• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.17 no.2
• /
• pp.99-105
• /
• 2004

Temporomandibular joint disorder is quite common dental problem. Research has shown that 5 to 15$\%$ of the population have a TMJ disorder requiring some type of treatment. TMJ disorder's symptoms are pains in the jaw and muscles of your face, limitation of opening or closing jaw and noises in jaw joint such as clicking or popping sounds. Two patients with TMJ symptoms visited our clinic. They complained pain, limitation of jaw opening and clicking sound. We treated them by stimulating trigger points on the TMJ muscle with acupuncture and had a good effects. The symptoms is reduced or disappeared.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.28 no.2
• /
• pp.141-146
• /
• 2002

Purpose: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. Materials and Methods: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. Results: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. Conclusion: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.

• Imaging Science in Dentistry
• /
• v.34 no.2
• /
• pp.91-97
• /
• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• Journal of Oral Medicine and Pain
• /
• v.35 no.2
• /
• pp.149-154
• /
• 2010

In benign exophytic lesion in TMJ such as osteoma, chondroma, osteochondroma, synovial chondromatosis etc, symptom such as pain, mouth opening limitation, Most case of condylar exophytic lesion manifest with facial asymmetry, malocclusion, mandibular midline deviation. An osteochondroma and synovial chondromatosis are most commom benign condylar tumor. However this tumor is most frequently found on long bone and flat bone and is unusual on the skull. We report cases of osteochondroma, synovial chondromatosis of TMJ and review literatures.

• Journal of Oral Medicine and Pain
• /
• v.24 no.4
• /
• pp.455-466
• /
• 1999

The purpose of this study was to investigate the magnitude of mandibular rotational torque movements in subjects with TMJ sounds, and to analyse correlation between quantitative characteristics of TMJ sounds and mandibular rotational torque movement. Twenty dental college students with TMJ clicking and twenty students without any TMD signs and symptoms were examined by mean of SonoPak and Rotate program of BioPAK system(Bioresearch Inc. MilWaukee, wisconsin, USA) in this study. Mandibular rotational torque movements were recorded and analysed during maximum mouth opening, protrusion, and lateral excursion in frontal and horizontal planes. The obtained results were as follows: 1. On maximum mouth opening, mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.05). 2. During maximum mouth opening closing, maximum mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.01). 3. On protrusion, mandibular rotational angle and distance of clickin group were significantly greater than those of control group in horizontal plane. (P<0.05). 4. On lateral excursion, there was no significant difference in mandibular rotational angle and distance between clicking group and control group in frontal and horizontal planes. 5. There were significant correlations between peak amplitude of TMJ sounds and maximum mandibular rotational distance during maximum mouth opening (r=-.481) and mandibular rotational distance on maximum mouth opening (r=-.455) in horizontal plane. 6. There were significant correlations between Above 300/(0-300)Hz ratio of TMJ sounds and mandibular rotational angle (r=-.499) and distance (r=-.457) on maximum mouth opening in frontal plane.

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

• Journal of Oral Medicine and Pain
• /
• v.42 no.2
• /
• pp.35-43
• /
• 2017

Purpose: This study aims to evaluate the correlation between joint sounds and radiographic bone change patterns along with clinical symptoms of temporomandibular joint osteoarthritis (TMJ OA) patients. Methods: The patients for this study were over 19 years of age, diagnosed tentatively with TMJ OA. The patients were examined with temporomandibular disorders analysis test and all three radiographs, including panoramic radiography, transcranial radiography, and cone beam computed tomography (CBCT). Information of the patients' age, pain status, joint sound and mouth opening range were collected. And bone change pattern was examined by reviewing panoramic radiography, transcranial radiography and CBCT images. Results: The patients with crepitus had a higher average active mouth opening (AMO) range than patients without crepitus, and the group with bilateral crepitus had a higher average AMO range than the group with unilateral crepitus (p<0.001). And the patient with pain during mastication was increased in the group with clicking than the group without clicking, and the group with bilateral clicking showed a statistically significant increase in the patient with pain during mastication than the group with unilateral clicking (p<0.05). The analytical results of the relevance of crepitus showed a high correlation with bone change observed from each of the three radiographs. And the agreement in bone change findings from 3 groups of paired radiographs showed high agreement (p<0.001). Meanwhile, 77.2% of CBCT findings showed bone change of condyle without crepitus (p<0.001). Conclusions: This study presented significant results in the evaluation of the correlation with crepitus and bone change of TMJ OA patients from panoramic radiography or transcranial projection. However, the accurate assessment is required through CBCT for the patient with complains of persistent pain, limitation of mouth opening, and occlusal change even if the crepitus does not exist.

• Journal of Oral Medicine and Pain
• /
• v.31 no.2
• /
• pp.177-183
• /
• 2006

The management of refractory pain and limitation of mouth opening in the temporomandibular joint (TMJ) is both challenging and controversial. Arthrocentesis is a simple technique and it can be used instead of more invasive surgical procedures for patients who failed to conventional conservative treatments. The patients in this case report had complained persistent severe pain and restricted mandibular movement of TMJ, although they had been treated with conservative therapy, e.g., stabilization splint therapy, behavioral therapy, physical therapy, pharmacological therapy. Therefore we employed arthrocentesis for these patients, and they showed significant reduction of pain and improvement of mandibular movement after repetitive arthrocentesis. We recommend arthrocentesis as an effective, minimally invasive technique for patients with continuing severe pain and restricted mobility in the TMJ that is unresponsive to conservative management.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.3
• /
• pp.125-132
• /
• 2015

Objectives: The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion: We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.1
• /
• pp.9-14
• /
• 2019

Objectives: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. Materials and Methods: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (${\leq}25\;years$, >25 and ${\leq}40\;years$, >40 and ${\leq}60\;years$), VAS pain level (${\leq}5$, >5 and ${\leq}7$, >7 and ${\leq}10$), and ROM (<25 and ${\geq}25mm$). Odds ratios (ORs) were used to describe the proportional benefit of each variable the on successful outcome of arthrocentesis. For the OR to be clinically relevant or even clinically noticeable, we assumed that the OR would need to be larger than 2. Results: Mean preoperative pain score was $6.49{\pm}1.560$ and at 6 months postoperative was $0.46{\pm}1.147$ with an average decrease of pain score 6 (P<0.001). The mean preoperactive maximum mouth opening was $26.14{\pm}4.969mm$ and mean maximum mouth opening at 6-month inerval was $38.92{\pm}3.392mm$. The mean increase in the mouth opening was a mean difference of 12.78 mm (P<0.001). Logistic regression showed that the maximum benefit occurred in patients aged <25 years (OR, 12.01; P=0.012), a VAS pain level of >7 (OR, 11.25; P=0.039), and a maximum vertical opening of <25 mm (OR, 7.70; P=0.038). Conclusion: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify "at-benefit" patients early and initiate specific treatment.