• Journal of Oral Medicine and Pain
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• 제31권2호
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• pp.155-165
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• 2006

본 연구는 단국대학교 치과대학 부속병원 구강내과에 내원한 측두하악장애 환자를 포함한 구강안면동통 환자들을 대상으로 치료의 결과와 예후를 평가하기 위하여, 2002년 1월부터 2004년 12월까지 3년간 (치아질환을 제외한) 구강안면동통 환자 6300명 중에서 진료기록부 상에서 경과기록을 확인할 수 있는 환자들을, 측두하악장애, 신경병성동통장애, 연조직질환 및 이 중 둘 이상을 질환을 동시에 가지고 있는 복합질환으로 나누어 치료기간, 치료유형 및 치료효과를 비교하여 다음의 결과를 얻었다. 1. 평균 진료기간은 신경병성 동통장애에서 가장 길었고 연조직질환, 복합 질환, 관절장애, 근육-관절 복합장애, 근육장애의 순이었다. 2. 사용된 치료방법을 비교하면 약물요법은 연조직질환과 신경병성 동통장애에서, 장치요법은 관절장애군에서, 물리치료는 근육장애군에서 사용빈도가 높았다. 3. 진단분류별 물리치료의 사용경향은 근육장애군은 EAST와 초단파요법의 사용빈도가 높았고, 관절장애군은 초음파 치료, 신경병성 동통 장애와 연조직 질환은 저출력 레이저 요법이 많이 사용되었다. 4. 통증에 대한 치료결과는 통증이 지속되는 경향이 신경병성 동통장애에서 가장 높았으며, 완화되거나 완전 소실되는 경향은 측두하악장애에서 높았다. 5. 측두하악장애 환자에서 근육장애, 정복성 관절원판장애, 비정복성 관절원판 장애 및 근육-관절 복합장애 세분하여 치료 후 개구량의 변화를 조사하였을 때는 진단군 간에 유의한 차이를 볼 수 없었으나 개구량 측정방법간에는 무통성 최대개구량이 치료 후 가장 증가하였고, 환자 스스로가 벌리는 능동적 최대개구량은 비정복성관절원판장애에서 가장 증가하였다. 이상의 결과로 볼 때, 구강안면통증 영역에서 현재 시행하고 있는 치료법들은 측두하악장애에서는 동통조절 및 기능개선에 좋은 결과를 보여주고 있으므로 그 예후가 좋은 반면, 연조직질환이나 신경계 질환 같은 기타의 구강안면통증은 길고 지속적인 치료를 요구하는 어려운 질환이라고 할 수 있겠다.

• Journal of Oral Medicine and Pain
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• 제19권1호
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• pp.93-103
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• 1994

In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

• 치과방사선
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• 제28권1호
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• pp.155-169
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• 1998

The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed on eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows; 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41 ％, 54％, 5％ of total cases in this study, respectively. 2. The third decade(65％) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent ( 61 ％) in this study. In joint sound, click(63％) was the most frequent in disc displacement with reduction group, but sound history(42％) and no sound (31 ％) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44mm, 32.9mm, 44mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 53％, 79％, 40％, and the trauma history of each group was 50％, 40％,60％.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권1호
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• pp.49-55
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• 2004

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

• Computers and Concrete
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• 제14권5호
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• pp.527-546
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• 2014

Portland cement concrete, which has higher strength and stiffness than asphalt concrete, has been widely applied on pavements. However, the brittle fracture characteristic of cement concrete restricts its application in highway pavement construction. Since the polypropylene fiber can improve the fracture toughness of cement concrete, Polypropylene Fiber-Reinforced Concrete (PFRC) is attracting more and more attention in civil engineering. In order to study the effect of polypropylene fiber on the generation and evolution process of the local deformation band in concrete, a series of three-point bending tests were performed using the new technology of the digital speckle correlation method for FRC notched beams with different volumetric contents of polypropylene fiber. The modified Double-K model was utilized for the first time to calculate the stress intensity factors of instability and crack initiation of fiber-reinforced concrete beams. The results indicate that the polypropylene fiber can enhance the fracture toughness. Based on the modified Double-K fracture theory, the maximum fracture energy of concrete with 3.2% fiber (in volume) is 47 times higher than the plain concrete. No effort of fiber content on the strength of the concrete was found. Meanwhile to balance the strength and resistant fracture toughness, concrete with 1.6% fiber is recommended to be applied in pavement construction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권5호
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• pp.335-340
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• 2020

Objectives: This study sought to evaluate the efficacy of injecting botulinum toxin into the masseter and temporal muscles in patients with temporomandibular myofascial pain and sleep bruxism. Materials and Methods: The study was conducted based on a clinical record review of 44 patients (36 females and eight males; mean age, 35.70±12.66 years). Patients who underwent the injection of botulinum toxin into the masseter and temporal muscles for the management of temporomandibular myofascial pain and sleep bruxism were included in the study. Patients were diagnosed based on the Diagnostic Criteria for Temporomandibular Disorders. Sleep bruxism was diagnosed according to the criteria defined by the American Academy of Sleep Medicine. The values of the visual analogue scale (VAS) and range of jaw motion, including unassisted maximum mouth opening (MMO), protrusion, and right and left laterotrusion, were observed preoperatively and postoperatively at one-, three-, and six-month follow-up visits. Results: MMO, movements of the right and the left laterotrusion, and protrusion increased significantly (P<0.05), while VAS ratings decreased significantly at the three follow-up points relative to baseline values (P<0.05). Conclusion: Botulinum toxin is an effective treatment for patients with temporomandibular myofascial pain and sleep bruxism.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.112-117
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• 2018

Purpose: The aim of this study is to compare the short-term effectiveness of hard and soft stabilizing appliances (H-A and S-A) in treating patients with acute temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). Methods: Eighty one patients diagnosed as acute TMJ DDwoR at oral medicine of Chosun University Dental Hospital from November 2016 to September 2017 were included in this study. The subjects were divided into three groups: The control group (34 patients treated without occlusal appliance), the H-A group (31 patients treated with H-A) and the S-A group (16 patients treated with S-A). The pain intensity using Visual Analog Scale and maximum mouth opening (MMO) were evaluated every week for 8 weeks. Results: The improvement of the pain intensity and MMO in the H-A group and the S-A group compared with the control group were noted (p<0.05). Conclusions: This study suggests that hard and S-As may be equally useful in treating patients with TMJ DDwoR. S-A could be recommended to reduce the symptoms of TMJ DDwoR in short period.

• 척추신경추나의학회지
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• 제18권2호
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• pp.31-42
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• 2023

Objectives This study aimed to conduct a systematic review evaluating the effectiveness of muscle energy technique(MET) in temporomandibular joint disorders (TMD). Methods Searches were conducted in 11 electronic databases until October 2023. Randomized controlled trials(RCT) comparing the effect of MET for TMD were included. All studies were evaluated using the Cochrane Risk of Bias tool. Results Nine documents that fulfilled all the criteria were obtained for analysis. All studies showed some concerns in high risk of bias, but showed a significant improvement in pain and maximum mouth opening compared to baseline of MET or control group. MET was not better than extracorporeal shock wave therapy or myofascial release in some outcomes. Conclusions MET seems to be an effective treatment for TMD in some regards, however, can be considered as an adjunct therapy which has weak evidence. Further studies are required due to the inconclusive data and poor homogeneity found in this review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.89-99
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• 2016

Objectives : This study was performed to develop objective methods for evaluating facial palsy sequelae using a 3D Facial Scanning System. Methods : Fifty-eight patients with facial palsy sequelae were selected. Their medical records were reviewed to collect demographic data, facial palsy sequelae evaluation, Facial Disability Index questionnaire, and test results (3D Facial Scanning System). Five different facial expressions (at rest, eye closure, eyebrow elevation, smiling, and whistling) were photographed. Sunnybrook Scale was associated with distances between predetermined facial points. Results : The average Sunnybrook composite score was $58.88{\pm}17.31$. Secondary movements (mouth to eye synkinesis, contracture of eye, and contracture of mouth) showed significant difference according to the Sunnybrook Scale. In voluntary movements, eyebrow height at eyebrow elevation, length between mouth angle and central line while whistling, and eyelid width at maximum eye opening showed significant difference. Facial palsy Sequelae Index (FSI) was correlated with Sunnybrook sub-scales (resting symmetry, voluntary movement, and synkinesis). Conclusion : These results demonstrate that a 3D Facial Scanning System is useful for evaluating facial palsy sequelae. This method may facilitate objective evaluation for facial palsy sequelae and it could be applied in clinical trials.