• Journal of Oral Medicine and Pain
• /
• v.39 no.4
• /
• pp.152-155
• /
• 2014

Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

• Imaging Science in Dentistry
• /
• v.52 no.4
• /
• pp.409-413
• /
• 2022

This report presents a rare case where a displaced temporomandibular joint (TMJ) disc was reduced to its normal position after orthognathic surgery, and long-term magnetic resonance imaging (MRI) follow-up visualized these postoperative changes. A 22-year-old male patient presented for facial asymmetry. He also complained of pain in the right TMJ area, and MRI showed disc displacements in both TMJs. After orthognathic surgery for facial asymmetry correction, the TMJ was re-evaluated. The symptom had resolved and the disc was positioned within the normal range during mouth opening. However, 6 and a half years after surgery, he complained of recurrent pain in the right joint, and MRI revealed medial disc displacement in the right TMJ. In conclusion, the influence of orthognathic surgery on the disc position might continue for a long time until the TMJ adapts to the new position. Careful and long-term follow-up is suggested to assess the TMJ complex.

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

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.3
• /
• pp.145-159
• /
• 2024

Dental injections are routinely performed and can result in pain and anxiety in patients. This systematic review aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) in dental injections for pain management in patients undergoing dental treatment. Indexed databases, including PubMed, EMBASE, Scopus, ISI Web of Knowledge, and Cochrane Library, were electronically searched without a time limit up to February 2024. A risk of bias evaluation was performed using the Cochrane tool. A preliminary investigation using electronic and manual methods yielded 4,920,881 manuscripts. Based on the eligibility requirements, 13 randomized control trials (RCTs) were included. Self-assessed pain was determined using the visual analog scale, Face, Legs, Activity, Cry, Controllability scale, or Wong-Baker face pain scale. Eight RCTs demonstrated a notable decrease in needle pain in patients undergoing dental needle injections using PBMT. Based on current evidence, PBMT may help reduce needle pain related to dental anesthesia. Further standardized studies are needed to assess the significance of PBMT for postoperative pain in patients undergoing dental injections.

• Journal of Korean Dental Science
• /
• v.17 no.1
• /
• pp.14-35
• /
• 2024

The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression.

• Journal of Oral Medicine and Pain
• /
• v.43 no.2
• /
• pp.56-60
• /
• 2018

Epidermoid cyst in bony wall of external auditory canal (EAC) is a very rare pathologic condition. In addition to its extreme rarity, its positional proximity to temporomandibular joint (TMJ) might lead to clinical misdiagnosis as TMJ disorders, especially when it is accompanied by temporomandibular disorders-like symptoms. In this article, we report a patient with epidermoid cyst in anterior bony wall of EAC, which was misdiagnosed as TMJ disorder because the left TMJ pain aggravated during mastication.

• Journal of Oral Medicine and Pain
• /
• v.47 no.2
• /
• pp.95-101
• /
• 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
• /
• v.41 no.2
• /
• pp.35-40
• /
• 2016

Purpose: This study aimed to investigate the characteristics of the symptoms of temporomandibular disorders (TMD) in Korean children and adolescents using representative samples and questionnaires. Methods: A survey involving the interview of 10-, 12-, and 15-year-old children and adolescents regarding the symptoms of TMD was conducted as a part of the 2010 National Oral Health Surveys. The study population included 18,112 subjects (male, 9,734; female, 8,378). The interview involved three questions related to the symptoms of TMD. The prevalence of symptoms of TMD, correlation of the symptoms with sex and age, and the difference in the number of symptoms according to sex and age were analyzed. Results: Among the symptoms of TMD in children and adolescents, the prevalence of temporomandibular joint (TMJ) sounds during mouth opening was 13.0%, while those of TMJ pain and limitation were 3.1% and 4.3%, respectively. While the prevalence of TMJ sounds during mouth opening did not show any statistically significant difference between the sexes, the rates of prevalence of TMJ pain and limitation of mouth opening in were higher in the female subjects than the male (p<0.05). It was also observed that the older the subjects, the higher the prevalence of TMJ sounds, TMJ pain, and limitation of mouth opening (p<0.05). The number of symptoms of TMD was found to be increased among female subjects as well as the older ones (p<0.05). Conclusions: There are variations in the prevalence of symptoms of TMD among Korean children and adolescents according to sex and age, which is consistent with the results of previous studies. It is necessary to conduct a national cohort study to evaluate the risk factors for TMD in children and adolescents.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.3
• /
• pp.277-284
• /
• 2011

This study is based on the data of adults between ages of 19~65 yrs of the National Health and Nutrition Survey 4th in year of 2009, which includes symptoms of temporomandibular disorder within gender and age. Subjects included in this study were 2,738 males and 3,427 females, total of 6,165. All statistical analysis was measured by Window SPSS 17.0K Program (SPSS Inc., Chicago, USA). Prevalence of analysis of gender, age, and symptoms of temporomandibular disorder was measured by descriptive statistics, and in order to find relationship among gender, age, and symptoms of temporomandibular disorder was based on crosstabulation analysis. As results, prevalence of TMJ sound was 10.1%, of TMJ pain was 1.5%, and of TMJ limitation was 2.0%. Among the three symptoms of temporomandibular disorder, subjects who have at least one symptom was 1.2%. Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in female were 10.7%, 1.8% and 2.2%, respectively, which were greater than in male 9.3%, 1.2% and 1.6% respectively but it was stastically insignificant (p>0.05). Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in ages between 19~24 yrs were 18.7%, 3.4% and 4.2% respectively, which were higher than any other ages (p<0.05). Also prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were higher in females but stastically insignificant (p>0.05). On the other hand, prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were greater in age below 45 yrs and was stastically significant (p<0.05).

• Biomedical Science Letters
• /
• v.24 no.3
• /
• pp.239-244
• /
• 2018

Recently, many researches regarding the natural products which alternate with chemical products have been done. Among them, boswellia is well known for effect on anti-oxidative effect and inflammation. The aim was the effect boswellia of formalin- induced orofacial and temporomandibular joint (TMJ) pain on experimental animals was investigated. Experiments were carried out using subcutaneous (SC) pain model and TMJ pain model that were induced by the injection of 5% formalin into the right vibrissa pad (SC, $50{\mu}L$) or TMJ ($30{\mu}L$) of rats, respectively. In both models, formalin (5%), formalin after distilled water (vehicle), formalin after boswellia extract (p.o., concentrations of 15, 30 mg/kg) (n=6). The number of scratching on the injected region was scored during the 9 successive periods of 5 min intervals following injection of formalin. Oral administration of boswellia (15, 30 mg / kg) reduced formalin-induced SC orofacial pain behavioral responses. SC orofacial pain behavioral responses was significantly reduced at 20~35 min. In the experimental group injected into temporomandibular joints, the pain response was significantly reduced by $276.2{\pm}8.20$ and $78.3{\pm}4.7$ after oral administration of boswellia (15, 30 mg / kg) at $398.3{\pm}24.8$ times. As a result of the passage of time, the oral administration of boswellia showed a significant effect of reducing the temporomandibular joint pain 30 minutes after the injection of formalin. This study confirmed that oral administration of boswellia modulated the pain behavior in both models. In conclusion, boswellia extract may be a potential therapeutic treatment for orofacial pain.