• The Journal of the Korean dental association
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• v.41 no.12 s.415
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• pp.818-824
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• 2003

Visually guided irrigation and lysis(VGIL) using temporomandibular joint(TMJ) arthroscope is useful for decreasing pain and increasing the functional mobility of TMJ. Also it demonstrated similar effectiveness comparing with arthrocentesis. Arthroscopy permits intracapsular inspection that is imperative not only for identification of morphological characteristics of joint space, but also for adequate irrigation and lysis of specific joint space. Conventional 2.3mm diameter arthroscope with 2.7mm catheter was too wide. So it was traumatic and uncomfortable to manipulate on temporomandibular joint space, especially on TMJ internal derangement patient with reduced space. We report our clinical experience on 6 TMJ closed lock patients who were treated with new 1.2mm fiberscope at Chung Hoon Dental Clinic between March 2003 and August 2003. Also we present clinical advantage & disadvantage of new system with literature review.

• Journal of Oral Medicine and Pain
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• v.15 no.1
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• pp.79-89
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• 1991

The author examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane and obtained the following results. 1. In the frontal trajectory, the mean amount of maximum mouth opening was 24.4mm and the opening paths were deviated to the affected side in 87.1% of the patients. The mean amount of maximum laterotrusion to the affected side was 10.4mm and that of non-affected side was 7.5mm. There was a significant difference between them(p<0.001). 2. In the sagittal trajectory, the mean amount of the maximum protrusion was 7.0mm, the mean amount of the maximal retrusion was 1.0mm 3. In the horizontal trajectory, the pattern of laterotrusion showed asymmetry: the mean length of non-affected side was smaller than that of the affected side. Protrusive path were deviated to the affected side in 64.5% of the patients, the mean degree of deviation was 16.4$^{\circ}$. The mandibular movements of TMJ lock-closed patients can be characterized by decreased range of mouth opening, protrusive movement, and laterotrusive movement to the non-affected side and also characterized by deviated opening and protrusive path to the affected side.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.76-82
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• 2000

In general, treatment of the patients with closed lock divides into a conservative and a surgical treatment. Surgical treatment has been often applied in case that occlusal splint therapy was not effective on the patient with closed lock. In recent, some clinicians reported good results with mandibular manipulation. Three patients complained limitation of month opening-(mean mouth opening was 22.3mm) and TMJ pain. Articular discs were displaced anteriorly on MRI. Two patients didn't improve the symptoms with long term occlusal splint therapy. We applied mandibular manipulation after injection with 2% lidocaine into the upper joint space of the affected TMJ and directly inserted occlusal splint to all patients. At the follow-up check, mean mouth opening was 41.7mm. TMJ pain decreased, condyle and disc relationship was improved functionally on MRI.

• The Journal of the Korean dental association
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• v.39 no.4 s.383
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• pp.251-257
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• 2001

• Journal of Oral Medicine and Pain
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• v.16 no.1
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• pp.113-120
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• 1991

The authors examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane pre-end post-treatment. And the author obtained the following results. 1. In the frontal plane, the patterns and ranges of mandibular movement of the patients were very irregular and small before treatment. But after the treatment, the patterns were similar to the typical shield shape of the normal subjects. And the velocity of opening and closing was improved after the treatment. 2. In the sagittal plane, the mean amount of maximum mouth opening was 27.0±4.0mm before treatment and 44.0±5.4mm after treatment. And there was statistically significant improvement(p<0.005). The patterns of the movement were very irregular and small before treatment, but were similar to the shape of "Posselt's envelope of motion" after the treatment. The velocity of opening and closing was improved after the treatment 3. In the horizontal plane, the mean amount of maximum laterotrusion was 8l2±2.5mm in the affected side and 6.7±2.2mm in the non-affected side before treatment. There was a significant difference between the sides(p<0.05). After the treatment, the mean was 10.4±2.6mm in the affected side and 8.9±2.3mm in the non-affected side and there was no significant difference between the sides(p>0.05). There was no significant difference in the mean amount of maximum protrusion between the before and aftertreatment(p>0.05), but the patterns of the movements were improved.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.207-217
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• 1997

This study was performed for Investigation of the magnitude of mandibular positional change in maximum mouth opening. protrusion, lateral excursion, gum and peanut chewing with BioPAK system(Bioresearch Inc. USA) which can analyze mandibular rotational torque movements. For this study 17 female patients with Temporomandibular joint(TMJ) closed lock and 18 female control without any Temporomandibular disorders(TMDs) signs and premature occlusal contact were included. The obtained results were as follows : 1. In maximum mouth opening, the mandibular rotational angle and distance of patients were significantly greater than those of control group in horizontal plane(P<0.05). 2. In protrusion, the mandibular rotational angle and distance of patients were significantly greater than those of control group in frontal and horizontal plane(P<0.01, P<0.05). 3. The mandibular rotational angle and 야stance in lateral excursion to affected side of patients were significantly greater than those in lateral excursion to non-affected side in frontal plane(P<0.05). 4. The mandibular rotational angle in gum chewing to affected side of patients was significantly greater than that in gum chewing to non-affected side in frontal plane. 5. The mandibular rotational angle and distance in peanut chewing to affected side of patients were significantly greater than those in peanut chewing to non-affected side in frontal and horizontal plane. 6. The mandibular rotational angle and distance in peanut chewing to affected side of patients were greater than those in gum chewing, and was the same result in control group in frontal and horizontal plane.

• The Journal of the Korean dental association
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• v.37 no.6 s.361
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• pp.445-455
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• 1999

Arthrocentesis is a simple, less invasive, inexpensive, and highly efficient procedure for closed lock of the temporomandibular joint with regard to the lack of recurrence of symptoms during extended periods of follow-up and significiant improvement in pain and jaw function. It can be performed under local anesthesia. Arthrocentesis closed lock provide sustained normal joint function and marked pain relief. This study is the clinical outcome of arthrocentesis for closed lock of the temporomandibular joint. 160 patients(169 joints) who had experienced sudden-onset, persistent limited mouth opening were the subjects of this study. Arthrocentesis of the upper compartment of the affected TMJ was performed using normal saline. As results, at 3-60 months postarthrocentesis maximum mouth opening(MMO) had increased from mean of 27.7mm to 43.5mm, contralateral movements(CLM) from mean 5.74mm to 9.55mm, midline deviation during mouth opening from mean 3.04mm to 0.69mm. In 130 cases there was a history of joint noises, in 52 cases all noise had ceased after procedures.

• Journal of Oral Medicine and Pain
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• v.19 no.1
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• pp.93-103
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• 1994

In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.17.1-17.5
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• 2015

Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.141-158
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• 1995

This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.