• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.43-47
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• 2015

Purpose : The aim of this study was to report a follow-up study on the prognosis following the arthrocentsis for the painful temporomandibular dysfunction not responsible to the conservative splint therapies. Arthrocentsis of TMJ is a simple precedure that can be performed in the out-patient clinic under the local anesthesia without any reported complications. Method : Seventy patients had been followed after the arthrocentsis for over 6 months. Maximum mouth opening, TMJ pain, TMJ noise, and their changes by time were examined and compared statistically. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predictors which was analyzed were age, duration of painful locking, MMO, the degree of pain, preoperative clicking and the amounts of irrigation fluid. Result : The result of this study were as follow; 1) Mouth opening was improved from 32.6 mm to 42.4 mm in the maximum inter-incisal distance. 2) TMJ pain was decreased in 45.7%. 3) TMJ clicking and noise disappeared in 60.0%, but recurred in 40.0%. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.317-323
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• 1999

TMJ ankylosis is defined as a mobile disorder of jaw such as mouth opening limitation, limitation of anterior or/and lateral movement of TMJ. Kazanjian published first clinical report about classification of TMJ ankylosis dividing with intracapsular ankylosis and extracapsular ankylosis. TMJ ankylosis is resulted from trauma, infection, metastatic tumor, irradiation, burn and etc. When TMJ ankylosis is manifested in growing period, it affects to functional disorder and development and position of mandible, so it can result in maxillofacial deformity such as facial asymmetry, micrognathia, malocclusion. For treatment of TMJ ankylosis, various surgical interventions were devised ; condylectomy, gap arthroplasty, interpositional arthroplasty and TMJ reconstruction. So, we report our results with documental study and cases of true ankylosis in our department.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.221-225
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• 1989

Arthrography is one of highly accurate diagnostic tools for internal derangements of the temporomandibular joint (TMJ). Both TM joints are connected by the mandible and one may have influence upon the other. We performed bilateral TMJ arthrograms in 42 patients with TMJ disorders to evaluate the bilaterality of internal derangements of the TMJ. The results were as follows : 1. We could not find any specificity in clinical symptoms according to each state of internal derangements of the TMJ. 2. The bilaterality of internal derangements of the TMJ was 61%. 3. Statistically, significant correlation was found in the aspects of the presence of arthrographic abnormality in both TMJ and each state of internal derangements in them. Therefore, the patients, who are diagnosed as any internal derangement of the TMJ, need to have assured examination in the contralateral joint.

• The Journal of Korean Academy of Prosthodontics
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• v.26 no.1
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• pp.113-131
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• 1988

Although TMJ sound is common, its relationship to subjective and objective evaluation and the magnitude and the position of the sound during the mandibular movement is not fully understood. So, the purpose of this investigation was to provide further insight into the characteristics of the TMJ sounds. Twelve subjects (9 men and 3 women) with TMJ sounds were selected from students at Chosun University, School of Dentistry. Condylar movements and TMJ sounds of each subject were recorded and analyzed using a simplified condylar path recorder and a sound checker. Although specific conclusions were difficult to make from this study, the finding suggested the followings. 1. The position of TMJ sounds were visually observed and marked on the condylar tracings during maximum opening and closing, protrusive and retrusive and right and left lateral movements. 2. Information about the size, location and number of condylar deviations and the translation freedom of the condyle was recorded and analyzed objectively. 3. The most obvious characteristic of TMJ sounds was their variability. 4. TMJ sounds were categorized into one of four groups (soft click, hard click, soft crepitus, hard crepitus) by the quality and quantity of the duration and amplitude components.

• Journal of TMJ Balancing Medicine
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• v.13 no.sup
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• pp.15-20
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• 2023

Objectives: This case is to report the effect of TMJ balancing therapy (TBT) and combined Korean Medicine (CKM) on a 15-year-old male patient with suspected cervical dizziness of unknown causes. Methods: He was treated with TBT and CKM included Yin-yang Balancing Therapy of TMJ, pelvic balancing therapy, cervical chuna therapy once a week for 3 months. He continued to wear accurate balancing appliance (ABA) in the mouth, did 12-way cervical gravity straightening exercise and took banhabakchulchunma-tang-gamibang for 3 months. The effects of treatment was evaluated using the numerical rating scale (NRS). Results: After the treatments, dizziness was relieved from NRS 7 to NRS 1. Conclusions: This case report suggests that TBT and CKM treatments can relieve suspected cervical dizziness of unknown causes.

• Journal of Korean society of Dental Hygiene
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• v.14 no.5
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• pp.739-746
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• 2014

Objectives : The purpose of this study was to examine the relationship of stress symptoms, oral habits and temporomanbibular joint symptom among 20-30 ages adults. And it's also meant to investigate the direct and indirect influence of these factors by using a path model to determine their causal relationship. Methods : The subjects in this study were 287 selected 20-30 ages adults, on whom a survey was conducted from June 15 to July 10, 2014. The data were analyzed using SPSS 18.0(SPSS 18.0 K for window, SPSS Inc USA) and IBM SPSS Amos 18.0(SPSS Inc, Chicago, IL, USA). Results : There were significant differences in oral habits, TMJ symptoms and stress according to gender. There were significant differences in oral habits, TMJ symptoms, physical and psycho-emotional symptoms according to Systemic disease. And stress, physical, psycho-emotional symptoms, oral habits and TMJ symptoms were correlated to one another. Stress exerted a direct influence on physical, psycho-emotional symptoms, and psycho-emotional symptoms had a direct impact on physical symptoms, oral habits and TMJ symptoms. Physical symptoms exercised a direct influence on oral habits and TMJ symptoms, and oral habits affected TMJ symptoms in a direct way. physical, psycho-emotional symptoms and oral habits served as parameters that produced partial mediation effects, and the two factors had an indirect impact on TMJ symptoms. Conclusions : It's found that stress exerted direct and indirect influence on oral parafunction and TMJ symptoms. Like other diseases, oral habits and TMJ symptom that stem from stress is likely to lead to chronic diseases if the two are not noticed at the right time. Therefore individual people should try to get rid of stress in a manner to be appropriate for their own characteristics in order to maintain their oral health.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.143-153
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• 2006

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

• International Journal of Oral Biology
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• v.41 no.3
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• pp.125-131
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• 2016

The aim of the present study was to develop an animal model for evaluation of temporomandibular (TMJ) nociception under TMJ inflammation. We also investigated the participation of $IL-1{\beta}$ in inflammation-induced TMJ nociception. Experiments were carried out using male Sprague-Dawley rats. Intra-articular injection of 3% formalin was administered to evaluate hyperalgesia 3 days after CFA injection. Intra-articular injection of 3% formalin did not produce nociceptive behavior in normal rats. Although intra-articular injection of 3 doses of CFA produced TMJ inflammation, only 1:3 diluted CFA produced hyperalgesia when formalin was injected intra-articularly 3 days after CFA injection. Co-administration of IL-1 receptor inhibitor with formalin into the TMJ cavity 3 days after CFA injection was performed. Co-administration of IL-1 receptor inhibitor significantly inhibited formalin-induced hyperalgesia in rats with CFA-induced TMJ inflammation. These results suggested that intra-articular injection of formalin produced hyperalgesia under chronic TMJ inflammation. Moreover, $IL-1{\beta}$ plays an important role in TMJ hyperalgesia under chronic inflammation and blockade of $IL-1{\beta}$ is a potential therapeutic target for inflammatory TMJ pain.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.48-53
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• 1999

Purpose: The aim of this study was to investigate the improvement of referred symptoms of TMJ internal derangement after open surgery of TMJ. Materials and Methods: The present study focused referred symptoms such as headache, neck pain, shoulder pain and evaluated the incidences and changes in their improvement at 1, 3, 6, 12 months after surgery in 118 patients who had TMJ internal derangement and received meniscoplasty(or meniscorrhaphy) and eminectomy at TMJ clinic of Yonsei University, Yongdong Severance Hospital, between 1992 and 1997. Results: One hundred eighteen patients(102 females, 16 males) with mean age of 29.6 years(range, 14 to 74) were included in this study and the mean follow-up period was 19.5 months(range, 12 to 60). The incidences of headache, neck pain, shoulder pain among the surgically treated TMJ internal derangement patients were 66.9%, 28.8%, 28.0% before surgery. Thirty-two preoperative severe(+++) headache patients were all improved their headache at 1, 3, 6 months after surgery, but slight relapse(9.4%) was found at 12 months after surgery. The clearance rate of preoperative neck and shoulder pain were 91.2% and 90.9% at 1 month after surgery and all of these groups had no pain at 12 months after surgery. Conclusions: Referred symptoms of TMJ internal derangement such as headache, neck pain, shoulder pain were dramatically improved after surgical treatment of TMJ.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.1-9
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• 2018

Purpose: To evaluate osseous changes of temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA) using cone-beam computed tomography (CBCT) and to correlate the imaging findings with the severity of TMJ dysfunction, clinical findings, and laboratory findings. Materials and Methods: This study consisted of 28 subjects, including 14 RA patients and 14 controls, who were scheduled to undergo CBCT imaging for the diagnosis of a complaint not related to or affecting the TMJ. The Fonseca's questionnaire was used to assess the severity of TMJ dysfunction. Rheumatoid factor (RF) and the erythrocyte sedimentation rate (ESR) were assessed in the RA patients. CBCT was then performed in all subjects and osseous TMJ abnormalities were assessed. Results: According to the Fonseca's questionnaire, 14.3% of the patients had no TMJ dysfunction, while 50%, 21.4%, and 14.3% had mild, moderate, and severe dysfunction, respectively. RF was positive in 64.3% of patients, and the ESR level was high in 100%. Imaging findings revealed a statistically significantly higher prevalence of erosion (85.7%), flattening (89.3%), osteophyte formation (32.1%), subchondral cyst (32.1%), sclerosis (64.3%), and condylar irregularities (28.6%) in the RA patients than in the controls. No correlations were found between CBCT findings and the clinical findings, the severity of TMJ dysfunction, disease duration, or laboratory results. Conclusion: RA patients might show extensive osseous abnormalities with no/mild clinical signs or symptoms of TMJ dysfunction that necessitate TMJ imaging for these patients. CBCT is a valuable and efficient modality that can assess osseous TMJ changes in RA patients.