• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.169-179
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• 2016

Purpose: This study is designed to analyse etiology and bone pattern at the first visit using cone-beam computed tomography (CBCT) and to evaluate the treatment outcome of conservative treatment in temporomandibular disorder (TMD) patients with rheumatoid arthritis (RA). Methods: One hundred condyles in 50 subjects with RA were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Dental Hospital, diagnosed as TMD. Condylar bone changes were classified by normal, erosive bony change, proliferative bony change and combined group (erosive bony change+proliferative bony change). They were treated conservatively with physical therapy, medication, behavioral therapy and/or occlusal stabilizing splint therapy. After 3 months on average, patients were re-evaluated with regards to subjective symptoms and the clinical findings were investigated. Results: TMD patients with RA have behavioral contributing factors such as parafunctional habit. The results that analyse bone pattern at the first visit using CBCT proliferative bony changes group (32.6%) were more common than erosive bony changes group (15.2%). In comparison between unilateral and bilateral bony change in temporomandibular joint, the ratio showed no significant differences. After 3 months of conservative treatments, pain, noise, limitation of motion (LOM) were markedly improved regardless of occlusal splint therapy. However only LOM was significantly improved through occlusal splint therapy during 3 months. Conclusions: TMD patients with RA had similar behavioral contributing factors and characteristics of CBCT images shown in general TMD patients and also similar response to conservative treatment so it is difficult to differentiate. Therefore when TMD patients show symptoms corresponding to clinical diagnostic criteria of RA at the first visit, serological testing should be conducted and through this, early diagnosis and treatment of RA should be initiated.

• Journal of Oral Medicine and Pain
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• v.42 no.4
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• pp.89-101
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• 2017

Purpose: The purpose of this study is to investigate the prevalence of temporomandibular disorders (TMDs) in children and adolescents, their characteristic contributing factors, the characteristic features of symptoms and symptoms, and the response to treatment. Methods: We studied the researches, that were the results of the searches for words such as temporomandibular disorder, TMD, children, adolescents, and juvenile through PubMed and DBpia. Results: According to a study conducted in Busan, the ratio of adolescents increased from 18.3% to 21% in 2008 compared to 2000, and the proportion of boys increased from 38.58% to 45.38%. One of the characteristic contributing factors for adolescents is the macrotrauma such as jaw trauma, vehicle accidents, sports, physical abuse, forceful intubation, and third molar extraction. The second is a microtrauma from parafunctional habit such as bruxism, clenching, hyperextension, wind instrument, and fingernail biting that can cause joint overload, cartilage breakdown, synovial fluid alterations, and other changes within the joint. The diagnosis of TMDs in juvenile adolescents is not significantly different from that of adults. Medical history, clinical examination and radiological examinations are required. Conclusions: In the temporomandibular joint history and assessment, all comprehensive dental history examination is required, including head and neck pain, mandibular dysfunction, previous orofacial trauma, history of present illness with an account of current symptoms. For the treatment and management of temporomandibular arthritis in juvenile adolescents, understanding the characteristics of TMDs in juvenile adolescents and thoroughly analyzing appropriate diagnosis and possible contributing factors through comprehensive history taking & examination, conservative treatment, including fast and active cautions education, will be essential.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.3
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• pp.239-245
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• 2003

The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

• Journal of Oral Medicine and Pain
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• v.35 no.1
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• pp.61-73
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• 2010

The aim of this study was to investigate clinical assessment and cephalometric characteristics in 10s patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients were 59. Female was 47 and male was 12, Females were predominant and patient's age ranged from 12 to 19. 2) Most of the patients had Grade II condyle resorption. 3) The number of who had Class I occlusion was 27, which was the largest group. The number of patients with openbite was 20. Average overjet was 3.58mm and average overbite was 0.97mm. 4) Most of the patients had parafunctional habit. 5) The patients of showing the pain in condylar resortion was 41 and the case of not showing the pain was 18. 6) Treatment duration of 23 patients were less than 1 month, 28 patients were treated with supported therapy. 2. Cephalometric Characteristics 1) A 16-year-old female patients showed smaller SNA, SNB and larger articular angle significantly as compared with those of normal group. 2) A 17-year-old female patients showed smaller SN, SAr, TPFH, ramus height and larger SN-GoMe, FMA, articular angle significantly as compared with those of normal group. 3) Over 18 years old female patients showed smaller SN, SNB, TPFH, ramus height and larger ANB, FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 4) Over 18 years old male patients showed smaller SN, TPFH, ramus height and larger FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 5) There was no significant difference between 10s and normal group in mandibular body length.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.409-420
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• 2009

The aim of this study was to investigate clinical assessment, panorama & MRI findings and cephalometric characteristics in 42 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006. The results were as follows; 1. Clinical assessment 1) Female was 34 and male was 8, females were predominant. Distribution of age showed as follows; 10s was 14, 20s was 13, 30s was 7, 40s was 3, 50s was 4 and 60s was 1 patient. 10s and 20s were predominant. 2) Most of the patients had parafunctional habit. 2. Findings of panorama & MRI 1) Most of the patients had degree of Grade II condylar resorption by panorama taking. 2) Most of the patients had disc dislocation and belonged to the degree of stage IV by MRI taking. 3. Cephalometric Characteristics 1) SN, SAr and saddle angle in female patients were significantly smaller and SN in male patients showed only significantly smaller than normal group. 2) SNA showed no difference from the normal group in both patients. SNB was smaller and ANB was lager in female patients than normal group. 3) SN-GoMe and FMA increased in patients. 4) Total posterior facial height & ramus height were significantly smaller. 5) Mandibular body length did not show any significant difference.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.101-111
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• 2006

Temporomandibular disorders (TMD) is a collective term embrassing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both. The prevalence of signs and symptoms associated with TMD can be best appreciated by examining epidemiologic studies. But domestic epidemiologic studies about sex, history, chief complaint, diagnosis were not sufficient comparing with foreign countries. The results obtained as follow. 1. The number of visiting patients were 6500 and mean age was 34.06 year (Male's mean age was 33.15, Female's 34.62). In the age of patients, there was no significant difference between sex. 2. There are most patients who were referred by dentist (80.07%). Most diagnostic group was arthrogenous TMD group and followed by myogenous TMD, soft tissue disease. 3. There was strong interaction between diagnostic groups and chief complaint. 4. There was little pain difference between right and left sides. Male mainly had pain onset under 6 month, but female had pain onset more than 6 month. 5. The number of patients who had joint sound history were 3445 (53.15%). There was no significant difference of pain onset between sex. Clicking sound was most among joint sounds which happened to patients. 6. In analyzing the parafunctional habit, male mainly had bruxism, but female had clenching habit.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.67-78
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• 1996

This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.87-101
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• 2012

Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

• Journal of Technologic Dentistry
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• v.31 no.3
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• pp.35-45
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• 2009

This survey study was conducted on dental technician school students in April 2008 to investigate the effects of smoking on oral health. 110 male and 39 female students were surveyed and cross analysis was performed to examine the relationship between oral health status and smoking-related and oral health maintenance characteristics of smoking and non-smoking group. T-test and one-way ANAVA was used to analyze the average difference verification of two independent samples(smoking group and non-smoking group) and followings are the results. In general characteristics, 74 male students(74.7%) and 25 female(25.3%) students smoked and the percentage of male students were higher in smoking group. Regarding class grade, 2nd-year students(37 students, 37.4%) and 1st-year students(18 students, 36.0%) took the highest percentage of smoking and non-smoking group, respectively. Concerning the experience of drinking, smoking group consumed more alcoholic beverages(94 students, 94.9%) With respect to the frequency of between-meal consumption, respondents who eat between-meal once or twice smoked more. Respecting preferences of sweet food, respondents who enjoyed sweet food smoked more. Concerning smoking characteristics, many of smoking group had been smoked fo a long time(two to five years) and it was worrisome. About the amounts of smoking, 50 respondents(52.6%) of smoking group smoked 20 cigarettes a day with the highest proportion. With regard to the awareness of harmfulness, 70 respondents(70.7%) considered smoking as very harmful and showed that smoking group were aware of its harmfulness but it was habitualized. Respecting smokers in family members, father was more common as smokers(58 respondents, 58.6%) in family and showed that the influence of father. Main reasons of poor periodontal health were alchoholic consumption, smoking, and oral parafunctional habit(57 respondents, 56.7%) in smoking group and neglect of oral hygiene(21 respondents, 42.0%) in non-smoking group. With regard to the scaling, 80 respondents of smoking group(80.8%) didn't received scaling and showed that more oral health education was required. Regarding the periodontal status, non-smoking group was $1.26{\pm}0.44$, respondents who received scaling was $1.43{\pm}0.50$, respondents who regularly floss was $1.50{\pm}0.52$, respondents who brush more than three times a day was $1.38{\pm}0.49$ and had better periodontal health. Bleeding during tooth brushing was more frequent in smoking group ($1.51{\pm}0.70$). Regarding mouth order, non-smoking group was $2.34{\pm}0.62$, after scaling was $2.02{\pm}0.76$, patients who regularly floss was $1.50{\pm}0.52$, patients who brush more than three times a day was $1.81{\pm}0.87$. Concerning the experience of dental caries treatment, smoking group was $1.20{\pm}0.40$, patients who do not floss was $1.30{\pm}0.46$, patients who brush once a day was $1.29{\pm}0.45$. With regard to dental prosthesis, non-smoking group was $3.78{\pm}1.62$, patients who received scaling was $1.43{\pm}0.50$, patients who regularly floss was $1.40{\pm}0.51$, patients who brush more than three times a day was $1.24{\pm}0.43$. From these results, oral health education and smoking has correlation and more oral health education needs to be carried out to educate students with non-health related majors about harmfulness of smoking on oral health. Also more study are required.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.57-67
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• 2005

The aim of this study was to evaluate bone scan(SUR) and SPECT(hot spot) in patients with TMJ osteoarthritis. 99mTc-MDP bone scan and SPECT were done in 27 patients, total 54 temporomandibular joints were examined with clinical examination, plain radiography. 42 TMJs were osteoarthritis and 12 TMJs were normal case, clinically diagnosed. We compared osteoarthritis group and control group of bone scan(SUR) and SPECT(hot spot). thus we compared before and after treatment of bone scan(SUR) and bone SPECT(hot spot) according to history, contributing factor, symptom degree, treatment, treatment period. The obtained results were as follows. 1. Bone scan(SUR) and SPECT(hot spot) activity of osteoarthritis group were higher than control group(P<0.05, P<0.01). 2. Bone scan(SUR) and SPECT(hot spot) activity were decreased after treatment at TMJ with osteoarthritis(P<0.01). 3. Bone scan(SUR) and SPECT(hot spot) activity were decreased at treatment group with splint(P<0.01, P<0.05). 4. Bone scan(SUR) and SPECT(hot spot) activity were decreased at Chronic group(P<0.01, P<0.05). 5. Bone scan(SUR) and SPECT(hot spot) activity were decreased at low noise NAS(<6) group(P<0.01,P<0.05). 6. Bone scan(SUR) and SPECT(hot spot) activity were decreased at TMD patient with parafunctional habit and without trauma history, psychosocial factor. 7. Bone scan(SUR) and SPECT(hot spot) activity were higher at before treatment required more treatment period.