• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.9-15
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• 2005

The objective of this study is screening the shear stress related proteins in chondrocytes using twodimensional electrophresis and MALDI-TOF. C-28/I2 cell line were grown. The fluid-induced shear stress(FISS) was applied using a cone viscometer at a rotational velocity of 80rpm for periods of 12 hours. Control cultures were tested under identical conditions without mechanical load application. Collected samples were used for the two-dimensional electrophoresis and MALDI-TOF. The identified proteins were calcyclin, RPE-spondin, interleukin-2, extracellular signal regulated kinase (ERK), lamin B2, porA protein, and RET-ELE1 protein. All of them showed a decreased expression. In conclusion, seven proteins were identified as a shear stress related proteins in chondrocytes. As the destruction of articular cartilage is one of main pathogenesis of TMJ internal derangement, this study will give useful information for the understanding of the molecular aspect of TMJ disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.211-216
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• 2007

Temporomandibular joint disorders (TMD) often show muscular disorder, internal derangement and degenerative change of articular surface of the condyle. It is important to choose adequate diagnostic method for obtaining data for the diagnosis and treatment. Magnetic Resonance Imaging (MRI) has some advantages, because it shows good resolution image for the soft tissue and it is not invasive to the human body. We have performed serial research about the retrodiscal tissue of the TMJ according to the progress of the disease, using T2 weighted image, since 2002. In this study, we applicated resized observation area to compare signal intensity between the retrodiscal tissue of the TMJ and cerebral gray matter, using T2 weighted image.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.141-148
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• 1995

The Magnetic resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.

• Imaging Science in Dentistry
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• v.36 no.4
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• pp.199-206
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• 2006

Purpose: The purpose of this study was to evaluate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. Materials and Methods: In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. Results: No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P<0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). Conclusion: This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.93-107
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• 1997

Magnetic resonance imaging has been used in the temporomandibular joint(TMJ) primarily to define morphology and positional relationship of associating structures. This report examines signal intensity characteristics of the posterior attachment as they related to the severity of internal derangement. Fifty six joints in 35 patients with a history of TMJ dysfunction were imaged writ MR using $T_1$-weighted spin echo sequence. According to disk position, ability to reduction, and the presence of osteoarthritis, the joints were categorized into three groups. A group 1 was anterior disk displacement with reduction; a group 2 was anterior disk displacement without reduction; a group 3 was anterior disk displacement without reduction and condyle had osteoarthritic change. The control group was determined by the clinical absence of any signs or symptoms of current or past TMJ pain and dysfunction. Calculated the relative value of MR signal intensity in posterior attachment and disk to cerebral cortex of temporal lobe by means of computer program, we have compared them with each groups. The result showed statistically little significant difference of disk signal intensity among each groups. but, signal intensity from posterior attachment in group 2 and 3 were significantly(p<0.05) decreased than control group. this might reflect an fibrosis or hyalinization of posterior attachment, which was part of remodeling process that occurs in disk displacement without reduction. However, this study could not demonstrate histologic confirmation of the decreased signal intensity in the posterior attachment. So, further investigation could be needed to understand the association between them.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.15-20
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• 2019

Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ${\geq}35mm$ and visual analogue scale [VAS] score ${\leq}3$), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ${\geq}35mm$ and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.1
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• pp.36-41
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• 2006

Objective. The objective of this study was to examine the hypothesis that inflammatory synovial fluid from TMJ internal derangement initiates a transient increase in intracellular calcium concentration ([$Ca^{2+}$]i) in chondrocytes and the induced Ca2+ signaling affects iNOS/COX-2 gene expression patterns following exposure to inflamed synovial fluid. Materials and Methods. Two female adult patients with symptoms of TMD who agreed to participate in the study were selected for this study. Immortalized human juvenile costal chondrocyte C-28/I2 was grown to 80% confluency and synovial fluids from two patients were added respectively to culture media for 24 hours at the concentration of 100ng/10ml. Confocal laser scanning microscope (CLSM) was used to examine changes of intracellular calcium concentration ([$Ca^{2+}$]i). RT-PCR was performed to identify the expression profile of IL-1${\alpha}$, iNOS, COX-2. Results. Increased [$Ca^{2+}$]i was observed in chondrocytes subjected to inflamed synovial fluid compared to control cultures and in respective cultures exposed to inflamed synovial fluids from each patient, IL-1${\beta}$, COX-2 mRNA were detected. However, in neither case iNOS mRNA was expressed. IL-1${\alpha}$, COX-2, and iNOS mRNA were expressed in control culture. Conclusion. Our results show that immortalized chondrocytes cultured with inflamed synovial fluids from patients diagnosed as disc displacement without reduction and limitation in mouth opening showed increased calcium concentration and expression of COX-2 while inhibiting the production of iNOS, which in turn could adversely affect the chondrocytes in at least short term by hindering physiologic role of NO against inflammatory cascades. These findings suggest that inflamed synovial fluid may differentially regulate the transcriptomes of relevant inflammatory mediators, especially iNOS/COX-2 axis in chondrocytes through adjusting calcium transients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.308-315
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• 1996

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondromembrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis is more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.113-121
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• 1989

In this study, 94 patients with temporomandibular disorders were interviewed to evaluate the effect of the treatment they received at the department of Oral diagnosis and oral Medicine in Seoul national university Hospital. The treatment administered to the patient were patient education, relaxation procedures, physical therapy, occlusal splint therapy and selective grinding of teeth. The following results were disclosed : 1. 97.9% of the patients reported no pain or considerably less pain than they had reported at their first visits to the department. 2. 89.3% of the patients thought that the treatment provided was either complete or considerably successful. 3. TMJ and facial pain was resolved within average 3.0 months 4. Of the 70 patients who previously reported having jaw joint sound, 34 patients (48.6%) no longer reported int. 5. Of the 48 patients who previously reported having headache regularly, 3 patients (68.8%) no longer reported headache regularly. 6. Of the 66 patients who previously reported having masticatory muscle pain, 41 patients (62.1%) no longer reported masticatory muscle pain. 7. Analysis of the data did not disclose a subgroup or factor, such as age, the stage of internal derangement, capsulitis, bruxism, MPD, duration of symptoms, that could be correlated with the reduction of pain or the patient's perception of success of treatment.