• Journal of Oral Medicine and Pain
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• v.25 no.1
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• pp.117-128
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• 2000

The present study explored the influence of temporomandibular disorders(TMD) with anterior open bite on swallowing. Fifteen subjects with anterior open bite(group A), 9 subjects with anterior open bite and TMD(group B), and 24 subjects without malocclusion or TMD symptoms (group C) were included. BioPAK system(Bioresearch Inc., Milwaukee, WI, USA) was used to record the muscle activities of anterior temporal, masseter, sternocleidomastoid(SCM) and anterior digastric muscles during maximum clenching and swallowing. Positional change of the mandible during swallowing was also recorded using the same system. The obtained results were as follows: 1. Group A, B, and C did not show significant differences each other in the muscle activity of resting position in most of head and neck muscles. 2. Group B showed significantly lower muscle activity in maximum clenching than group C in anterior temporal(p<0.01), masseter(p<0.05), SCM(p<0.05) and digastric muscles(p<0.05). 3. Group A showed significantly lower muscle activity during swallowing than group C in anterior temporal and masseter muscles(p<0.01). Group B showed significantly lower muscle activity during swallowing than group C in anterior temporal(p<0.01), masseter(p<0.01), and SCM muscles(p<0.05). 4. Group A and B showed increased positional change of the mandible during swallowing measured from vertical, anteroposterior and lateral aspects, and prolonged swallowing(p<0.05). 5. After given instructions for normal swallowing pattern, group A and B showed increased muscle activity during swallowing in anterior temporal, masseter and SCM muscles(p<0.01). Positional change of the mandible and time elapsed for swallowing also decreased after the instruction(p<0.01). 6. Occlusal splint did not change the muscle activity during swallowing. However, vertical change(p<0.01) and swallowing time(p<0.05) were decreased with splint.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.6
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• pp.326-331
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• 2012

Objectives: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. Materials and Methods: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. Results: The high-risk group (PWI-SF${\geq}27$, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. Conclusion: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.

• Journal of Oral Medicine and Pain
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• v.26 no.1
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• pp.59-73
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• 2001

This study was performed to investigate the effects of occlusal appliance on the mandibular position and the mandibular rotational torque movement during speech. For this study, 20 patients with temporomandibular disorders(TMDs) and 20 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) and a sentence of 'Sue is missing her house' were used for recording and for observing of speech pattern. There were five mandibular positions observed in this study, that is, mandibular rest position, 'ssi', 'her', 'ha', and 's' speech position. In each position, slant and A-P distance in sagittal plane, vertical distance and lateral distance in frontal plane were measured. Amount of the mandibular rotational torque movement were measured at 'her', 'ha' speech position and for all through speech movement. Centric relation splint(CRS) was placed in both groups, but anterior or posterior bite plane were placed in normal subjects only. Data collected were processed and analysed by SPSS windows program. The results of this study were as follows : 1. Mandibular positions in both groups were not different before adaptation, with CRS, and after removal, but total amount of the mandibular rotational torque movement was greater in patients. 2. Mandible was slightly placed anteriorly with CRS at 'her' and 'ha' speech position in patients, but was placed anteriorly at all the five positions in normal subjects. 3. Difference with type of occlusal appliance in normal subjects were noted only for vertical distance at 'ssi' and 'ha' speech position, and the distance with CRS were more than that with posterior bite plane. 4. Mandibular rotational torque movement at 'her' and 'ha' speech position was greater in patients, but the difference was disappeared after appliance removal. And the torque movement was greater at 'ha' speech position than that at 'her' speech position in frontal plane. It could be concluded that the adaptation of occlusal appliance showed a tendency to locate the mandible anteriorly during speech in both groups, but did not affect total mandibular rotational torque movement which was greater in patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.12.1-12.6
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• 2016

Background: Temporomandibular joint (TMJ) ankylosis can be accompanied by various degrees of functional and esthetic problems. Adequate mouth opening, occlusal stability, and harmonious facial form are the main goals of treatment for ankylosis. Distraction osteogenesis has proven to be an excellent treatment for lengthening the ramus-condyle unit. However, various timings for distraction have been suggested, and there is no consensus on selection criteria for performing the procedure in stages or simultaneously with other treatments. Case presentation: In this case report, concomitant intraoral distraction and gap arthroplasty was planned to treat TMJ ankylosis and associated facial asymmetry. After gap arthroplasty and 23 mm of distraction, the ramus-condyle segment was successfully lengthened and mouth opening range was significantly increased. The resultant interocclusal space was stably maintained with an occlusal splint for 4 months after distraction. Finally, good occlusion was achieved after prosthetic treatment. The remaining mandibular asymmetry was corrected with osseous contouring and augmentation surgery. The mouth-opening range was maintained at 35 mm 24 months after treatment. Conclusion: Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.13.1-13.12
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• 2016

Background: Mandibular motion tracking system (ManMoS) has been developed for orthognathic surgery. This article aimed to introduce the ManMoS and to examine the accuracy of this system. Methods: Skeletal and dental models are reconstructed in a virtual space from the DICOM data of three-dimensional computed tomography (3D-CT) recording and the STL data of 3D scanning, respectively. The ManMoS uniquely integrates the virtual dento-skeletal model with the real motion of the dental cast mounted on the simulator, using the reference splint. Positional change of the dental cast is tracked by using the 3D motion tracking equipment and reflects on the jaw position of the virtual model in real time, generating the mixed-reality surgical simulation. ManMoS was applied for two clinical cases having a facial asymmetry. In order to assess the accuracy of the ManMoS, the positional change of the lower dental arch was compared between the virtual and real models. Results: With the measurement data of the real lower dental cast as a reference, measurement error for the whole simulation system was less than 0.32 mm. In ManMoS, the skeletal and dental asymmetries were adequately diagnosed in three dimensions. Jaw repositioning was simulated with priority given to the skeletal correction rather than the occlusal correction. In two cases, facial asymmetry was successfully improved while a normal occlusal relationship was reconstructed. Positional change measured in the virtual model did not differ significantly from that in the real model. Conclusions: It was suggested that the accuracy of the ManMoS was good enough for a clinical use. This surgical simulation system appears to meet clinical demands well and is an important facilitator of communication between orthodontists and surgeons.

• Restorative Dentistry and Endodontics
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• v.35 no.1
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• pp.20-23
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• 2010

Mouthguards were used to protect boxers from lip lacerations and other soft tissue injuries in the late 19th century. Now they are used various parts of dental treatment, which are sports protective aid, bleaching tray, orthodontic retainer, implant insertion guide tray, splint and so on. Repeated dislodgement of Class V restoration due to habitual clenching stress should be restored with stress control. Mouthguard can be used as stress relief device. This case describes methods that can relieve occlusal force to teeth by using mouthguard. Satisfactory results can be obtained by using mouthguard for retention of repeated dislodgement Class V restorations. If patients suffered from repeated restorations of Class V due to clenching, mouthguard can be used additional device to relieve the occlusal stress in conservative dentistry.

• Journal of Oral Medicine and Pain
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• v.17 no.1
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• pp.73-87
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• 1992

저자는 28명의 측두하악장애 환자와 31명의 정상인을 대상으로 최적기능교합의 개념에 입각하여 교합시의 치아접촉점을 동적이며 정량적인 방법으로 평가하여 교합안정장치의 사용으로 인한 교합안정성의 개선여부를 알아보고자 하였다. 이와 동시에 교근과 전측두근의 활성도를 측정하여 치료의 경과에 따른 근활성의 변화를 알아보기 위해 본 연구를 시행하였다. 측정항목은 개구범위, 두개하악장애지수, 치아접촉점 좌우균형치, 치아접촉점 전후균형치, 치아접촉점 평균시간간격, 치아접촉점의 개수, 접촉시간, 좌우측 교근과 좌우측 전측두근의 근활성, 근활성 비대칭 지수 등이었다. 이의 측정을 위해 T-Scan System, K-6 Diagnostic System 그리고 EM 2등을 사용하였으며 얻어진 자료에 대해 검정한 후 다음과 같은 결론을 얻었다. 1. 교합안정장치를 이용하여 측두하악장애 환자들을 4주간 치료한 결과 전반적인 임상증상이 호전되어 개구범위와 두개하악장애지수에 있어서 뚜렷한 개선이 있었다. 2. 측두하악장애 환자에서 최대 악물기시의 치아접촉점 좌우균형치및 평균시간 간격이 큰 것으로 나타나 치아접촉이 일어나는 순간의 교합안정성이 좋지 않은 것으로 평가되었다. 3. 치료 4주후 교하안정장치를 장착한 상태에서 측정한 치아접촉점 좌우균형치및 치아접촉점 평균시간간격은 치료전에 비해 개선된 것으로 나타났다. 4. 치료 4주후 치아접촉점의 전후방 분포가 구치부위로 이동되는 양상을 보였다. 5. 측두하악장애 환자에서 최대 악물기시의 좌우측 교근 및 전측두슨의 근활성은 정상인에 비해 낮에 나타났으며, 이는 치료기간 동안 감소되는 경향을 나타내었다. 6. 측두하악장애 환자에서 전측두근의 근활성 비대칭지수는 정상인에 비해 상당히 높게 나타났으며 이는 치료기간 동안 감소되는 경향을 나타내었다.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.210-219
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• 2021

Excessive teeth wear can lead to reduced chewing efficiency, occlusal plane collapse, and facial changes. Full mouth rehabilitation with a change in vertical dimension may cause pain in the temporomandibular joint, masticatory muscle and teeth, so an accurate diagnosis and treatment plan is required. In this case, a 69-year-old man had excessive teeth wear with a loss of posterior support. We evaluated the degree of adaptation to the increased vertical dimension with the removable occlusal splint and provisional restoration. We report this case because the treatment result has been functionally and aesthetically satisfactory by providing stable anterior guidance, proper posterior teeth disclusion, and even contact of all teeth in centric occlusion.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.77-86
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• 2013

In order to evaluate the effect of conservative treatment for Temporomandibular Disorders(TMD), 137 patients were subjected at the Department of Oral Medicine, Pusan National University Dental Hospital from June 2012 to Sept. 2012. They were treated conservatively with behavioral therapy, physical therapy, medication and occlusal stabilizing splint therapy. Subjective symptoms and clinical findings were investigated to evaluate and compare the patients' status after 3 months treatment. The results were as follows; 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurements of TMD were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender and chronicity. 3. Conservative treatment including stabilization splint produced better results than physical therapy with medication. 4. After 3 months of treatment, pain and LOM were significantly improved in the MD(Muscle disorder) group. Pain, LOM and noise were significantly improved in the DD(Disc displacements) group. In the OA(Osteoarthritis) group, pain, noise, LOM and MCO were significantly improved.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.113-121
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• 1989

In this study, 94 patients with temporomandibular disorders were interviewed to evaluate the effect of the treatment they received at the department of Oral diagnosis and oral Medicine in Seoul national university Hospital. The treatment administered to the patient were patient education, relaxation procedures, physical therapy, occlusal splint therapy and selective grinding of teeth. The following results were disclosed : 1. 97.9% of the patients reported no pain or considerably less pain than they had reported at their first visits to the department. 2. 89.3% of the patients thought that the treatment provided was either complete or considerably successful. 3. TMJ and facial pain was resolved within average 3.0 months 4. Of the 70 patients who previously reported having jaw joint sound, 34 patients (48.6%) no longer reported int. 5. Of the 48 patients who previously reported having headache regularly, 3 patients (68.8%) no longer reported headache regularly. 6. Of the 66 patients who previously reported having masticatory muscle pain, 41 patients (62.1%) no longer reported masticatory muscle pain. 7. Analysis of the data did not disclose a subgroup or factor, such as age, the stage of internal derangement, capsulitis, bruxism, MPD, duration of symptoms, that could be correlated with the reduction of pain or the patient's perception of success of treatment.