• 대한치과교정학회지
• /
• 제36권2호
• /
• pp.136-144
• /
• 2006

본 연구는 표준 경두개 방사선사진에서 나타나는 하악두/관절와의 위치 관계 및 형태 특징과 MRI에서 관찰되는 관절원판의 변위 여부를 비교함으로써 측두하악관절 내장증 평가 시 경두개 방사선사진의 임상적 이용 가능성을 알아보고자 하였다. 연구는 성인 환자 76명(남자 26명, 여자 50명)의 113개 악관절을 대상으로 하였다 MRI 자료를 기초로 하여 각 악관절을 정상군, 정복성 관절원판 변위군, 비정복성 관절원판 변위군으로 분류하였으며 최대 감합시의 경두개 방사선사진에서 관절와와 하악두 간의 전방, 후방 및 상방 직선 거리를 계측하여 상대적 위치 평가를 하고 형태적 특징을 판별하기 위해 악관절 경부와 두부간의 각도를 계측하였다. 또한 각 군에 따라 경두개 방사선 계측항목 간에 유의성 있는 차이가 있는지 알아보기 위해 일원분산분석과 다중비교분석을 시행하였다. 표준 경두개 방사선사진에서 나타나는 관절와와 하악두의 위치 관계는 관절원판 변위 여부 및 진행 정도와 상관성을 보이지 않았다. 또한 하악측두관절 경부와 하악두가 이루는 각도는 비정복성 관절원판 변위군에서 유의성 있게 증가하였다. 이는 하악두각이 악관절 내장증의 진행에 따른 악관절의 구조적인 경조직 변화를 반영한다고 볼 수 있으나 이것에만 근거하여 관절원판 변위 여부를 판단하기에는 근거가 미약하다.

• Imaging Science in Dentistry
• /
• 제35권2호
• /
• pp.69-75
• /
• 2005

Purpose : To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. Materials and Methods : The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the preauricular area and masticatory muscles and TMJ sounds. Results : There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Conclusion : Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

• 대한치과의사협회지
• /
• 제42권2호통권417호
• /
• pp.101-107
• /
• 2004

• 대한치과교정학회지
• /
• 제45권3호
• /
• pp.136-145
• /
• 2015

This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권3호
• /
• pp.458-463
• /
• 1994

A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

• Imaging Science in Dentistry
• /
• 제32권4호
• /
• pp.221-225
• /
• 2002

Purpose: To evaluate the relationship between internal derangement and osteoarthrosis in the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). Materials and Methods: One hundred and six MR images of TMJs in 53 patients were evaluated. Disc displacements and osseous changes of the TMJs were assessed. Lateral and rotational disc displacements were also evaluated on coronal images. Results: No significant differences in the frequency of osseous changes of the TMJs between disc displacement with reduction and disc displacement without reduction groups were found. The erosion of the condylar head and the sclerosis of the articular eminence were more frequent in the internal derangement group than in the no disc displacement group. The flattening was the most frequently observed osseous change of both the condylar head and articular eminence. Conclusion : The relationship between internal derangement and osteoarthrosis is obscure, but it is thought that both disorders adversely affect each other.

• 대한치과교정학회:학술대회논문집
• /
• 대한치과교정학회 2004년도 제37회 학술대회
• /
• pp.34.3-35
• /
• 2004

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.221-225
• /
• 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.

• 대한치과교정학회지
• /
• 제30권2호
• /
• pp.235-243
• /
• 2000

측두하악관절의 자기공명영상(MRI)은 하악과두와 관절원판(disc)의 관계를 잘 보여주기 때문에 관절내장증(internal derangement)의 진단을 위해 매우 유용하다. 이번 연구의 목적은 서울대학교 치과병원 교정과에 내원한 측두하악관절 장애가 의심되는 환자들의 MRI 자료를 평가하여 관절 내장증의 유무, 발생빈도 및 심도를 파악하는 것이다. MRI를 촬영한 표본은 남자 10명, 여자 40명으로 총 50명이었고 평균 나이는 22.9세였다. 전체 50명 중에 43명에서 positive finding이 관찰되었다. Positive finding을 나타낸 환자 중에서 전방관절원판변위(anterior disc displacement : ADD)는 비정복성이 $56\%$로 가장 많았으며, 양쪽 관절에서 동시에 일어난 경우가 $65\%$로 가장 많았다. Positive finding을 나타낸 환자를 Angle 분류 시, II급 1류 부정교합 환자가 $39.6\%$, II급 2류 부정교합 환자가 $2.3\%$로 II급 부정교합이 $41.9\%$로 가장 많았고, I급 부정교합 환자는 $37.2\%$, III급 부정교합 환자가 $18.6\%$, 확인 안된 경우가 $2.3\%$였다. Positive finding을 나타낸 환자 중에서 안면 비대칭 환자는 $8.6\%$, 개교 환자는 $55.8\%$였다. 결론적으로 측두하악관절의 관절 내장증을 가진 환자에서는 II급 부정교합이 차지하는 비율이 매우 크다고 할 수 있다. 개교나 안면 비대칭은 측두하악관절 장애로 인한 보상적 또는 비보상적인 변형에 의해 나타날 수 있으며 퇴행성 관절 질환으로 진행되는 과정중 안면 골격 개조의 결과로 보인다. 그러므로 개교 및 안면 비대칭이 있는 환자는 교정 치료 시작 전에 측두하악관절의 이상 유무를 MRI로 확인(screening)할 것이 권장된다. 측두하악관절 장애가 있는 경우 교정 치료 후에도 재발의 경향이 크고 측두하악관절에 대한 계속적인 관찰이 필요하므로 감별진단이 필수적이다.

• Imaging Science in Dentistry
• /
• 제31권4호
• /
• pp.235-240
• /
• 2001

Purpose: To evaluate displacement and morphologic changes of the temporomandibular joint (TMJ) disc in patient with internal derangement using magnetic resonance imaging (MRI). Materials and Methods: One hundred and forty five MR images of TMJs in 73 patients were evaluated. Positional and morphologic changes of the TMJ discs were assessed. Lateral or medial disc displacement was also evaluated on coronal images. Results: Among 63 discs with anterior disc displacement, 37 discs were assessed as a biconcave disc and 21 as a deformed disc. Rotational disc displacement was observed in 35 discs. Anteromedial disc displacement was observed in 29 discs, and anterolateral direction in 6 discs. Among 35 rotational displacement, 5 biconcave discs and 21 deformed discs were observed. Conclusion : Rotational and sideways displacement of TMJ discs were found to be common and an important aspect of internal derangement. This study also suggests that sagittal and coronal images of the TMJ have complementary abilities for an assessment of joint abnormality.