• Journal of Korean Dental Science
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• v.4 no.2
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• pp.85-91
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• 2011

Some treatment methods have been proposed for patients with chronic closed lock of temporomandibular joint. We report a conservative treatment for patients who had chronic closed lock of temporomandibular joint and who did not want surgical treatment. Two patients who had been treated in the Template clinic, Soonchunhyang University Bucheon Hospital, are the subjects of this report. The subjects had chronic closed lock symptom for over 3 months after an onset of locking; conventional therapies had no effect. The subjects were treated by making them wear a Template appliance while sleeping and exercise for 10 hours a day. After periodic follow-up, significant improvement was observed for Template treatment in terms of the maximal mouth opening range. When conventional therapy is expected to be ineffective, The Template appliance can be used as conservative treatment for temporomandibular disorders patients with chronic closed lock of temporomandibular joint.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.43-47
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• 2015

Purpose : The aim of this study was to report a follow-up study on the prognosis following the arthrocentsis for the painful temporomandibular dysfunction not responsible to the conservative splint therapies. Arthrocentsis of TMJ is a simple precedure that can be performed in the out-patient clinic under the local anesthesia without any reported complications. Method : Seventy patients had been followed after the arthrocentsis for over 6 months. Maximum mouth opening, TMJ pain, TMJ noise, and their changes by time were examined and compared statistically. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predictors which was analyzed were age, duration of painful locking, MMO, the degree of pain, preoperative clicking and the amounts of irrigation fluid. Result : The result of this study were as follow; 1) Mouth opening was improved from 32.6 mm to 42.4 mm in the maximum inter-incisal distance. 2) TMJ pain was decreased in 45.7%. 3) TMJ clicking and noise disappeared in 60.0%, but recurred in 40.0%. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Journal of Oral Medicine and Pain
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• v.42 no.1
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• pp.16-19
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• 2017

Clinicians are familiar with limitation of opening mouth caused by temporomandibular disorders. Sometimes, patients also complain of difficulty in closing mouth. Difficulty in closing mouth can be caused by anterior, posterior disc displacement, and subluxation of temporomandibular joint (TMJ). In this report, we presented a patient who had a difficulty in both opening and closing mouth. The patient complained of TMJ noises and intermittent limitation of opening mouth, and inability to get teeth back into maximal intercuspal position. Magnetic resonance images revealed that the left TMJ had an anterior disc displacement with relative posterior disc displacement. We reviewed the possible causes, signs and symptoms, and treatment for difficulty in closing mouth with related literatures.

• Journal of Oral Medicine and Pain
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• v.24 no.1
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• pp.37-47
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• 1999

This study was performed to investigate the factors related to vibration of temporomandibular joint during mandibular opening movement. For this study, 144 patients with temporomandibular disorders were randomly selected. Angle's classification, lateral guidance pattern, range of maximal mouth opening, preferred chewing side, and affected side were investigated clinically. Mandibular torque rotational movement during opening was recorded with $BioEGN^{(R)}$ and vibration of temporomandibular joint during opening was recorded with $Sonopak^{(R)}$. After clinical diagnosis was made, visual analogue scale(VAS) was used for evaluation of clinical progress of the subject's chief complaints. The author calculated VAS treatment index(VAS Ti) from the record of VAS. The more VAS Ti was, the less remission of subjective symptom was, The data were analyzed with SAS/Stat program and the results of this study were as follows: 1. There were no significant difference in all the variables of joint vibration by age and sex. 2. Integral and peak amplitude in patients of Angle's class I were higher than those of class II or III patients. Integral in patients of group function was higher than that in patients of canine guidance or other types of lateral excursion. 3. As to Angle's classification or lateral guidance type, there were almost not significant difference between subgroup of same class or type and subgroup of different class or type on both sides. And there were also almost not difference between one side and the other side related to preferred chewing side or affected side. 4. Patients with disk displacement with reduction showed higher value of integral and peak amplitude than any other patients. 5. Joint vibration variables significantly correlated with VAS Ti of pain. with clinical range of mouth opening, and with ingredients of mandibular torque rotational movement.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.521-528
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• 2010

Purpose: Anatomical reduction of the fractured condylar process is an important prerequisite for re-establishing function. The authors reported about effectiveness of transoral approach for mandibular subcondyle fracture using trochar device in cases that the fracture line is below the reference line, the perpendicular line of the longitudinal axis of condylar process passing the lowest point of sigmoid notch. As a serial study, we report the open reduction via preauricular approach for mandibular condyle fracture, in cases that the fracture line is above the reference line. Patients and Methods: Sixteen condylar fractures of 15 adult patients were divided two groups and treated by open reduction via preauricular approach (8 cases) or by closed reduction (8 cases). The degree of maximal mouth opening, occlusion, anatomical reduction, condylar resorption and complications were assessed and evaluated for the two groups. Results: The open reduction of condyle via preauricular approach leads to good results without permanent complications. Anatomical reduction of open reduction group and maximal mouth opening range of the closed reduction group is significantly better than the other group. No significant differences were found in the condylar resorption and the occlusion. Conclusion: The preauricular approach was useful to reduce and fix the condylar fragment, in cases that the fracture line is above the reference line.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.127-141
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• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

• Physical Therapy Korea
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• v.26 no.1
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• pp.28-36
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• 2019

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

• The Journal of Korean Medicine
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• v.20 no.1 s.37
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• pp.106-112
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• 1999

The purpose of this study is to investigate the effects of Bee Venom Herb-Acupuncture on the jaw opening reflex evoked by tooth pulp stimulation. Rats were anesthetized with thiopental sodium given intraperitoneally in an initial dose of 80mg/kg. Maintenance doses of 5mg/kg thiopental sodium were given through a cannular in the femoral vein as required to maintain light anesthesia. To apply noxious stimuli, a pair of enameled wires were inserted into the tooth pulp of the lower incisor. The effects of conditioning stimuli were estimated as an indicator of the degree of suppression of the digastric muscle electromyogram(dEMG) in the jaw opening reflex. Bee Venom Herb- Acupuncture(0.2% solution 0.1ml/rat) was injected to Hapgok(LI4) loci. In addition, Normal Saline (0.1ml/rat) was injected to Hapgok loci so as to compare the degree of suppression elicited from Bee-Venom. By administration of Bee Venom Herb-Acupuncture, the amplitude of dEMG was maximally suppressed to $67.5{\pm}3.38%$ ipsilaterally, 73.33{\pm}8.00%$ contralaterally. Generally, the dEMG activities caused by electrical stimulation were gradually suppressed during the stimulation and maximal suppressive effect showed at 15min after its onset. However the dEMG activities by Be Venom Herb-Acupuncture were immediately suppressed after its onset and the suppressive effect continued for a long time compared to electrical stimulation. In conclusion, Bee Venom Herb-Acupuncture may have a different mechanism of analgesia from that of electro-acupuncture and contribute to the modulation of pain analgesia.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.25-34
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• 1989

The author performed on epidemiological study of the TMD in 189 elderly people and 195 young people with Helkimo index. The clinical dysfunction index was based on data from clinical examination and the anamestic dysfunction index was based on data from the interview with the investigated person. The results were as follows : 1. In the elderly population, 27.5% reported that they had subjectively symptom of TMD but 43.4% had sign and symptoms of TMD in clinical examination. 2. The mean values for maximal opening differed significantly between elderly and young populations, 47.22mm and 51.44mm (p<0.001) and less than a 40mm opening was observed 7.9% in elderly population, 0.5% in young population (p<0.001). 3. The mean values for lateral movement to the right and left did not differ with age, which were 8.56mm and 8.47mm in elderly population, 8.90mm and 8.81mm in young population, but the mean value for protrusion differed significantly between elderly and young populations, 6.89mm and 7.64mm (p<0.01). 4. A higher incidence of TMJ noise was recorded in the elderly and young populations than young population, especially crepitus, but a higher incidence of clicking was recorded in young population (p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.363-370
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• 2022

Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side. Conclusion: The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.