• Phonetics and Speech Sciences
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• v.3 no.3
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• pp.141-148
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• 2011

There are many factors that affect speech intelligibility and speech acceptability. Structural anomalies and neuromotor pathologies are known for the reasons of abnormal speech sounds. And there are minor variations related to oral mechanism. Speaking with restricted mouth opening related to therapeutic procedure or habitual speech pattern might affect the quality of speech sounds. So this study compared speech intelligibility and speech acceptability of recorded 24 words in two conditions (restricted mouth opening condition and normal mouth opening condition) by 30 normal hearing adults. The results showed that speech intelligibility and speech acceptability were significantly lower in restricted mouth opening condition. And speech acceptability was significantly lower than speech intelligibility in restricted mouth opening condition. Speech acceptability in restricted mouth opening condition was significantly lower especially in open vowel. These findings indicated that the mouth opening condition could affect vowel shape and could be an adverse effect on speech intelligibility and speech acceptability.

• Physical Therapy Korea
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• v.26 no.3
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• pp.99-105
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• 2019

Background: Although magnetic resonance imaging is accurate, it is expensive to measure the movement of temporomandibular joint. The three-dimensional (3D) motion analysis system is an inexpensive measurement tool. Objects: This study examined the reliability of quantifying the mouth opening and lateral mandibular shift and differences between individuals with and without temporomandibular disorder (TMD) using the hygienic method of surface markers on the skin with 3D ultrasound-based motion analysis. Methods: This study included 24 subjects (12 with and 12 without TMD). Temporomandibular joint motion during mouth opening was recorded using two surface markers with 3D ultrasound-based motion analysis. An intraclass correlation coefficient [ICC (3,k)] was used to confirm the intrarater reliability of quantifying kinematic temporomandibular joint motion, and an independent t-test was used to evaluate differences in maximal mouth opening and lateral mandibular shift between the two groups. Results: Assessment of mouth opening and lateral mandibular shift showed excellent test-retest reliability with low standard error of measurement. The lateral mandibular shift and opening-lateral mandibular shift ratio were significantly increased in the TMD group during maximum mouth opening (p<.05). However, no significant difference in maximal mouth opening was observed between the groups with and without TMD (p>.05). Conclusion: This hygienic and simple surface marker method can be used to quantify the mouth opening and lateral mandibular shift at the end-range of mouth opening. The TMD group showed an increased lateral mandibular shift movement at the end-range of mouth opening. The lateral mandibular shift movement can be regarded as a symptom in the diagnosis and treatment of TMD.

• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.26-37
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• 2018

Purpose: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. Methods: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. Results: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. Conclusion: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.3
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• pp.242-248
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• 2015

Maximum mouth opening is regarded as an important tool used to evaluate the clinical function of temporomandibular joint and the masticatory system. It has been reported that children can also exhibit severe dysfunction or pain in some cases of temporomandibular disorder. The purpose of this study was to measure the normal maximum mouth opening in Korean children and to analyze the correlations between mouth opening and the associated factors. Maximum mouth opening was measured from 151 healthy children between the ages of 2 and 6 years old. Age, height, weight, and mouth width were also recorded. As a result, the mean maximum mouth-opening was $37.72{\pm}5.10mm$. While the values were greater in boys than in girls without statistical significance, the increases of maximum mouth opening based on age, height, weight, and mouth width were significant (p < 0.05). In children, positive correlation coefficients were observed between maximum mouth opening and the associated factors and height showed the highest correlation. In conclusion, we collected data of the normal range of maximum mouth opening in Korean children, and this study can be utilized as a basis in diagnosing pediatric temporomandibular disorder and safety standard of mouth opening during dental procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.4
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• pp.283-294
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• 1992

Functional recovery associated with mouth opening after mandibular condyle fracture was a contradictory result of many authors. The treatment goal of condyle fracture has been not only the good reduction and fixation but also the rapid functional recovery with mouth opening capacity. The purpose of this study is to evaluate the mouth opening capacity after surgical or non-surgical treatment of condyle fracture according to the site, level, maxillomandibular fixation(MMF) and operation method based on 39 patents with condyle fracture who were admitted to the department of oral and maxillofacial surgery, Wonkwang University Hospital from May.1, 1990 to Aug.31, 1992. The results were as follows. 1. The most common fracture site was level IV (17 cases : 42.2%) and level I (14 cases : 36.8%), level II (5 cases: 13.2%) and level III(3 cases : 7.9%) were in decreasing order of frequency. Compound fracture with symphysis was more frequent (69.2%) than simple fracture(30.8%). 2. The mouth opening capacity was increased in the level I compared with level IV. 3. The mouth opening capacity was increased in the group of segment removal. 4. The mouth opening capacity was increased in the MMF period was decreased. 5. Better mouth opening capacity was recorded in the physical therapy group of more than 3-4 weeks of treatment period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.174-179
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• 2019

Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and tendons lead to the restriction of muscle extension. The criteria for the diagnosis of MMTAH are limited mouth opening that progresses very slowly from adolescence, intraoral palpation reveals a hard cord-like structure along the overhang of the anterior border of the masseter muscle on maximum mouth opening, and a square mandible. Conservative treatment, including pharmacotherapy, occlusal splint and physical therapy are ineffective. The standard therapy is surgical treatment, such as anterior partial aponeurectomy of the masseter muscle and coronoidectomy. The long-term results are very satisfying.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.112-117
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• 2023

Coronoid process hyperplasia (CPH) of the mandible is a rare condition in which abnormal elongation of the coronoid process leads to chronic mandibular hypomobility. CPH causes impingement or impedance of the coronoid process on the inner surface of the frontal part of the zygomatic bone during mouth opening. The lack of significant symptoms makes the diagnosis difficult. Its etiology remains inconclusive despite several theories being suggested. In this report, three reviewed cases are presented. All three patients visited our clinic with limited mouth opening as the chief complaint. Standard clinical and radiographic examinations were conducted under the initial impression of temporomandibular disorders (TMDs), and restricted jaw movements were confirmed in all cases. The absence of improved signs and symptoms following conservative treatment for TMDs or the indeterminate plain radiographs required the attending clinicians to consider three-dimensional imagery. Computed tomography revealed bilateral coronoid hyperplasia in all cases and impingement on the zygomatic bone in two of the three cases. After concluding that this condition caused the patients' limited mouth opening, the patients were referred to the Department of Oral and Maxillofacial Surgery for possible bilateral coronoidectomy or coronoidotomy. CPH usually presents no symptoms apart from a progressive reduction of mouth opening over time. Diagnosis is often delayed, and patients may undergo unnecessary treatment procedures. Clinicians should be aware of this condition and exercise caution in the differential diagnosis of patients with chronic mandibular hypomobility.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.44.1-44.7
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• 2019

Background: We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results: We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion: The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.18.1-18.10
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• 2019

Background: Temporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis. Methods: A total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period. Results: All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS's guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery. Conclusions: Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.11.1-11.6
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• 2017

Background: This case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia. Case presentation: A 14.5-year-old male patient of white Caucasian ethnicity presented with limited mouth opening, mandibular asymmetry, and dental crowding. Investigations confirmed bilateral coronoid process hyperplasia and management involved bilateral intraoral coronoidectomy surgery under general anaesthesia, followed by muscular rehabilitation. Mouth opening was restored to average maximum opening within 4 months of surgery. Conclusion: Limited mouth opening is a common presentation to medical and dental professionals. The rare but feasible diagnosis of coronoid impingement syndrome should not be overlooked.