Journal of Dental Rehabilitation and Applied Science
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v.31
no.2
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pp.86-95
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2015
Purpose: The aim of the study was to evaluate the subjective symptoms and clinical signs through the TMD-questionnaire, clinical examination and radiography against the many instrumental performers and to investigate the association between playing instruments and TMDs. Materials and Methods: A total of 803 instrumental performers received TMD-related questionnaire and evaluations of prevalence and disease distribution were performed. Among those who reported at least one symptom of TMD, 70 volunteers visited in clinic then received clinical examination and radiography for diagnosis and evaluations of prevalence and disease distribution were performed. 70 subjects were divided into three groups as woodwind, brass wind, string. Comparative analysis of disease distribution was performed. Results: Among 803 instrumental performers, 610 people (75.97%) were reported to one or more symptoms of TMD. The most frequent symptom was click (29.68%).70 subjects underwent a clinical examination and radiography survey results, the most frequent symptom was a click (29.75%). Most commonly diagnosed disease was a myofacial pain (30.53%).Comparison of the three groups, a significant difference was not observed in the clinical sign. But among subject symptom, muscle pains howed significant differences in accordance with the Group (P = 0.024). During the 70 people who underwent clinical examination, 66 people (94.3%) showed moderate to severe attrition, mild to severe tongue ridging, mild to severe cheek ridging assigns of parafunction. Conclusion: Instrumental performers showed a high prevalence of TMD and the most of the musicians with temporomandibular disorder had bruxism or clenching habits.
Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.
Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.
There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.
Park, Jong-Hyuk;Lee, Jun-Mo;Bae, Hyun-Kyung;Im, Jong-Han;Lee, Ju-Hong
Journal of Korean Orthopaedic Sports Medicine
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v.8
no.2
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pp.95-101
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2009
Purpose: The purpose of this study was to determine how many of our patients who had had anterior cruciate ligament (ACL) reconstruction returned to their previous levels of sports and to identify why not doing so. Material and Methods: We evaluated 43 knees with a minimum of two years follow-up among whom undergoing 109 ACL reconstruction from September 2003. The mean age of patients was 26 years (17 to 45 years) Clinical results was evaluated according to the Lysholm Knee scores, Tegner activity score, subjective IKDC questionnaires, objective IKDC evaluation form and KT-1000 arthrometer. Results: The overall clinical results demonstrated significant improvement at the final follow-up comparing to preoperative data (P<0.05). Among 43 patients, 25 patients (58%) returned to their previous level of sports and 18 patients (42%) did not. Of whom, 11 patients (61%) were not able to return to sports due to fear to re-injury and 7 patients (39%) suffered from instability and pain. The differences in the Lysholm Scores, KT-1000 arthrometer and subjective IKDC in the 3 groups of patients by ANOVA test were found to be statistically significant (P<0.001). Although there is no difference in objective IKDC and KT-1000 arthrometer, the difference was observed in Tegner activities, subjective IKDC obtained by those who returned to sport and those who had fear to reinjury (P<0.001). Conclusion: This study showed that a quater of patients could not return to their previous level of sport after ACL reconstruction because of fear to reinjury. We thought that not only improving the technique of ACL reconstruction and systemic rehabilitation but also considering psychological factor of patients could allow more patients to return to the previous level of sports.
Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.
Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.
Temporomandibular disorder(TMD) is relatively prevalent disease, and quality of life may be impaired in TMD patients. Like general population, dental hospital workers are also exposed to the risk of TMD. But, many of them tend to overlook or tolerate their symptoms for lack of time and interest. Therefore, problems may become more serious, causing interference of performing task and decrease of quality of life. The aim of this study were to obtain data for TMD prevalence in dental hospital workers and to evaluate quality of life according to TMD symptoms. Subjects were recruited from Wonkwang University Dental Hospital. After consent, subjects completed quality of life questionnaire and were evaluated for subjective and objective signs and symptoms of TMD. Subjects were classified into 4 groups : (1) normal group (2) joint disorder group, (3) local myalgia group, and (4) myofascial pain group. The result of the study indicated that TMD negatively influences the quality of life in dental hospital worker. TMD symptoms can deteriorate quality of life in dental hospital worker. Future effort to make protocol for proper management is needed.
Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.
There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.
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