• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.25-34
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• 1989

The author performed on epidemiological study of the TMD in 189 elderly people and 195 young people with Helkimo index. The clinical dysfunction index was based on data from clinical examination and the anamestic dysfunction index was based on data from the interview with the investigated person. The results were as follows : 1. In the elderly population, 27.5% reported that they had subjectively symptom of TMD but 43.4% had sign and symptoms of TMD in clinical examination. 2. The mean values for maximal opening differed significantly between elderly and young populations, 47.22mm and 51.44mm (p<0.001) and less than a 40mm opening was observed 7.9% in elderly population, 0.5% in young population (p<0.001). 3. The mean values for lateral movement to the right and left did not differ with age, which were 8.56mm and 8.47mm in elderly population, 8.90mm and 8.81mm in young population, but the mean value for protrusion differed significantly between elderly and young populations, 6.89mm and 7.64mm (p<0.01). 4. A higher incidence of TMJ noise was recorded in the elderly and young populations than young population, especially crepitus, but a higher incidence of clicking was recorded in young population (p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.5
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• pp.232-236
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• 2018

Objectives: Hormonal changes during menopause alter a woman's susceptibility to some disorders. Information regarding the prevalence of temporomandibular disorder (TMD) in menopausal women is limited in the literature. In this study, the prevalence and severity of TMDs were compared between menopausal and non-menopausal women. Materials and Methods: The study included 140 women (69 premenopausal and 71 postmenopausal) 45 to 55 years of age that were examined in Shiraz Dental School, Shiraz in Iran. The Helkimo clinical dysfunction index (Di) was used to evaluate temporomandibular joint (TMJ) dysfunction. The data were analyzed using chi-square and Fisher's exact tests. Results: Occurrence of TMD was significantly higher in menopausal than non-menopausal women (P<0.001). All the TMD criteria based on Helkimo Di except range of mandibular movement were significantly more common in menopausal women. The range of mandibular movement was not significantly different between menopausal and non-menopausal women (P=0.178). Conclusion: The results from this study show that TMD can be considered more common and severe in menopausal than non-menopausal women. This finding indicates that, similar to other conditions in menopausal women such as arthritis and osteoporosis, TMD should be taken into consideration by dental and medical professionals.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.109-121
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• 1992

Temporomandibular joint is a major structure to play an important role in the function & stability of the occlusion as well as the stomatognathic system. Therefore, the TMJ is the structure that requires the complete analysis for diagnosing and planning treatment of pathologic changes by TMJ dysfunction and malocclusion. So, in this study, to evaluate TMJ situation in Korean malocclusion, based on the previous accomplishments, students of the dental college of Won-Kwang Univ. are surveyed and selected in terms of Angle's classification of malocclusion, whose TMJ radiographs were taken in the centric occlusion and centric relation. In each maiocclusion groups, the mean and standard deviation of anterior, posterior and superior joint space of the right, left and both side in CO & CR are evaluated and also those of the fossa height and the articular eminence angle of the right, left and both sides are evaluated. The obtained results were as follows: 1. In the correlation coefficient between the malocclusion groups, no other items except the posterior joint space of the right side in CR between in class I and class III are significant. 2. In the correlation coefficient between the right and left side, the each joint space in class I malocclusion group and class II malocclusion group are significant. 3. In the change of each joint space during the transmit from CO to CR, there is a tendency of increasing anterior joint space and decreasing posterior, superior joint spaces in class I, II malocclusion and increasing superior joint space and decreasing anterior, posterior joint space in class III malocclusion, which is significant in the correlation coefficient, but not significant in the T-test. 4. In each malocclusion group, the correlation coefficient between the posterior joint space and the superior joint space in C.R is highly significant. 5. The fossa height of class II malocclusion group is lesser than that of class I or class III, which is not significant in T-test. 6. In the correlation coefficient between Rt. and Lt. side in the fossa height, it is not significant in class I and class III group, but significant in class II malocclusion group. 7. The articular eminence angle of class II malocclusion group is larger then that of class I or class III groups, which is fairly significant. 8. In the correlation coefficient between Rt. and Lt. side in the articular eminence angle, it is significant in each malocclusion group.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.289-300
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• 2006

This study was performed to investigate the influence of orthognathic surgery on the temporomandibular dysfunction in skeletal class III malocclusion. The temporomandibular joint status in 22 patients(mean age: 23.7 years) who received orthognathic surgery such as mandibular BSSRO(14 patients), maxillary Le Fort I osteotomy with mandibular BSSRO(8 patients) was evaluated by craniomandibular index. All these patients received orthognathic surgery at least 6 months ago. The mean score and standard deviation was obtained and compared with that of 22 normal individuals(mean age: 24.8years) by Student's t-test. In mandibular movement, the score of orthognathic surgery group was higher than that of the normal group. All the items except mandibular movement did not show any differences between the two groups.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.36-50
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• 1995

Acupuncture is so effective and simple to use in the pain and dysfunction syndrome of TMD. Acupuncture treatment is a point-specific. So, the selection of acupuncture point is very important. According to the traditional meridian theory, we select the points; local points around TMJ and mastication muscles(ST6, ST7, GB20, GB21) and remote point(LI4). And if there is another pain, one or two other points are added. Both neural and humoral mechanism play an important role in acupuncture analgesia. The discovery of spinal gate mechanisms shows somatic stimulation can induce pain inhibition. Humoral mechanism has been established from the discovery of opioid receptors and endogenous opioids. Acupuncture induces a relaxation in the patient, which further decreases the muscle tension.

• Journal of Oral Medicine and Pain
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• v.9 no.1
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• pp.117-125
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• 1984

악관절 기능장애증의 증상 및 임상소견에 관해 많은 연구가 보고되었으나 국내에서는 이에 대한 연구가 미비한 편이며, 이들간의 상호 관련성을 조사한 연구는 별무하였다. 이에 저자는 1983년 3월부터 1984년 7월 사이에 서울대학교 병원 구강진단과에 내원한 악관절 기능 장애증 환자 367명 중 방사선 사진상으로 기질적인 변화를 보이지 않는 327명을 대상으로, 증상 및 임상소견에 관한 조사와 아울러 악관절 동통이 하악 운동에 미치는 영향에 관해 연구한 결과 다음과 같은 결론을 얻었다. 1. 악관절 기능장애증은 약 3:1의 비율로 여자에게 빈발하였고, 15세에서 29세까지의 청장년 층에 많았다. 2. 악관절 기능장애증 환자가 경험한 주 증상은 동통, 관절잡음, 개구장애 등이었다. 3. 관절잡음은 편측성인 경우가 많았고, 좌우 발현 빈도는 비슷하였으며 말기의 관절잡음이 많았다. 4. 악관절 기능장애증의 발병 기간은 1개월 이하인 경우가 많았다. 5. 악관절 동통은 개구와 하악 전방운동을 제한하는 것으로 추정된다. 6. 악관절 동통은 동통이 있는 쪽으로 하악 개구로의 편위를 일으키는 것으로 추정된다.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.3
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• pp.43-53
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• 1991

It is important to harmonize the occlusion with TMJ and neuromuscular system. However, clinically, how to harmonize is very difficult. The mandibular movement is the motion in which all component part of stomatognathic system participate. This study was performed to compare mandibular movement of mandibular prognathic patients group with that of normal group, to ascertain which components of mandibular movement have differences between two groups, and to use for occlusal treatment of mandibular movement. Thirteen adult who have physiologically normal occlusion and are free of TMJ dysfunction were selected as a control group(Group 1). Eight adult who are mandibular prognathic patient and have more than four anterior teeth crossbite, therefore have not anterior guidance function and have posterior interference at protrusion were selected as a experimental group(Group 2). Electronic pantograph, Denar Pantronic (Denar Corp., U.SA.), was used to record mandibular movement. Pantronic survey was performed by using an arbitrary hinge axis according to manufacturer's direction. Of the Pantronic recordings, immediate side shift (ISS), progressive side shift (PSS), orbiting condylar path (ORB), protrusive condylar path (PRO) between two groups were compared and analysed. The results were as follows: 1. The average protrusive and orbiting condylar inclination of mandibular prognathic patient$(28.44^{\circ},\;36.94^{\circ})$ was significantly lower than those of normal group$(40.15^{\circ},\;48.00^{\circ})$ (P<0.01). 2. There was no statistically significant difference between .the average immediate and progressive side shift of mandibular prognathic patient $(0.37mm,\;6.19^{\circ})$ and those of normal group$(0.52mm.\;5.96^{\circ})$ (P>0.01). 3. The significant correlation was found between orbiting condylar inclination and protrusive condylar inclination.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.4
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• pp.295-304
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• 1992

The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.