• Journal of Oral Medicine and Pain
• /
• v.32 no.3
• /
• pp.305-318
• /
• 2007

To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

• Journal of Oral Medicine and Pain
• /
• v.36 no.3
• /
• pp.187-197
• /
• 2011

Temporomandibular disorders(TMD) is a collective term which is embracing a number of clinical problems that involve the masticatory musculature, the TMJ and associated structures, or both. Myofascial pain, which is a kind of masticatory muscle disorder of TMD, is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. There has been some controversies regarding etiologies of TMD and MFP. Especially the issue of occlusal conditions has been a critical issue for long time. Despite much efforts, the results of studies regarding occlusal conditions were contradictory. These controversies might be mostly due to various factors resulting from the complex nature of TMD, however, inaccurate and inappropriate study design, selection criteria, methodologies also play significant roles. Recently, a computerized occlusal analysis system, T-Scan II which made it possible to reveal quantifiable time data and relative force data for analyzing occlusion, was introduced. Some authorities suggested that the concept of disclusion time and prolonged disclusion time of posterior tooth and MFP are related using T-Scan II. But the previous studies which used T-SCAN II are not reliable for they did not provide accurate diagnostic criteria of MFP. Morever they did not compare with controls, and had many other problems. The purpose of this study was to evaluate the relationship between MFP and prolonged disclusion time of posterior tooth, which is one of the occlusal factors of TMD, by selecting 30 subjects as the study group through strict criteria and comparing them with 38 controls using T-SCAN II, computerized occlusal analysis system. The results, statistically analyzed, are summarized as follows: 1. Cronbach ${\alpha}$ coefficient of repeated measurements of disclusion time was 0.92. 2. There were no statistically significant differences at repeated measured disclusion time of both side between control and study group. 3. There was no statistically significant diffefence in the disclusion time between right and left side. From the results above, we can suggest that there was no relationship between MFP and disclusion time, so irreversible treatments leading to the reduction of disclusion time for treating MFP would not be appropriate. However more controlled, large scaled study, which consider various occlusal factors, and quantification of symptoms using Helkimo index would be necessary in the future.

• The Journal of Korean Academy of Prosthodontics
• /
• v.49 no.4
• /
• pp.324-332
• /
• 2011

Purpose: The purpose of this study was to compare the stress distribution of teeth and jaw on load by differentiating property of materials according to each layer of widely used mouthguard. Materials and methods: A Korean adult having normal cranium and mandible was selected to examine. A customized mouthguard was constructed by use of DRUFOMAT plate and DRUFOMAT-TE/-SQ of Dreve Co. according to Signature Mouthguard system. The cranium was scanned by means of computed tomography with 1mm interval. It was modeled with CANTIBio BIONIX/Body Builder program and simulated and interpreted using Alter HyperMesh program. The mouthguard was classified as follows according to the layers. (1) soft guard (Bioplast)(SG) (2) hard guard (Duran)(HG) (3) medium guard (Drufomat)(MG) (4) soft layer + hard layer (SG + HG) (5) hard layer + soft layer (HG + SG) (6) soft layer + hard layer + soft layer (SG + HG + SG) (7) hard layer + soft layer + hard layer (HG + SG + HG) The impact locations on mandible were gnathion, the center of inferior border, and the anterior edge of gonial angle. And the impact directions were oblique ($45^{\circ}$). The impact load was 800 N for 0.1 sec. The stress distribution was measured at maxillary teeth, TMJ and maxilla. The statistics were conducted using Repeated ANOVA and in case of difference, Duncan test was used as post analysis. Results: In teeth and maxilla, the mouthguard contacting soft layer of mandibular teeth presented lowest stress measure and, in contrast, in condyle, the mouthguard contacting hard layer of mandibular teeth presented lowest stress measure. Conclusion: For all impact directions, soft layer + hard layer + soft layer, the mouthguard with three layers which the hard layer is sandwiched between two soft layers, showed relatively even distribution of stress in impact.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.593-599
• /
• 2001

Recently, tempormandibular disorder(TMD) shows an tendency to increase every year. TMD is a collective term embracing a number of clinical problems that involve the masticatory musculature, temporomandibular joint(TMJ) and associated structures, or both. TMD, viewed in distribution of age, often occurred from late teens to late twenties. But recently, the age of occurrence tends to be lower. Accordingly, early diagnosis of tempormandibular disorder is very important. In this study, we measured the maximum mouth opening which is simple and easy to carry out as a way of TMD diagnosis. In this study, the maximum mouth opening was examined for 1,775 children from 4 to 12 years of age. We compared the relationship between the maximum mouth opening with the age, height, and weight. The results obtained were summarized as follows; 1. The mean maximum mouth openings of 4, 8, and 12 year of age were respectively 40.16mm, 47.32mm, 50.54mm for male, 39.79mm, 44.85mm, 48.09mm for female. 2. The maximum mouth opening increased with age, and the values were greater in male than in female. 3. The maximum mouth opening increased with height, and the values were eater in male than in female except between 105cm and 115cm 4. The maximum mouth opening increased with weight, and the values were eater in male than in female. 5. The correlation between the maximum mouth opening with the age, height, and weight was all significant, and height showed the highest correlation.