• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.61-71
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• 2016

Purpose: This study was designed to evaluate the comparison between the subjective and the objective evaluation of pain control effect in masticatory muscle pain depending on time and dose change. Methods: The patients were recruited to this study and diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Experimental group were divided into three groups; saline injection group (n=10), morphine 1.5 mg injection group (n=10), and morphine 3.0 mg injection group (n=10). Evaluation list was the subjective pain evaluation (visual analogue scale, McGill pain questionnaire) and the objective pain evaluation (pressure pain threshold [PPT], pressure pain tolerance [PTO]). The subjective and the objective pain evaluation were performed at the times of just before injection, 10 minutes, 30 minutes, 1 hour, 24 hours, and 48 hours after injection. Then, data were statistically analyzed. Results: The results were as follows: 1) There is no statistically significant difference between the results of the subjective and the objective pain evaluation with regard to the short-term (within 1 hour) analgesic effect of morphine sulfate. 2) However, after 1 hour of injection, while the subjective pain evaluation score still decreased, the objective pain evaluation didn't show significant changes in PPT and PTO (1 hour, p<0.05; 24 hours, p<0.01; 48 hours, p<0.001). 3) In comparison to changes in the dose, the McGill pain questionnaire was the most statistically effective method among the subjective pain evaluations (1.5 mg, p<0.05; 3 mg, p<0.01). Conclusions: Therefore, it was revealed that the subjective pain evaluation was more effective to evaluate long-term pain control, and that the McGill pain questionnaire could be an effective way to evaluate pain control depending on dose changes. It requires further investigations with time and dose extension.

• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.261-266
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• 2013

근막동통은 국소적인 통증과 촉진시 근 압통을 보이면서 근막 발통점이 존재하는 것이 특징인 근육질환이다. 본 증례에서는 야간 이갈이를 호소하는 환자의 임상검사에서 촉진을 통해 측두근 전방 부위의 잠재성 발통점을 확인하였고, 양측의 측두근과 교근에 대해 표면 근전도 검사를 시행한 결과, 이환된 측두근에서 수축 후 근과민성, 이완 지연 및 근피로 가속과 같은 소견을 얻을 수 있었다. 표면근전도 검사는 저작근의 비정상적인 기능을 확인할 수 있으므로 근육성 측두하악장애의 평가에 도움이 될 수 있다.

• Journal of Oral Medicine and Pain
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• 제41권3호
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• pp.133-136
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• 2016

Facial abscess is a suppurative condition that is caused by infection and that its infected materials built up within the loose connective tissues or a fascial space of the head and neck. Facial abscess should be treated with a caution since it can make threat to patient's life. When pus collects near masticatory muscles, it may lead to masticatory muscle disorder reducing the range of mouth opening and the mobility of jaw. The authors review an uncommon case of facial abscess which occurred in temporal muscle and induced mouth opening limitation.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.26-29
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• 2016

Intramuscular hemangioma is a rare type of hemangiomas and sometimes overlooked by orofacial pain specialist who encountered various types of masticatory muscle problems. A 42-year-old male, presented with feeling of unilateral hypertrophy on left mandibular area, is finally diagnosed as hemangioma with thrombus by excisional biopsy. However, he was initially treated by injection of botulinum toxin A due to misdiagnosis as unilateral masseter hypertrophy. In the present report, we remind the importance of careful examination and diagnostic images to orofacial pain clinicians in early detection of intramuscular hemangioma of masticatory muscles.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권5호
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• pp.321-327
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• 2020

Objectives: This study is aimed to evaluate and compare the effect of moist heat fomentation therapy with ultrasound therapy in patients with the masticatory myalgia. Materials and Methods: The study was conducted on 42 patients with masticatory myalgia, dividing them into two groups; Group A (21 patients), received moist heat therapy and Group B (21 patients), received ultrasound therapy for seven effective days. Prior and after the treatment the numeric rating scale (NRS) and the electromyography (EMG) scores were recorded and compared. The observations were analyzed clinically and statistical support was taken to assess the NRS and EMG data. Results: Irrespective of the groups, patients testified a significant reduction in pain after the treatment. From the EMG readings; even though the standard deviation for each group was varied considerably, EMG recorded an improved muscle activity. Statistical analysis was used to assess and identify the best treatment methodology between the two modalities. Conclusion: From the statistical analysis, it is concluded that, though both the therapies had significantly reduced the symptomatic response, it is moist heat fomentation that improved muscle activity both statistically and clinically in comparison to ultrasound.

• Journal of Oral Medicine and Pain
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• 제31권2호
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• pp.127-139
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• 2006

측두하악관절 장애를 가진 환자를 저작근 동통을 가진 환자와 관절강 내 동통을 가진 환자 그룹으로 구분하여, 두 그룹사이의 동통의 정도나 기간의 차이, 그리고 수면질의 차이에 따른 삶의 질의 차이를 비교하였다. 총 61명의 환자는 관절강 내 통증을 가진 환자 24명과 저작근 동통을 가진 환자 37명으로 구성되었다. 상기 환자들은 첫 내원 시 맥길 통증설문지(McGill Pain Questionnaire), 피츠버그 수면 질 평가 (Pittsburgh Sleep Quality Index), SF-36 (Medical Outcome Study 36 Item Short Form Health Survey)을 작성하고 치과적 병력과 의과적 병력을 기록한 후, 전반적인 측두하악관절에 대한 검사를 시행하였다. 두 그룹 사이에는 동통의 강도나 기간에 유의한 차이는 보이지 않았으나, 6개월 이상 측두하악관절장애를 가지는 환자 중에서는 저작근 동통을 가진 환자가 관절강 내 동통을 가지는 환자보다 SF-36의 평균과 정신적인 부분에서의 점수에서 낮은 수치를 보인다(p<0.05). 피츠버그 수면 질 평가에서는 평사시의 수면 효율면에서 저작근 동통을 가진 환자 ($1.9459{\pm}0.8481$)가 관절강내 동통을 가지는 환자 ($1.375{\pm}0.9237$)에 비해 낮은 효율을 보인다. 또한 저작근 동통을 가진 환자군에서 피츠버그 수면 질 평가의 총점이 5이상인 나쁜 수면질을 가지는 군은 맥길 통증 설문지, SF-36에서 높은 동통 정도와 낮은 삶의 질을 가지는 것으로 결과가 도출되었다. 또한 저작근 동통을 가진 환자는 전체적인 삶의 질을 나타내는 SF-36에서는 감정적인 문제로 인한 역할의 제한, 생활력, 신체적 동통에서 관절강 내 동통을 가진 환자에 비해 낮은 수치를 나타내어, 삶의 질이 특히 정신적인 면에서 손상되었다는 것을 나타낸다.

• Journal of Oral Medicine and Pain
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• 제46권3호
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• pp.93-97
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• 2021

The limited mouth opening, also known as trismus, can result from temporomandibular joint disorders, infection, neoplasm, trauma, and abnormal anatomic structure like coronoid hyperplasia. Head and neck cancer patients often complain of limited mouth opening, which is usually induced by myofibrotic contracture of masticatory muscle. But clinicians should consider any reasons such as infection or cancer growth and metastasis if trismus gets worse or pain develops. We report the case of the patient, who was diagnosed with myxofibrosarcoma on nasal cavity. He had suffered from trismus after concurrent chemoradiotherapy. However, pain had developed and trismus had worsened. He was diagnosed with infratemporal space abscess and myositis of masticatory muscles.

• Journal of Oral Medicine and Pain
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• 제15권1호
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• pp.105-115
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• 1991

The purpose of the study was to evaluate the occlusal stability at the moment of dynamic occlusal tooth contact and to investigate the correlation between the occlusal stability and the masticatory muscle activities. It also evaluated the effect of short-term use of occlusal splints on the occlusal stability and the masticatory muscle activities in patients with temporomandibular disorders during maximum voluntary clenching by synchondronized with temporomandibular disorders during maximum voluntary clenching by synchronized use of the T-Scan system(Tekscan, Inc, USA) and K6-Diagnostic system(Myo-tronics Research, Inc, USA) The author measured its distance from retruded contact position(RCP) to intercuspal position(IP), average of contact intervals(ACI), total left-right statistics(TLR), average muscle activities of masseter and anterior temporal muscles during maximum voluntary clenching in 20 patients with temporomandibular disorders and 22 dental students as a control group. The data were compared between two groups and investigated for any correlations between the parameters. The results were as follows : 1. Both of the mean average of contact intervals and the mean absolute value of total left-right statistics during maximum voluntary clenching were increased in the patient group when compared with the control group. 2. Muscular disharmony of anterior temporal muscles of patient group is significantly greater than that of control group. However, muscular disharmony of masseter muscles of patient group is not significantly greater than that of control group. 3. There were significant correlations between muscular disharmony of anterior temporal muscles and average of contact intervals as well as total left-right statistics, and also between muscular disharmony of masseter muscles and total left-right statistics. 4. There were not any significant correlations between distance from RCP to IP and any other parameters. 5. There were a significant decrease in total left-right statistics and muscular disharmony of anterior temporal muscles during maximum voluntary clenching after a 1week use of occlusal splint in the patient group.

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.327-339
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• 1997

This study aimed at evaluating tile relationship between pressure pain threshold(PPT) and electromyographic(EMG) activity in 30 healthy volunteers and 30 patients with temporomandibular disorders. PPTs were determined with electric pressure algometry over masseter, temporalis anterior, sternocleidomastoid, and trapezius muscle during resting and clenching. To obtain more reliable result, two examiners measured PPTs two times on each muscles, randomly. Resting and clenching EMG activity and tenderness of all muscles were measured to evaluate the relationship with PPTs. The collected data were processed by SAS/STAT program. The obtained results were as follows : 1. Pressure pain thresholds in tendered muscles were lower than those in non-tendered muscles. This tendency was more prominant in masticatory muscles than in cervical muscles and in clenching than in resting. 2. There ware a tendency of higher PPTs in unaffected side than in affected side, but there were no significant difference statistically. 3. There wert no difference of PPTs between in preferred side and in ipsilateral side, significantly. 4. There was a significantly positive correlation between resting and clenching PPTs, but there were no correlation between PPTs and EMG activities. 5. Comparison of EMG activity between in higher group and in lower group by resting PPTs didn't show any significant difference. But resting EMG activity in the higher group of clenching PPTs were lower, on the contrary, clenching activity were higher than those in lower groups of clenching PPTs. From this results, the author concluded that the clenching PPTs was more important than resting PPTs in diagnosis of muscle dysfunction. And the author recommanded that all of three following test were performed for the proper diagnosis and treatment of orofacial Pain : muscle tenderness, EMG activity, and PPT.

• Journal of Oral Medicine and Pain
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• 제39권2호
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• pp.55-62
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• 2014

Purpose: This study aims to evaluate the changes in soft tissue thickness of the masseteric region after injection of botulinum toxin type A (BTX-A). Methods: Twenty-four data acquired from medical records were classified into 4 groups: bruxer group that received masseter muscle injection only (M-B), bruxer group that received both masseter and temporalis muscle injections (MT-B), non-bruxer group that received masseter muscle injection only (M-NB) and non-bruxer group that received both masseter and temporalis muscle injections (MT-NB). Injection dose of BTX-A was 30 units for each masseter muscle and 20 units for each temporalis muscle. We measured the reduced thickness of the masseteric region before and after 12 weeks after injection using cone-beam computed tomography. Results: Among the patients that received both masseter and temporalis muscle injections, bruxer group showed a tendency to have more reduction in masseter muscle thickness than non-bruxer group. The difference in reduced thickness between M-B and MT-B tended to show greater than the difference between M-NB and MT-NB. Conclusions: In case of masseter hypertrothy patients with bruxism there was a tendency to show a difference in reduced thickness of soft tissue between the group that received both masseter and temporalis muscles injection and the group that received masseter muscle injection only hence a thorough inspection before the injection of BTX-A is condisered to be needed.