The subjects were evaluated clinically in TMDs' Occlusal and Prosthodontic Restoration examinations. TMDs' examination was composed of the TMJ pain, sound, locking, temporal or masseter muscle palpation, mandibular movement, oral habits and headache. Occlusal examination was made of overjet, overbite, lost teeth number, nonfunctional interference, midline shift, then pattern of lateral movement and attrition. prosthodontic restoration examination had the existence of restoration, placement, then number of crown or bridge and Satisfiable index which estimated the quality of occlusal state of prosthodontic restorations. Following results were obtained : 1. The prevalence of TMDs was higher in their 20s & 30s, female of the TMD patients group. 2. The clenching frequency in the TMDs group(40.71%) was higher than those in the control group(18.00%), and there was a significant statistical difference(p<0.05). 3. The frequency of Nonfunctional interference in the TMDs group(10.00%) was higher than those in then Control group(2.00%), and there was a significant statistical difference(p<0.05). The result of this study indicated TMDs prevalence was higher in their 20s, 30s, female group of TMDs patients similar to the previous studies. Clenching and nonfunctional interference were estimated as the contributing factors of TMDs.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.3
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pp.543-549
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2005
The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and is a key in esthetics due to its position. Maxillary canine has the longest time to develop and a complex route from the place of formation to the site of eruption, and so it is prone to impaction more than other teeth. The clinician should consider the various treatment options : (a) No treatment and observation, (b) surgical exposure and orthodontic traction (c) autotransplantation (d) extraction. Surgical exposure of the canine and orthodontic treatment to bring the tooth into the line of occlusion is considered the most desirable approach. This case presents the results of treatment for impacted maxillary canine by surgical exposure and orthodontic tooth movement.
The objective of this study was to compare the condylar path and the anterior angle of articular fossa and to analyze the pattern of condylar path in edentulus patients. Nineteen male and female edentulous patients with normal masticatory system ranging in age 42 to 78, without present symptoms and any history of TMJ disturbance were selected for this study. On the computer analysis on the transcranial radiographs of the TMJ, the angle of slope of articular eminance and condylar path to the Frankfort Horizontal Plane and the height of glenoid fossa was measured respectively, and stuied their interrelationship comparatively. Obtained results were asfollows. 1. The angle of the slope of articular eminence averaged 37.28 degree. and there was no significant difference between the right and left side. 2. The condylar path angle averaged 29.05 degree and there was no significant difference between the right and left side. 3. The height of the glenoid fossa averaged 8.11 mm and there was no significant difference between the right and left side. 4. The sequence of the frequence of condylar movement patterns were concavex curve(39.5% ), 'S' shape curve(34.2%), reverse 'S' shape(15.8%) and convex curve(10.5%). 5. The horizontal distance of the point of the changed curve of the condylar path averaged 2.91 mm. 6. The height of glenoid fossa was highly correlated to the slope of articular eminence and relatively highly correlated to tile condylar path and the condylar path was closely correlated to the slop of articular eminence.
The purpose of this study was to investigate the relationship between the mandibular positions and the habitual mandibular opening and closing movements in normal subject using the newly developed electric mandibular movement analyzing device(Saphon Visi-Trainer C-II.Tokyo Shizaisha Inc. Tokyo, Japan) One of the cause of the temporomandibular joint dysfunction has been considered abnormal mandibular positions especially the abnormal deviation between intercuspal position from retruded contact position. The subjects in this study were consisted of 55 young adults in 20 decade who had normal occlusion, no prosthodontic restorations and no history of disturbance or pain on temporomandibular joint and masticatory muscles. The results were as follows : 1. The deviations of intercuspal position from retruded contact position were 0.23mm in frontal view and 1.02mm in sagirral view. 2. The larger the deviation of intercuspal position from the retruded contact position, the higher the proportion of uncoincidence of the habitual nandibular closing and opening trajectories was, and the proportion was higher in sagittal view than frontal view, 10mm opening than 5mm opening. 3. Correlation between the deviation of intercuspal position from retruded contact position and uncoincidence rate of the habitual mandibular closing and opening trajectories was higher in frontal view than sagittal view.
The author has studied on the clinical features and symptomatology of 97 MPDS patients, who visited the Dept. of Dentistry, Kyungpook National University, from January to September in 1982. The results were as follow : In age and sex distribution of patients in this population, the third decades appeared to have the highest prevalence and the male to female ratio was almost 1 to 2.23. As to occupation, students and housewives were revealed to have the highest incidence of MPDS. The chief complaints of patients were pains, TMJ noises, and limitation of mouth opening in order of frequency, and the most prevalent site of symptom was that of preauricular area. In symptom sequence, the majority of initial symptoms were TMJ noise and pain but limitation of mandibular movement was progressively developed, regardless of nature of early symptoms. Chronic unfavorable oral habits were found to be the most possible predisposing factors in this study. The average maximum interincisal distance was $38.13\pm10.00mm$ in males and $30.73\pm8.75mm$ in females, and a deviation of mandible during mouth opening was observed in 60.8% of patients. In TMJ signs, tenderness of the TMJ to palpation was found in 60.8% of patients and TMJ noise was audible in 50.5% of patients with a stethoscope. The muscles of masticatory system were palpated according to usual methods, and a significant indidence of muscular tenderness was present, with the lateral pteygoid muscles being most frequently involved, followed by masseter, medical pterygoid and temporalis muscles.
Maximal active movements of the mandible in the vertical and the horizontal plane were measured in 147 boys and 155 girls. with an age of 13, 15, 17 years respectively. The studied persons had no pain or severe symptoms of dysfunction of the masticatory system and the method used in this paper was devised by Agerberg, and the numerical calculations were performed at the Dept. of Medical Engineering of Seoul National University Hospital. The obtained results were as follows : 1. The mean values of maximal opening in 13 year-old boys and girls were 58.5 mm,58.9 mm respectively, and the mean values of boys were increased with age. 2. The mean values of maximal lateral movement to the right in 13-year-old boys and girls were 9.1 mm, 8.3 mm respectively, and the mean values to the left were 9.3 mm, 8.7 mm resprctively. The mean values were not increased with age in both. 3. The mean values of maximal protrusion in 13-year-old boys and girls were 8.7 mm, 8.1 mm respectivly, and in all ages the mean values of boys were larger than those of girls. 4. The range of maximal mandibular movements in teen-agers with 95% probability prediction ellipses were presented.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.4
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pp.498-502
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2008
Ameloblastoma is the most common aggressive benign odontogenic tumor of the jaws. Because of slow growth and tendency to local invasion of bone and soft tissue, high rates of recurrence are common. The treatment for ameloblastoma is still controversial and poses some special problems in children. Because of growth of the jaw and the different incidence, prognosis of the tumor make the surgical consideration different from adults. Radical resection cause facial deformity, jaw abnormal movement and masticatory disturbance especially to child and adolescents. So conservative treatment as enucleation, curettage is acceptable initial treatment of ameloblastoma in children who can be followed up in a precise, detailed manner. This report describes a case of unilocular plexiform ameloblastoma treated by enucleation and curettage followed by marsupialization.
mastication is basically regulated by central pattern regulalor(CPG) of brain system, target organ output from CPG is modulated by oral sensory feedback, anterior cross bite pattern infuluence the feedback mechanism and change muscle activity and jaw movement. The purpose of this study was to investigate differnce anterior cross bite group from normal group, the selected sample groups were 30 normal patient, 30 anterior cross bite patient. EMG and EGN of Biopak system were used for this study The following results were obtained 1 In resting slate of mandible, anterior cross-bite showed the higher muscle activities in all the muscle.(exception:left digastric muscle) than normal group. 2. In clenching state, No significant difference in muscle activities of normal group and anterior cross bite group was noticed 3. In swallowing state Normal group showed the higher muscle activities in left and right masseter muscle, right posterior temporal muscle. 4. In maximum opening and closing velocity, normal group showed the higher value than anterior cross-bite. 5. In the mean value of the maximum opening,the maximum anterior posterior movemenl from centric-occlusion, the lateral deviation from centric occclusion, normal group showed the higher value than anterior cross-bite group.
Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.
Many types of occlusal splints are used for treatment of craniomandibular disorders. Most widely used splint among them is flat-type centric relation splint. Insertion of splint into the mouth may cause increasing of vertical dimension, masticatory muscle realignment and rearrangement of maxillo-mandibular relationship, so as a result of splint treatment, occlusal relation may vary whether you like it or not. From this point of view, occlusal state of patient shold be frequently monitored to prevent undesired or harmful effect during occlusal splint therapy. The purpose of this study was to investigate the effect of occlusal splint, especially centric relation splint, on the occlusal contact state after 3 months treatment. 32 patients with craniomandibular disorders who had unilateral symptoms participated in this study. To observe and record occlusal contact state, the author used T-Scan system (Tekscan Co. U.S.A.) at both pretreatment and posttreatment. The recorded date were analyzed with regard to contact number, contact force and contact time, change of anterior tooth contact and coincidence of first contact point with affected side were observed, too. Aan last, the subjects were divided into 2 groups and compared, according to average value of VAS index, with respect to joint pain, sound and limitation of movement, respectively. The collected date were statistically processed with SPSS and the result as follows : 1. Total occlusal contact number and force were not changed by occlusal splint therapy but total occlusal contact time decreased slightly. 2. There was a tendency of increasing number of subjects with anterior tooth contact after treatment and change of first contact point side were observed in as many as 40.6% of subjects. 3. There were no difference between higher and lower group of VAS index, and between pretreatment and posttreatment in each group, either.
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