• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.458-463
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• 1994

A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.207-217
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• 1997

This study was performed for Investigation of the magnitude of mandibular positional change in maximum mouth opening. protrusion, lateral excursion, gum and peanut chewing with BioPAK system(Bioresearch Inc. USA) which can analyze mandibular rotational torque movements. For this study 17 female patients with Temporomandibular joint(TMJ) closed lock and 18 female control without any Temporomandibular disorders(TMDs) signs and premature occlusal contact were included. The obtained results were as follows : 1. In maximum mouth opening, the mandibular rotational angle and distance of patients were significantly greater than those of control group in horizontal plane(P<0.05). 2. In protrusion, the mandibular rotational angle and distance of patients were significantly greater than those of control group in frontal and horizontal plane(P<0.01, P<0.05). 3. The mandibular rotational angle and 야stance in lateral excursion to affected side of patients were significantly greater than those in lateral excursion to non-affected side in frontal plane(P<0.05). 4. The mandibular rotational angle in gum chewing to affected side of patients was significantly greater than that in gum chewing to non-affected side in frontal plane. 5. The mandibular rotational angle and distance in peanut chewing to affected side of patients were significantly greater than those in peanut chewing to non-affected side in frontal and horizontal plane. 6. The mandibular rotational angle and distance in peanut chewing to affected side of patients were greater than those in gum chewing, and was the same result in control group in frontal and horizontal plane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.109-113
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• 2000

Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The knee and elbow are the most commonly involved sites and involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) is presented. A 28-year-old women had experienced pain of the left TMJ area and limitation of mouth opening. Radiographs of the left TMJ revealed calcified mass surrounding over the mandibular condyle and under the glenoid fossa. Treatment consisted of removal of calcified mass, reshaping of affected condyle and reconstruction with a auricular cartilage. After surgery, the patient's range of motion improved although deviation to the affected side. Until present after surgery there have been no recurrence of symtoms. We think that findings of this patitent agree with those of synovial synchondrmatosis in many aspects.

• Journal of Oral Medicine and Pain
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• v.19 no.1
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• pp.93-103
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• 1994

In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

• Imaging Science in Dentistry
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• v.43 no.1
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• pp.25-30
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• 2013

Purpose: This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. Materials and Methods: A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Results: Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). Conclusion: BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

• Journal of Oral Medicine and Pain
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• v.47 no.1
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• pp.27-37
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• 2022

Purpose: This study aimed to broaden our understanding of the predisposing factor and treatment of dislocation by analyzing and evaluating the morphology of the articular eminence (AE) in subjects with temporomandibular joint (TMJ) dislocation using cone beam computed tomography (CBCT). Methods: The subjects were divided into two groups: dislocation (31 subjects) and control (32 subjects). CBCT was used to examine 126 TMJs in 63 subjects (26 males, 37 females). The height, width, and posterior slope of the AE were measured in the parasagittal plane. The posterior slope was measured using the "top-roof line angle (TR angle)" method and the "best-fit line angle (BF angle)" method. The AE on the left side (AEL) and the AE on the right side (AER) of the subjects in the dislocation group were separately analyzed and compared with the control group after taking measurements. The average value of both sides was used when comparing with subjects with bilateral dislocation. Results: Dislocations were more frequent in females (67.7%) than in males (32.3%). The dislocation group showed a gentler TR angle than the control group in the AER and in the average of AE on the both sides (AEB). The same group also showed a wider AE in the AEL and the AER (p<0.05). In subjects with unilateral dislocation, the width of the AE with dislocation was narrower and the TR angle and BF angle was steeper than the other side without dislocation (p<0.05). Conclusions: In subjects with unilateral TMJ dislocation, the posterior slope of the AE is steeper, and the width is narrower at the site of dislocation compared to the site without dislocation. However, in subjects with bilateral TMJ dislocation, AEB were wider, and the mean value of the posterior slope of AEB was gentler than that of the control group.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.106-111
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• 2023

Purpose: In this study, we evaluate the potential of the relative ratio of capsular width (RCW) between the affected side (Aff) and non-affected side (Non-aff) in patients with temporomandibular joint (TMJ) arthralgia. We assessed whether RCW may hold greater diagnostic significance than the objective capsular width (CW) reported in previous studies when diagnosing arthralgia using ultrasonography (US). Methods: Forty-nine patients were assessed using US, excluding four patients with bilateral arthralgia. The patients were divided into two groups: 40 with unilateral arthralgia (UA), and nine without arthralgia (NA). We measured CW and masseter muscle thickness using US. Moreover, we employed RCW to analyze the variances between the groups. The numerical rating scale (NRS) and RCW were compared before and after dexamethasone injection in 10 patients who underwent follow-up evaluations. Results: Within the UA group, CW on the Aff was found to be significantly larger compared to the Non-aff (p<0.001). Additionally, RCW in the UA group was greater than that in the NA group (p<0.01). Furthermore, after dexamethasone injection, a reduction in the NRS and RCW values was observed in the 10 patients who were followed up. Conclusions: While previous studies have suggested a link between arthralgia and TMJ effusion, making CW a possible indirect diagnostic indicator for arthralgia, our findings propose that RCW could hold more diagnostic value than objective CW. However, additional studies are required to standardize the protocols for interpreting US results and determining the cutoff value of RCW in diagnosing TMJ arthralgia.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.12 no.1
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• pp.69-80
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• 1982

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandi.bular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthorsis was eburnation of cortical bone (35. 64%) of total cases). Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed !tate, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relatioships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movenent in 332 cases (28.55%), bone on bone relation- ships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). bone on bone relationships in 243 cases (21.32%) and downward positioning of condyle in 217 cases (18.66%). 5. In the TMJ arthrosis patients with bone changes, 1249 cases of abnormal condylar position in the mouth closed state and 1163 cases of abnormal condylar position in the mouth open state could be interpreted. so, for the radiographic interpretation of TMJ arthrosis, the reading of condylar positional changes as well as that of bond changes should be performed and their interrelations should be profoundly considered.

• Journal of Oral Medicine and Pain
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• v.23 no.1
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• pp.45-55
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• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.237-242
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• 2009

the primary diagnosis of synovial chondromatosis of temporomandibular joint is extremely rare. often many months, or even years pass before the diagnosis is confirmed. synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. a 28-year-old women had experienced pain of the left TMJ area at mastication. Radiographs of the left TMJ revealed calcified loose bodies in superior temporomandibular joint space. treatment consisted of removal of calcified loose bodies and synovail membrane. after surgery, pain of Lt temporomandibular area at mastication disappeared. until present after surgery there have been no recuurence of symptoms.