• The Journal of the Korean dental association
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• v.51 no.2
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• pp.92-98
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• 2013

Osteoarthritis is one of the most common degenerative disease in the temporomandibular joints(TMJ). Structural changes in the osseous structure is associated with destructive changes such as erosion, flattening and other bony changes. Destructive degenerative changes quite often cause shortening of the condyles which eventually produces the changes in the occulsion and the facial profile which require orthorgnathic surgery and/or orthodontic treatment by the dental professional. The dentists need to understand the nature and the pathophysiology of the osteoarthritis in the TMJ for the better dental treatment, especially in orthodontic and prosthodontic treatment. The possibility of serious complication can not be avoided after any dental treatment is given to the patient if osteoarthritic changes in the TMJ is under progression as undiscovered.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.175-185
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• 2013

Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.355-363
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• 2023

Purpose: Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint(TMJ) osteoarthritis. Materials and Methods: This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results: The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion: The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.

• Journal of Oral Medicine and Pain
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• v.47 no.2
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• pp.95-101
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• 2022

Temporomandibular joint osteoarthritis (TMJ OA) causes destruction of the temporomandibular joint (TMJ) and can lead to occlusal changes such as anterior open bite in some patients. Consequently, these patients may experience difficulty in chewing food items and exhibit abnormal functional habits such as bruxism, preventing healing of the TMJ condyles. Treatment protocols include the use of traction appliances to reduce stress on the condyles. Unstable occlusions can lead to weakness of the masticatory muscles which, in turn, worsen the occlusal changes and complicate pain management. Therefore, the current study evaluated the condition of the masseter muscle using ultrasonography and educated patients on the execution of gum-chewing exercises for muscle strengthening. It also aimed to assess the effects of traction appliances and strengthening exercises on the masticatory muscles of patients with occlusal changes caused by TMJ OA.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.379-385
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• 1998

A patient with TMJ osteoarthritis and anterior open bite was treated with an intermaxillary traction device. Pretreatment examination revelaed a pain in both TMJ during mouth opening, moderate tendernesso f left sternocleidomastoid and right trapezius muscles. Anterior open Bite was aobserved with interincisal distance of 2mm. Tomograms and MRI showed anterior disc displacement withouit reductoin of both temporomandibular joints, and the condyles were flattened and slightly eroded. A pair of full-coverage occlusal appliances was made on both maxillary and mandibular dentition, with pivoting fulcrum on the site of the second moalr. Traction force was gained by the intermaxillary orthodontic elastics which were hooked by orthodontic brackets on the labial surfaces of the upper and lower anterior and premolar teeth. After 8 weeks of traction treatment, the joint pain was subsided completely and the anterior open bite was closed to get an edge to edge relationship of anterior teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Imaging Science in Dentistry
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• v.31 no.3
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• pp.159-164
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• 2001

Purpose: To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. Materials and Methods: MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes, 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. Results: The most frequent Stage in internal derangement of TMJ was Stage I. And 28 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage II (1.8%) and III (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. Conclusion: MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle.

• The korean journal of orthodontics
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• v.42 no.3
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• pp.144-154
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• 2012

This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

• Journal of Oral Medicine and Pain
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• v.47 no.3
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• pp.156-160
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• 2022

Temporomandibular joint (TMJ) ankylosis is a condition in which condylar movement is restricted because of fibrous or bony union between the mandibular condyle and temporal bone. TMJ ankylosis is most often caused by trauma, followed by systemic or local infection, and secondary to unknown causes. Diagnostic imaging plays a vital role in diagnosing TMJ ankylosis and establishing a treatment plan. Computed tomography (CT) or cone beam computed tomography (CBCT) is currently the imaging technique of choice to accurately demonstrate preoperative ankylosing masses and other surgically important findings, such as the shape of the mandibular condyle and the pathological changes in the joint. The osseous changes in the mandibular condyle are easily identified in the coronal and sagittal sections of CT or CBCT images. This report describes the case of a middle-aged woman who developed TMJ ankylosis of the left TMJ while undergoing repeated treatment for TMJ disease. We report the findings observed on radiographic and CBCT images through continuous observation.

• Journal of Oral Medicine and Pain
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• v.39 no.1
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• pp.2-9
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• 2014

Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.