• Journal of Oral Medicine and Pain
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• 제44권1호
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• pp.35-39
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• 2019

Calcifying aponeurotic fibroma (CAF) is an uncommon benign soft-tissue fibroblastic tumor with characteristic histological features. It mainly occurs in the distal part of the extremities, such as the hands and feet, in children and adolescents. Males are twice as commonly affected as females. CAF exhibits local invasiveness, and hence, its recurrence rate is also high. Therefore, complete surgical excision is both diagnostic and therapeutic. The occurrence of CAF in the maxillofacial region, especially the temporomandibular joint (TMJ), is very rare, and this necessitates its differentiation from other TMJ neoplasms. The differential diagnosis of CAF requires microscopic examination. Herein, we report a rare case of CAF located at the left mandibular condyle, which was confirmed by histopathological analysis.

• 한국치위생학회지
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• 제17권5호
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• pp.911-919
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• 2017

Objectives: The baobab tree is a multipurpose, widely-used species with medicinal properties and numerous food uses. The aim of study was to evaluate the effect of oral administration of baobab on the formalin-induced inflammatory pain in rat model injected into the orofacial regions. Methods: Male Sprague-Dawley rats weighing 260-280 g were used. Pain in the orofacial region was induced using two models, 5% formalin was injected $50{\mu}l$ subcutaneously or $30{\mu}l$ in temporomandibular joint (TMJ), respectively. Rats were divided into 4 groups (n=6); formalin, formalin after distilled water (vehicle) or baobab (150, 300 mg/kg). The number of noxious behavioral responses with scratching the facial region was recorded for 9 successive 5-min intervals following formalin injection. Results:There was no significant difference in the first response to the pain between the formalin induced group and the drug administration group. However, in the secondary infusion group, all of the pain medication were responded (Bao 150, 300 mg/kg) (p<0.05). Conclusions:The results showed analgesic effect of baobab on formalin-induced orofacial inflammatory pain. This suggests that the natural product is an effective alternative to the postinflammatory pain control.

• Journal of Oral Medicine and Pain
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• 제31권4호
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• pp.327-335
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• 2006

긴장성두통은 일반적으로 근육성 두통이 많지만 측두하악관절장애 등과 같은 관절통이 주소인 경우도 있는데 본 연구의 목적은 근육통을 호소하는 긴장성 두통환자와 측두하악관절의 통증을 호소하는 긴장성 두통환자의 임상적 통증양상을 비교 연구하는데 있다. 일정기간 긴장성두통을 주소로 내원한 환자 167명을 관절통군 18명, 근육통군 50명, 그리고 관절통과 근육통이 함께 있는 관절근육통군 99명을 대상으로, 국제두통학회에서 제시한 두통의 진단기준인 통증의 질, 통증의 강도, 통증의 양측성 유무 그리고 일상생활시 통증의 증가유무, 악습관의 유무 등을 설문조사한 후 통계처리 하여 결과를 얻었다. 1. 통증의 질은 세 군 모두 둔통이 많았다. 관절통군이 94%, 근육통군이 94%, 그리고 관절근육통군이 85%로 둔통이 많았다. 그러나, 세 군간의 통계적으로 유의한 차이는 없었다. 2. 통증의 강도는 세 군 모두 심하지 않은 정도의 통증이 많았다. 관절통군이 89%, 근육통군이 88%. 그리고 관절근육통이 94%로 비심도의 비율이 높았다. 하지만, 세 군간의 통계적으로 유의한 차이는 없었다 3. 통증의 양측성 유무는 세 군 모두 편측성이 많았으나, 관절통군이 83%, 근육통군이 82%, 그리고 관절근육통군이 63%로 편측성이 많았다. 세 군간의 통계적으로 유의한 차이는 없었다. 4. 일상생활시 통증의 증가유무는 세 군 모두 악화되는 경우가 많았으며, 관절근육통에서 75%로 관절통의 61%, 근육통의 54%보다 악화되는 비율이 통계적으로 유의성있게 더 높았다(p=0.03). 이상의 연구로 관절통 혹은 근육통 하나 만이 있는 긴장성 두통 환자보다, 관절통과 근육통을 모두 가지고 있는 긴장성 두통환자는 더욱 쉽게 악화됨이 관찰되었다.

• Journal of Oral Medicine and Pain
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• 제11권1호
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• pp.57-66
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• 1986

A study of occlusal relationship and TMJ dysfunction, parafunctional relationship and TMJ dysfunction using PRI was investigated in 23 dental students without history of being treated, ranging from 19 to 24 years old. The author used Denar Pantronic and D5-A articulator to study above. The obtained results were as follows : 1. Distribution of PRI in experimental subjects was as follows. None 13%, Slight 43%, Moderate 40%, Severe 4% Prevalance of TMJ Dysfunction was 87% 2. PRI scores of occlusal group Aoi (less than 5 in Helkimo occlusion/articulation index) was $11.72\pm2.32$ , those of occlusal group Boi (more than 5 in Helkimo occlusion/articulation index) 23.0 $\pm$ 8.06. There was a significant difference between group Aoi and group Boi(P<0.01) 3. PRI scores of occlusal group Ald (no eccentric interference, less than 0.5mm in lateral shift of slide in centric) was 12.0 $\pm$ 2.49, those of occlusal group Bld(no eccentric interference, less than 0.5mm in lateral shift of slide in centric) 24.5$\pm$5.33 There was a significant difference between group Ald and group Bld(P<0.05) 4. Prevalance of parafunction subjects(%) was 65.2%. 5. PRI scores of parafunction group was 21.6 $\pm$ 9.48, those of nonparafunctional group 18.7 $\pm$ 9.06. There was not significant difference between parafunctional group and nonparafunctional group(P>0.1)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.403-410
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• 2009

Those composing temporomandibular joint (TMJ) complex such as the temporal bone, the disc and the mandibular condyle perform their own functions with organic relation. The retrodiscal tissue is the main area of pain induction and contributes to compositional change of synovial fluid. If displacement of the disc lasts long time, not only adaptive changes, but also destructive or degenerative changes may happen. It was reported that these changes and symptoms appear mostly to female rather than male and especially, in the case of patients suffering from TMJ disorder, a large quantity of female sex hormone is found in the joint synovium. And that may play a role in bone resorption and inflammation. Also, the frequency and the intensity of pain perception for female is reported to be much more than for male. In this study, we investigated the expression extents of estrogen receptors (ER) and progesteron receptors (PR) in retrodiscal tissue with immunohistochemistry among the patients received TMJ surgery and compared with MRI findings and surgical findings. We report the relations between the expression of ER in retrodiscal tissue and the pathological change in TMJ, such as inflammation, internal derangement and osteoarthritis.

• Journal of Oral Medicine and Pain
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• 제31권3호
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• pp.231-236
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• 2006

류마티스 관절염은 다발성 관절염을 특징으로 하는 원인 불명의 진행성 염증성 질환이다. 초기에는 관절활막이 침습되지만 점차 주위의 연골과 골이 침습되어 관절의 파괴와 변형을 초래한다. 류마티스 관절염은 손목관절, 중수지관절과 근위지절간관절이 침범하기 쉽고 그 밖의 여러 관절에서도 나타날 수 있으며 측두하악관절에서도 빈번하게 나타나는 것으로 보고되고 있다. 이 증례에서는 다른 관절에서 보다 측두하악관절에서 두드러지고 급속하게 진행되었다. 의과적 약물 치료와 더불어 16개월동안의 교합안정장치 및 물리 치료, 운동요법을 통한 치과적 처치와 측두하악관절의 경과를 보고한다. 치료중 급속한 관절의 파괴는 있었으나 더 이상의 교합변화는 없었고 하악운동과 통증은 상당히 개선되었다. 다른 관절에 비해 측두하악관절에 두드러지게 나타나게 되는 요인과 이를 가속화시키는 요인에 대해서는 앞으로의 연구가 더 필요할 것이다.

• Journal of Oral Medicine and Pain
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• 제46권4호
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• pp.161-164
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• 2021

The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient's symptom level and the patient's general health status. If the clinical symptoms are not severe, no treatment is required.

• Journal of Oral Medicine and Pain
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• 제48권4호
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• pp.152-158
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• 2023

Purpose: This pilot study aimed to evaluate changes in joint space (JS) using cone-beam computed tomography (CBCT) images of patients diagnosed with temporomandibular joint (TMJ) osteoarthritis (OA) and to determine the association between occlusal changes and JS. Methods: CBCT images were used to measure the anterior, superior, and posterior JSs of the sagittal plane. The differences in JS values over time and between groups were compared. The percentage change in the anteroposterior position of the mandibular condyle between groups was also analyzed. Results: Thirty-four subjects (mean age=43.91±20.13), comprising eight males (23.5%) and 26 females (76.5%), were divided into 18 patients with no change in occlusion (NCO) and 16 patients with a change in occlusion (CO) during TMJ OA. The JS measurements of the study subjects showed a decrease in anterior joint space (AJS) values over time. There was no difference in JS measurements between the groups at T1 and T2. AJS values measured at T1 were lower in the CO group than in the NCO group, but the difference was not statistically significant. In both groups, a posterior position of the mandibular condyle was initially observed with high frequency. However, there is a statistically significant difference in CBCT images taken after occlusal changes, with an increased frequency of condyles observed in the anterior or central positions. Conclusions: In conclusion, AJS decreased over time in TMJ OA, and the mandibular condyle became more anteriorly positioned with occlusal changes. Therefore, clinicians should diligently monitor mandibular condyle morphology and JS using CBCT, along with the patient's clinical symptoms, to treat and control TMJ OA effectively.

• 치과방사선
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• 제22권2호
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• pp.351-364
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• 1992

Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articuar fossa and eminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and magnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement througth inferior joint space arthrography at the department of Oral & Maxillofacial Radiology, Dental Hospita, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displcement with reduction, 48 disc displcement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd 3rd decades and the average age of perforation was higher than that of disc displcement with higher than that of disc displcement with reduction. The sexual predilection was 2 times hiher in females. 2. The most frequent chief complaints were TMJ sound in disc displcement with reduction, pain and limitation of mouth opening in disc displcement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displcement with reduction with than in preforation and disc displcement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displcement with reduction. History of joint sound in disc displcement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4㎜ in disc displcement with reduction, 31.4㎜ in disc displcement without reduction and 33.8㎜ in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displcement with reduction. posterior and concentric condylar position was frequent in disc displcement without reduction, concentric and anterior condylar position in perforation. At 1 inch opening, the same position to articular eminence was most frequently found in disc displcement with reduction, posterior position in disc disp1cement without reduction, posterior and nterior position in perforation was frequently found. 6. Bony changes, especially sclerosis and flattening, was most frequently found in perforation.

• Imaging Science in Dentistry
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• 제31권2호
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• pp.73-84
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• 2001

Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.