• 대한치과의사협회지
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• 제42권2호통권417호
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• pp.101-107
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• 2004

• 대한치과마취과학회지
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• 제11권2호
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• pp.172-176
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• 2011

For dental treatment of children with severe dental phobia, sedation or general anesthesia is usually selected for enhancement of cooperation. But in the case of mouth opening limitation due to temporomandibular disorders, general anesthesia administration is a challenge for anesthesiologist. Because airway management failure was concerned, awake fibroscopic intubation is selected first. But, skillful fibroscopic intubation is not easy in case of uncooprative children patients. In this report, we present two cases of pediatric patients with mouth opening limitation. In the first case, the patient was 52 months old and the maximum opening distance was 1.2 cm, and in the second case the patient was 38 months old and the maximum opening distance was 1.5 cm. Both patients showed severe dental phobia. After sevoflurane inhalation without any intravenous drug, we successfully performed intubation using a fibroscope.

• 대한물리의학회지
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• 제4권4호
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• pp.257-267
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• 2009

Purpose：The purpose of this study is to examine the effectiveness of ultrasound and myofascial release in patients who have opening mouth limitation and temporomandibular disorder. Methods：Twenty students were randomly assigned to a myofascial release group(n=10) or an ultrasound group(n=7). Each group was treated for 15 minutes per a every treatment session for four weeks. Cervial range of motion(CROM) was used to measure cervical R.O.M., and a mm(millimeter) graduated ruler was used to measure opening mouth limitation. Results：Results of the follows : 1. The neck extension of range of motion of both groups was significantly increased in length of time (p<.05). 2. The neck flexion of range of motion of both groups was significantly increased (p<.05). 3. The quantity of opening mouth of temporomandibular joint of both groups was significantly increased (p<.05). Conclusion：These data suggest that myofascial release and ultrasound are beneficial to increasing a functional recovery of neck(flexion and extension) and opening mouth.

• Journal of Oral Medicine and Pain
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• 제42권1호
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권1호
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• pp.69-77
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• 2001

PURPOSE : The Purpose of this study was to investigate the anti-inflammatory effect on combination dosage of dexamethasone and naproxen after removal of impacted 3rd molars. We evaluated postoperative pain, swelling, and mouth opening limitation quantitatively. PATIENTS AND METHODS : Removal of an impacted lower third molar was done under local anesthesia with 2% lidocaine to 239 healthy patients. We randomly gave experimental group 1.5mg dexamethasone and 200mg naproxen three times a day for postoperative 2days, and also gave control group 200mg naproxen alone three times a day for postoperative 2days. Swelling and pain were measured by visual analogue scale (VAS). Mouth opening limitation was measured by maximum interincisal opening length. We estimated these measurements in the first and second postoperative days. Differences between experimental and control group were investigated considering age, sex, BMI(body mass index), impacted type, surgical site(right or left), and operation time by independent student T-test. RESULTS : In general, swelling, pain, and mouth opening limitations were significantly reduced (p<0.01) by combination dose of dexamethasone and naproxen in postoperative one day. But there was no difference in pain on the second postoperative day. As variables being considered, in the postoperative pain, there was significant difference between experimental group and control group in only male, little bony removal group, left side extraction group. In case of postoperative swelling, there was no significant differences in male, adolescence, long operating time group (over 20 minutes), medium BMI group and right side extraction group. In case of postoperative mouth opening limitation, there was significant difference between only female and long operating time group (over 20 minutes). CONCLUSION : Variables being considered, postoperative swelling was more reduced by the combination dose of naproxen and dexamethasone than that of naproxen alone after removal of impacted 3rd molars. But there was varoius results in pain and mouth opening limitation.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.316-324
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• 1998

This study was performed to evaluate the clinical features and treatment results on 55 temporomandibular disorder patients who had treated by conservative treatment using occlusal splint. The results were as follows; 1. The ratio of men to women was about 1:2.2 and most of the patients were second and third decades. 2. Pain was the most frequent symptom, followed by clicking and mouth opening limitation. 3. The number of acute and chronic groups on the basis of 6 months duration of symptoms were similar. 4. Most of patients had Angle's Class 1 molar relationships(78.2%), followed by Class 3 and Class 2. 5. Centric Relation splints were used alone for treatment of 34 patients and 21 patients were treated with Centric Relation splints and Anterior Repositioning splints. The treatment duration of the patients who had complained pain was average 9.8 weeks and 6 patients of them had slight pain continuously during follow-up. 6. Eleven patient's maximum mouth opening who had mouth opening limitation was improved from 30. 7mm to 43.0mm during procedures.

• 대한구순구개열학회지
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• 제7권2호
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• pp.133-139
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• 2004

Congenital bilateral idiopathic hyperplasia of the coronoid processes presents with limited mouth-opening without visible maxillofacial deformity or temporomandibular joint dysfunction / disorder. According to Blanchard et al and McLoughlin et al, it was lnitially described in 1853 by Langenbeck, and the first cases were reported by Holmes in 1956. Since then, there have been regular reports of a certain number of cases. In 1995, McLoughlin et al recorded 79 published cases of bilateral hyperplasia of the coronoid processes. Among them, Fabie et al have found only 3 published cases relating to children younger than 8 years, and have presented the first case of objectively diagnosed restricted mouth opening from birth by pediatricians. Authors have experienced 2 child patients with mouth opening limitation who was diagnosed congenital bilateral idiopathic hyperplasia of the coronoid processes without any other TNJ morphology in Dept of Oral and Maxillofacial surgery, Seoul National University Dental Hospital in 2004. Coronoidectomy was performed and postoperative active mouth opening exercise is indicated. Authors report 2 cases of congenital bilateial idiopathic hypeiplasia of the coronoid processes with literature liview.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권3호
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• pp.125-132
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• 2015

Objectives: The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion: We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.

• 대한소아치과학회지
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• 제32권2호
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• pp.256-261
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• 2005

피부 경화증(scleroderma)은 만성 결체조직 질환으로 정확한 원인은 밝혀지지 않았으나 자가 면역 질환으로 알려져 있다. 대개 $30{\sim}50$세의 여성에서 호발하며 소아에서는 매우 드물다. 장기의 이환여부에 따라 국소성과 전신성 피부 경화증으로 분류할 수 있다. 국소적 형태는 예후가 양호하고 피부에만, 또는 피하 근육까지 이환되며, 내부 장기에는 이환되지 않는다. 전신적인 형태는 피부와 구강점막 및 위장계, 호흡계, 심혈관계 등을 포함하늘 전신 다발적 발생 (multisystemic involvement)이 특징적이다. 안면피부 이환시 작고 예리한 코, 무표정한 응시 (expressionless stare), 좁아진 입모양(narrow oral aperture) 등이 특징적이다. 대개 레이노 현상(Raynaud's phenomenon)이 존재하며 질환이 진행되면서 개구장애와 혀, 치은의 경화가 나타나게 된다. 피부 석회증(calcinosis cutis), 레이노현상(Raynaud's phenomenon). 식도 기능부전(esophageal dysfunction), 공지증(sclerodactyly), 모세혈관 확장증(telangioectasia)이 복합된 질환을 크레스트 증후군(CREST syndrome)이라 부른다. 피부 경화증의 치료는 국소적 및 전신적 스테로이드 치료, collagen cross-link inhibitor (D-penicillamine), 면역억제제 등을 사용한다. 개구제한의 치료는 설압자를 이용한 mouth stretching exercise를 통해 개선될 수 있다. 본 증례에서는 국소성 피부 경화증으로 진단되고 개구제한이 있는 6세 남아에게 아산화질소와 enflurane을 이용한 깊은 진정요법을 이용하여 상하악 제 1, 2 유구치의 우식치료 치험례를 보고한다.

• 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.