• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.1-13
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• 1997

Preoperative and postoperative TMJ symptoms were observed in mandibular prognathism of 30 patients operated on by Le Fort I osteotomy and intraoral vertical ramus osteotomy. The alterations of TMJ symptoms were investigated and the relationship between changes of TMJ symptoms and some cephalometric values including occlusal plane angle, mandibular plane angle, posteior ramal height and a degree of deviation of mandibular incisor midline to facial midline were observed. The results are as follows. The incidence of patient with TMJ symptoms before orthognathic surgery was 40% and after orthognathic surgery was 20%. The most frequetly encountered symptoms in orthognathic TMJ dysfunction patients were TMJ pain and/or clicking. After surgery 66% of the preoperative symptomatic patients reported improvement TMJ symptoms. On the orther hand 2 patient (6%) of the preoperative asymptomatic patients developed TMJ symptoms after surgery. Preoperatively, 60% of the facial asymmetric patients with mandibular prognathism had TMJ symptomas. The more severe facial asymmetry was, the higher incidence of TMJ symptoms was. The alteration of occlusal plane angle and mandibular plane angle seems to be one of the contributing factors which make to change TMJ symptoms in orthognathic patients. But its amount seems to be low significance. Increase or decrease of posterior ramal height have influence on the change of TMJ symptoms.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.205-213
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• 1998

This study was designed to reveal the correlationship between the internal derangement state of TMJ and clinical characteristics including pain and mandibular dysfunction. One hundred and twenty five subjects with TMJ signs and symptoms were chosen for two years. The level of pain and madibular dysfunction were evaluated by Visual Analog Scale(VAS) and Craniomandibular Index(CMI). The diagnostic categories of TMJ internal derangement were determined by arthrography and they included normal disc position, anterior disc displacement with reduction(ADDR), rotational disc displacement with reduction (RDDR), anterior disc displacement without reduction(ADDNR), and rotational disc displacement without reduction(RDDNR). Also disc perforation was used as a criteria to divide the diagnostic subgroups. The obtained results were as follows; 1. The patient distribution of each group was 5 in normal disc position(4％), 40 in ADDR(32％), 30 in RDDR(24％), 34 in ADDNR(27％), and 16 in RDDNR(13％). 2. Perforation was observed in 8％ of ADDR, 10％ of RDDR, 32％ of ADDNR, and 19％ of RDDNR. 3. CMI of non-reduction group was higher than that of reduction or normal group(p<0.05), but V AS showed no significant difference.4. CMI of perforation group was higher than that of non-perforation group in reduction group (p<0.05). 5. There were no significant differences of CMI and VAS between anterior disc displacement group and rotational disc displacement group in both reduction and non-reduction group. 6. CMI of RDDNR group was higher than that of RDDR group(p<0.05). 7. There were no significant difference of CMI and VAS between bilateral involvement group and unilateral involvement group(p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.50-58
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• 2022

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.31-43
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• 1993

To evaluate the correlationship between sign/symptoms of craniomandibular disorder(CMD) and possible contributing occlusal factors, the author analyzed craniomandibular index(CMI), clinical dysfunction index(CDI) and occlusal index(Oi) obtained from 88 subjects (32 males, 56 females, mean age 28.7) consisted of 49 CMD patients(15 males, 34 females, mean age 28.7) and 39 non-CMD patients (17 males, 22 females, mean age 24.5). The obtained results were as follows : 1. There was very high significant correlation bebween CMI and CDI in total subjects (r=0.83, p<0.01) 2. There was very low correlation between working-side interference and TMJ noise which was observed as a statistically significant value(p<0.05). And also there ws very low correlation between nonworking side interference and muscle tenderness, CDI, dysfunction index(DI), palpation index(PI) which were observed as statistically significant value (p<0.01) 3. There was very low correlation between as ymmetry of tetruded contact position(RCP)-intercuspal position(ICP) slide and muscle tenderness, TMJ tenderness, TMJ noise, CMI, DI, PI which were observed as statistically significant values(p<0.05) 4. In general there was low correlation between Oi and muscle tenderness, CDI, CMI, DI, PI which were observed as statistically significant values (p,0.05). But Oi had a relatively higher correlation with muscle tenderness, PI than whith CDI, DI.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.703-713
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• 1992

Researches in pathologic entities and syndromes that describe temporomandibular joint (TMJ) or TMJ-related pain and dysfunction, have been hampered by confusion and conflict over the pathogenesis of myofascial and joint pain, the character and causes of joint noises, and the lack of scientific methods. Investigators have more recently correlated clinical diagnosis and arthrographic and surgical findings to demonstrate 'internal derangements' of the TMJ. It is thought that the structural and functional changes characteristic of internal derangements constitute the principal pathologic entity of the TMJ. Cephalometric data from a group of 34 subjects with documented functional changes in the TMJ were compared with those of a group of 35 subjects from a control sample. The results were as follows: 1. Comparison of a group which shows Class I relationship, there was a tendency to show clock-wise rotation of mandible and linguoversion of upper and lower anterior teeth in the experimental sample. 2. Excluding the vertical relationship, there was a tendency to show low values of the lingual surface slope of the upper central incisor and high values of the interincisor angle in the experimental sample.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.10 no.1
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• pp.47-55
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• 1980

The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological ylar head, articular eminence, and articular fossa were analized and discussed view point. The positional changes of condylar head and articular fossa relatation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthrotic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 106 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrom and osteoarthrosis of TMJ.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.52 no.2
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• pp.112-119
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• 2003

This paper proposes a model of SP(silent period) generation in masseter muscle by means of computer simulation. The model is based on the anatomical and physiological properties of trigeminal nervous system. In determining the SP generation pathway, evoked SPs of masseter muscle after mechanical stimulation to the chin are divided into normal and abnormal group. Normal SP is produced by the activation of mechanoreceptors in periodontal ligament. The activation of nociceptors contributes to the latter part of normal SP, abnormal extended SP is produced. As a result, the EMG signal generated by a proposed SP generation model is similar to both real EMG signal including normal SP and abnormal extended SP with TMJ patients. The result of this study have shown differences of SP generation mechanism between subjects both with and without TMJ dysfunction.

• The Journal of Korean Academy of Prosthodontics
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• v.22 no.1
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• pp.17-22
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• 1984

A clinical evaluation was made on teeth in 113 subjects from ages 19 to 23 with Angle's Class I occlusion who were free from prosthesis, orthodontics, and occlusal equilibration. The study was made to determine if there was a relation between the type of occlusion, non-working contact and temporomandibular dysfunction. From the foregoing study, the author obtained the following results. 1. In lateral excursion, there was not any significant difference between bilateral canine protected occlusion (31%), bilateral group function (32.7%), and mixed type (34.5%). 2. Only 10 of 113 subjects studied had non-working side tooth contacts (8.2 per cent). 3. Twenty per cent of subjects with non-working side contact showed temporomandibular joint dysfunction. 4. Non-working side contacts were not observed in subjects with canine guided occlusion. 5. It would be premature to relate the type of occlusion on working side directly to temporomandibular joint dysfunction.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.1-4
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• 2003

Purpose : The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. Materials and Methods: On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Results: Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1 %) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Conclusion: Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

• The Journal of Korean Academy of Prosthodontics
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• v.16 no.1
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• pp.23-26
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• 1978