• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.15-20
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• 2019

Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ${\geq}35mm$ and visual analogue scale [VAS] score ${\leq}3$), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ${\geq}35mm$ and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

• The Korean Journal of Oral and Maxillofacial Pathology
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• v.42 no.5
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• pp.145-152
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• 2018

A 57 years old female complained of severe pain on the right temporomandibular joint (TMJ) area. Her right condyle had been partly resected under surgical operation 13 years ago due to condyle hypertrophy, thereafter she felt dull pain on TMJ area and recently the lesion became severely swelled and painful leading to cancer phobia. The present radiological views showed slightly enlarged and sclerosed condyle with increased radiopacity, but its articular sliding function was almost disable during mouth opening. The patient's TMJ lesion was carefully managed with conservative physiotherapy and pain treatment. The microsection of condyle head obtained from the previous operation was re-evaluated histologically, and it was finally diagnosed as osteochondrosis dissecans (OCD), exhibiting hyperplastic proliferation of cartilage in condyle head and marked vascular dilatation in epiphyseal zone. This abnormal cartilage tissue was distinguishable from normal cartilage tissue found in the peripheral cartilaginous cap of the same microsection. The involved cartilage cap showed thick hypertrophic chondrocyte zone with horizontal and vertical clefts accompanying diffuse hyaline degeneration. The superficial fibrous zone of cartilage cap was thickened and frequently peeled off, while lower hypertrophic zone of cartilage cap was highly cellular and proliferative. Consequently, the endochondral ossification became aberrant and resulted pre-mature apoptosis of many hypertrophic chondrocytes, followed by diffuse and mild inflammatory reaction in the underlying marrow tissue. Therefore, it was suggested that this hypertrophic condyle lesion, OCD, be differentiated depending on radiological and histological features from ordinary condyle hyperplasia, osteochondroma, and osteoarthritis, and that the pathological confirmation of OCD may provide a reliable modality for dental and medical treatment of chronic and painful TMJ lesion.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.289-294
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• 2022

Background: Orofacial pain is defined as pain felt in the soft or hard tissues of the head, face, mouth, and neck. Chronic orofacial pain is often challenging to diagnose and difficult to treat. Due to the lack of available information about the prevalence and clinical form of orofacial pain, this study aimed to evaluate the characteristics of chronic orofacial pain in patients presenting at the Department of Oral Medicine of Shahid Beheshti Dental School between 2012 and 2022. Methods: In this retrospective study, we evaluated the files of 121 patients at the Department of Oral and Maxillofacial Diseases of Shahid Beheshti Dental School, which were completed during 2012-2022. We extracted the required information from these files. Results: In total, 121 files were included in the study (30 male, 91 female). The mean age of the patients was 43.68 ± 16.79 years. The most common diagnosis in patients with chronic orofacial pain was temporomandibular disorders (TMD) (55.3%). Among pain-related factors, psychological factors showed the highest frequency (30.5%). Opening and closing (43.8%) had the highest frequency among factors that increased pain, and the rest (6.6%) had the highest frequency among the factors that reduced pain. Most patients experienced unilateral pain over the masseter area. Most patients reported their pain intensity to be greater than 7 in the verbal analog scale (VAS). The most common symptom associated with pain was joint noise (37.1%). Conclusion: A ten-year retrospective evaluation of patient files showed that more than half of the patients with chronic orofacial pain had TMD.

• Computers and Concrete
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• v.29 no.6
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• pp.393-405
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• 2022

Lightweight concrete is a superior material due to its light weight and high strength. There however remain significant lacunae in engineering knowledge with regards to shear failure of lightweight fiber reinforced concrete beams. The main aim of the present study is to investigate the optimum usage of steel fibers in lightweight fiber reinforced concrete (LWFRC). Multi-scale finite element model calibrated with experimental results is developed to study the effect of steel fibers on the mechanical properties of LWFRC beams. To decrease the amount of steel fibers, it is preferred to reinforce only the middle section of the LWFRC beams, where the flexural stresses are higher. For numerical simulation, a multi-scale finite element model was developed. The cement matrix was modeled as homogeneous and uniform material and both steel fibers and lightweight coarse aggregates were randomly distributed within the matrix. Considering more realistic assumptions, the bonding between fibers and cement matrix was considered with the Cohesive Zone Model (CZM) and its parameters were determined using the model update method. Furthermore, conformity of Load-Crack Mouth Opening Displacement (CMOD) curves obtained from numerical modeling and experimental test results of notched beams under center-point loading tests were investigated. Validating the finite element model results with experimental tests, the effects of fibers' volume fraction, and the length of the reinforced middle section, on flexural and residual strengths of LWFRC, were studied. Results indicate that using steel fibers in a specified length of the concrete beam with high flexural stresses, and considerable savings can be achieved in using steel fibers. Reducing the length of the reinforced middle section from 50 to 30 cm in specimens containing 10 kg/m3 of steel fibers, resulting in a considerable decrease of the used steel fibers by four times, whereas only a 7% reduction in bearing capacity was observed. Therefore, determining an appropriate length of the reinforced middle section is an essential parameter in reducing fibers, usage leading to more affordable construction costs.

• Journal of Acupuncture Research
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• v.40 no.3
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• pp.214-237
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• 2023

This study aimed to evaluate the clinical efficacy and safety of acupuncture and electroacupuncture for temporomandibular joint disorder (TMD). We searched 11 databases to find randomized-controlled trials (RCTs) published between January 2018 and January 2023 that used acupuncture and electroacupuncture to treat patients with TMD. We performed a meta-analysis of 18 RCTs involving 1,109 patients. Nine studies reported that the treatment and control groups showed improvement in the evaluation index post-treatment. The results of the meta-analysis showed that the treatment groups receiving acupuncture combined with manual therapy had significantly improved visual analog scale score and dysfunction index than the control groups receiving manual therapy. Moreover, the treatment groups receiving acupuncture combined with Western medicine had statistically improved maximum mouth opening than the control groups using Western medicine. In conclusion, acupuncture and electroacupuncture have clinical effects on TMD patients. Given that 11 studies were obtained from the Chinese database, a regional bias would be considered. Furthermore, the included studies had high a risk of bias in terms of randomization, concealment, and blinding. Further studies are required to correct these limitations.

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.31-36
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• 2023

This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.50-58
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• 2022

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

• Journal of the Korea institute for structural maintenance and inspection
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• v.27 no.6
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• pp.193-200
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• 2023

This paper investigates the effect of directional alignment of steel fibers using an electromagnetic field on the flexural fracture behavior of steel fiber reinforced concrete. A specially designed and manufactured solenoid, capable of aligning steel fibers in the longitudinal direction of the beam specimen, was employed for this purpose. Beam specimens with a design strength of 30 MPa were produced, and failure tests were conducted on specimens exposed to electromagnetic fields and those without exposure. Experimental variables included the mixing ratio and aspect ratio of steel fibers. The results of the experiments revealed a slight increase in flexural strength and crack mouth opening displacement at the maximum load for specimens exposed to the electromagnetic field. Notably, a significant enhancement in fracture energy was observed.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.433-446
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• 2005

The purpose of this study was to investigate the sociopsychological factors which might influence the course of the temporomandibular disorders and to develop models for prediction of treatment outcome related to pain, dysfunction and sound. For this study, 268 patients with temporomandibular disorders were selected from the patients presented to department of Oral Medicine, Wonkwang university dental hospital. Chief complaints of these subjects were largely grouped into three categories such as pain, dysfunction and sound, and 10 cm visual analogue scale(VAS) was used to record the state of the three complaints every visit and Treatment Index(VAS TI) was calculated from VAS. All the forty-two items obtained from clinical examination or questionnaire were statistically processed with $SPSS^{(R)}$ windows. The results of this study were as follows: 1. The items showed a difference between male and female subjects were maximum mouth opening, palpation score, jaw jerk during mandibular movement, and sleep disturbance. Among questionnaires such as SRRS, HAD scale and PSQI, the HAD scales showed the most highly significant correlation with the each scale item of the SCL-90R. 2. Among the groups classified by VAS TI, the group with the lowest VAS TI showed the highest VAS score in the start of treatment but showed the lowest score in the end of treatment, without respect to the type of chief complaint. From these results, it is assumed that the active treatment duration for the subjects with lower VAS score in the first visit would be longer than the subjects with higher score with the somewhat poor treatment outcome. 3. With regard to all the three complaints, the items showing significant effect in the model for prediction of treatment outcome were from questionnaire, except one item, maximum mouth opening, which suggest that the sociopsychological factors would be strongly related to development and progress of the symptoms.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.365-377
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• 2012

Objectives : This research was conducted to determine the effect of the Visiting Oral Health Care Program by examining the oral health of the elderly women, who are the beneficiaries of this Visiting Oral Care Program. Methods : This research was conducted from November of 2011 to February of 2012, in Chilgok-gun in the Kyeongbuk Province, South Korea. One hundred and twenty five (125) elderly women among the beneficiaries of the Visiting Oral Care Program within the area were randomly selected for the research. The research subjects would regularly visit the area senior citizen center, and they were divided into two groups, with 64 of them belonging to a control group, and the rest (61 people) belonged to a intervention group. The research subjects were examined for their dental health condition, and we investigated the effect of the Visiting Oral Care Program through this research. Results : 1. When they were asked about how many times they wash their dentures, the majority of the control group, 57.4% of them answered that they do it "once" a day. The majority of the intervention group answered "more than 3 times", with 35.2% of group mentioning that they wash their dentures more than 3 times a day(p<.001). 2. When the research subjects were asked to scale their overall quality of life before and after the Visiting Oral Care Program, the control group had rated 49.3 before the Service and 56.8 after the Service (p<.01), and scores for the individual factors to determine the overall quality of life has significantly improved as well (p<.01, p<.01, p<.01, p<.01, p<.01, p<.01, p<.01). 3. The oral hygiene condition after the Visiting Oral Care Program has shown improvement as well. The control group scored 64.2 for the severity of the symptoms of dental plaque before the dental care, and scored 46.8 after the dental care (p<0.1). The control group was diagnosed for the symptoms of coated tongue, and the severity of the symptoms were scaled as 3.7 before the Program and 2.0 after the Program (p<.01). Furthermore, the overall functionality of the oral cavity was improved as well. The control group showed 1.0 time increase in repetitive voluntary swallowing test (p<0.1), increased amount of sublingual saliva from 0.8mm to 1.4mm, and from 1.6mm to 2.0mm in dorsum linguae(p<0.1). Also, the control group showed an improvement in mouth opening as well, increased from 3.9 to 4.0cm after the oral care program (p<.05). When compared the result with the examination after the Visiting Oral Care Program, the two groups showed a significant difference with the control group showing a significant improvement compared to the intervention group(p<.01, p<.01, p<.01, p<.01, p<.05). 4. The correlation between the dental hygiene condition and the functionality of oral was made for the result of examining the beneficiaries for Visiting Oral Care Program. The amount of saliva showed a negative correlation with the severity of dental plaque (p<.05), and a positive correlation with the repetitive voluntary swallowing count (p<0.1). Also, mouth opening showed a positive correlation with repetitive voluntary swallowing count (p<.05). Conclusions : After the Visiting Orall Care Program, the beneficiaries of the program experienced improvement in their quality of life related to oral health, overall oral hygiene and functionality of oral.