• Imaging Science in Dentistry
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• v.33 no.2
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• pp.63-70
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• 2003

Purpose: To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. Materials and Methods: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. Tl-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. Results: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment(TPA) were correlated neither with clinical, nor with other MRI findings. Conclusion: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

• The Journal of Korean Academy of Prosthodontics
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• v.22 no.1
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• pp.85-94
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• 1984

The purpose of this study was to investigate treatment effectiveness of TENS and bite plane for bruxism and TMJ dysfunction patients. The electromyograms were made on males aged 23 to 25 with sound stomatognathic system, 5 males bruxism aged 24 to 27, and 1 male and 4 females TMJ dysfunction patients (right TMJ pain) aged 14 to 33. The electromyographic study was limited to the middle of masseter muscle and anterior temporal muscle. The electromyographic study was carried out with 8-channel EM2 (Myotronics Research Inc.) and was taken 5 mandibular positions of clinical rest position, clench intercuspal position, clench protruded, cluch right, clench left. The 2 pairs of surface electrodes were used exactly, with the ear lobe as reference point. The recording were subjected to determine the mean voltage. The results were as follows; 1. In the clinical rest position, the muscle activities of bruxism and TMJ dysfunction patients were higher than those of normal at the before treatment, but that were lower or similar to those of normal at the TENS after and after bite plane wearing. 2. In the clench I.C.P., the muscle activities of TMJ dysfunction patients were decreased as the order of the before treatment, after TENS, after occlusal bite plane wearing, but those of bruxism were irregular. 3. In the clench right and the clench left, the muscle activities of the middle of masseter muscle of the non-working side of bruxism were higher than those of the working side at the before treatment and after TENS, but the muscle activities of after occlusal bite plane wearing were similar to those of the normal. 4. In the clench right and the clench left, the muscle activities of the middle of masseter muscle and anterior temporal muscle of the working side of TMJ dysfunction patients were higher than those of non-working side as like the normal at the before treatment, after TENS, and after occlusal bite plane wearing.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.87-95
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• 2013

Osteoarthritis (OA) of the temporomandibular joint (TMJ) is a severe form of temporomandibular disorders (TMDs), presenting gradual breakdown of articular cartilage and subchondral bone by the functional load sustained to exceed the physiologic tolerance of the joint. In such a joint loaded, offensive bioactive materials such as matrix degrading proteins, cytokines, and free radicals increase in concentration to shift the tissue response in the joint to degeneration from regeneration or remodeling. Recently, it has been issued that obesity can play an offensive role in pathogenesis of OA in a metabolic way. Adipokines released by adipose cells are present at higher concentration in the arthritic joint and joints of obese individuals. However, because of conflicting data reported, further scientific study should be performed to elucidate the practical role of adipokines in pathogenesis of TMJ OA. As far as the clinical signs and symptoms of TMJ OA are not much different from those of other forms of TMD and any definitive treatment modality to control directly the bone resorptive activity is not available yet, the treatment of TMJ OA should be directed to reduce the physical load and enhance the physiologic tolerance of the joint by means of conservative treatment such as physical therapy, medication, and occlusal splint therapy for sufficient period and, if needed after that, supplementary surgical procedure such as intra-articular injection, arthrocenthesis, and arthroscopic surgery that have turned out to be effective to control OA signs and symtpoms. Enthusiastic reassurance and motivation for patients to control behaviors for themselves to reduce unnecessary functional load in daily life is very important for the joint to reach to more favorable orthopedic stability of the TMJ more quickly, guaranteeing more successful management TMJ OA.

• Journal of Oral Medicine and Pain
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• v.37 no.2
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• pp.125-133
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• 2012

TMJ Osteoarthritis is a degenerative disease caused by overload on joint tissue, and often accompany with local tenderness on the joint, crepitus by mandibular movement, restriction of mandibular movement, and anterior openbite. In general, panoramic radiography, TMJ panoramic radiography, and transcranial radiography are conducted to diagnose osteoarthritis after clinical examination, however, these radiographic evaluations are limited in detecting minute bony changes of early pathologic lesion. The aim of this pilot study was to evaluate the limitation and usefulness of several TMJ imaging techniques, so we compare the findings from clinical examination, plain film radiographs, tomograph, and bone scan from 81 patients with temporomandibular joint disorder. The proportion of patients showing same findings in plain film radiographs, TMJ tomograph, and bone scan was high, however, it is desirable that clinician should conduct phased imaging examinations according to the clinical findings due to the possibilities of false negative findings in diagnosis of osteoarthritis.

• Journal of dental hygiene science
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• v.11 no.3
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• pp.285-292
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• 2011

The purpose of this study was to analyze and investigate temporomandibular disorders(TMD) and dental clinic outpatients by food intake ability to improve the quality of life. A survey of questionnaires with 208 subjects visiting a dental clinics located in Daejeon city from January to September in 2010 was performed. Analysis were performed with survey results, in which a symptoms of TMD, parafunctional habits and abnormal functions, food intake ability : 1. The main symptoms of TMD showed pain on TMJ(45.7%), pain on joint sound(45.2%), pain during chewing(41.3%), pain during mouth opening(38.0%), pain during non chewing(19.7%) and pain on joint dislocation(13.0%) in turn. 2. The symptoms of TMD by gender showed joint dislocation of 18.0% for male and 8.3% for female(p=0.038); pain on chewing of 49.0% for male and 34.3% for female(p=0.031), which were statistically significant. 3. The parafunctional habits and abnormal functions by gender showed clenching habit of 35.0% for male and 22.0% for female; bruxism of 21.0% for male and 9.3% for female, which were statistically significant. 4. The symptoms of TMD by age showed 52.8% of 27.8% for often and 25.0% for sometimes of 21-30 age in pain on TMJ, which were statistically significant(p=0.001). 5. The parafunctional habits and abnormal functions by age showed over 31 age of 48.3%, which were statistically significant(p=0.003). 6. The food intake ability by symptoms of TMD showed no joint sound(p=0.000), no pain on chewing(p=0.000) and without pain on TMJ(p=0.000), which were statistically significant. 7. The food intake ability by parafunctional habits and abnormal functions showed no clenching habit(p=0.000), no bruxism(p=0.000) and no headache, which were statistically significant. 8. The distribution type of operation by symptoms of TMD showed 30.8% of rest, 24.0% of physical medicine and 16.4% of pharmacotherapy. The pain on chewing showed 36.0% of pharmacotherapy; 52.4% of pain on TMJ for often and 40.5% for sometimes, in which pharmacotherapy and physical medicine were statistically significant(p=0.000). These results showed that management run parallel with survey for multiple factors in TMD we consider aspect of physical, social, physiology to enhance quality of life to increase food intake, construction of program for treatment and prevention because the individual differences need to be multifaceted, further research is suggested to continue.

• Journal of Oral Medicine and Pain
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• v.37 no.2
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• pp.113-123
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• 2012

To evaluate the treatment outcome of occlusal stabilizing splint in patients with TMJ osteoarthritis, the 76 subjects were chosen among the patients who presented to the Department of Oral medicine of Pusan National University Hospital, diagnosed as TMJ osteoarthritis by cone beam computed tomography, x-ray and clinical exam, and treated with occlusal stabilizing splint from 2009 to 2011. They were treated with physical therapy and medication before occlusal stabilizing splint delivery and checked monthly after occlusal stabilizing splint delivery. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit, splint delivery visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO were significantly improved between the first visit and occlusal stabilizing splint delivery visit, and between occlusal stabilizing splint delivery and the last visit. 2. In the acute group, pain and noise were significantly improved between the first visit and occlusal stabilizing splint delivery visit. Pain, LOM and MCO were significantly improved between splint delivery visit and the last visit 3. In the chronic group, pain, noise and LOM were significantly improved between occlusal stabilizing splint delivery visit and the last visit.

• Journal of Oral Medicine and Pain
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• v.24 no.2
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• pp.107-115
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• 1999

The author studied the prevalence and sites of orofacial pain during the latest 6 months, and psychologic symptoms under the emotional stress through SCL-90-R in thirty-five dental students(nineteen men and sixteen women) of school of Dentistry, Chonbuk National University. 26 students(74.3%), 12 men and 14 women, experienced the orofacial pain; headache, toothache, facial & buccal pain, TMJ pain and intraoral pain were occurred in 51.4%, 37.1%, 25.7%, 17.1% and 17.1% respectively. In psychological scores in before-, during- and after examination, there was no significant difference between men and women. On the other hand, when these scores were compared each other in one group with orofacial pain experience and the other group without pain experience, the former showed significantly higher values in somatization, depression, hostility, and paranoid ideation dimension before examination, interpersonal sensitivity and anxiety dimension during examination, and somatization dimension after examination than those of the later group(P<0.05). The changes of psychologic symptoms in before-, during-, and after examination were observed in one group with pain experience and the other group without pain experience, respectively; in the former group the significantly higher values of anxiety dimension in during examination than after examination, and the significantly higher values of interpersonal sensitivity dimension in before examination than after examination(P<0.05) were evaluated.

• 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

• Journal of Korean Dental Science
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• v.6 no.2
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• pp.87-95
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• 2013

Synovial chondromatosis (SC) is a rare, benign disease found in metaplastic cartilaginous nodules within the synovial membrane. The etiology of SC is not well-known, but it may be associated with trauma, chronic abnormal loading, or inflammatory joint disease. It is often found in knee, elbow, ankle, and shoulder joint but rarely in the temporomandibular joint (TMJ) area. SC of TMJ frequently appears in middle age and more often in females. Clinical symptoms include periarticular swelling, pain, crepitus, and limitation of joint motion. The most common feature is a radiographic finding of loose bodies in the joint. Irregularity of joint space and condylar head is also observed. Treatment involves the surgical removal of synovium and loose bodies. The prognosis is good, with low postsurgical recurrence rate. Functional improvement of the joint and pain relief are noted in many patients. Malignant transformation of SC has not been recorded. In this study, we report a 54-year-old female patient who experienced discomfort on the right TMJ with SC on the area but made a satisfactory recovery after surgery.

• Journal of Oral Medicine and Pain
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• v.16 no.1
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• pp.113-120
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• 1991

The authors examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane pre-end post-treatment. And the author obtained the following results. 1. In the frontal plane, the patterns and ranges of mandibular movement of the patients were very irregular and small before treatment. But after the treatment, the patterns were similar to the typical shield shape of the normal subjects. And the velocity of opening and closing was improved after the treatment. 2. In the sagittal plane, the mean amount of maximum mouth opening was 27.0±4.0mm before treatment and 44.0±5.4mm after treatment. And there was statistically significant improvement(p<0.005). The patterns of the movement were very irregular and small before treatment, but were similar to the shape of "Posselt's envelope of motion" after the treatment. The velocity of opening and closing was improved after the treatment 3. In the horizontal plane, the mean amount of maximum laterotrusion was 8l2±2.5mm in the affected side and 6.7±2.2mm in the non-affected side before treatment. There was a significant difference between the sides(p<0.05). After the treatment, the mean was 10.4±2.6mm in the affected side and 8.9±2.3mm in the non-affected side and there was no significant difference between the sides(p>0.05). There was no significant difference in the mean amount of maximum protrusion between the before and aftertreatment(p>0.05), but the patterns of the movements were improved.