• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제41권1호
• /
• pp.52-56
• /
• 2015

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권2호
• /
• pp.162-167
• /
• 2010

This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권5호
• /
• pp.336-342
• /
• 2017

Synovial chondromatosis is a rare benign lesion originating from the synovial membrane. It presents as adhesive or non-adhesive intra-articular cartilaginous loose bodies. Although the causes of synovial chondromatosis have not been fully elucidated, inflammation, external injury, or excessive use of joints have been suggested as possible causes. Synovial chondromatosis has been reported to occur most frequently at large joints that bear weights, with a rare occurrence at the temporomandibular joint (TMJ). When synovial chondromatosis develops at TMJ, clinical symptoms, including pain, joint sounds, and mouth opening may common. Moreover, synovial chondromatosis rarely spreads to the mandibular condyle, glenoid cavity, or articular eminence of TMJ. The goal of this study was to discuss the methods of surgery and other possible considerations by reviewing cases of patients who underwent surgery for synovial chondromatosis that extended to the temporal bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제36권2호
• /
• pp.134-140
• /
• 2010

Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a characteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressive resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 18 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for this synovial chondromatosis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spaces and to remove the loose bodies without interruption of the whole synovial membranes.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권1호
• /
• pp.93-107
• /
• 1997

Magnetic resonance imaging has been used in the temporomandibular joint(TMJ) primarily to define morphology and positional relationship of associating structures. This report examines signal intensity characteristics of the posterior attachment as they related to the severity of internal derangement. Fifty six joints in 35 patients with a history of TMJ dysfunction were imaged writ MR using $T_1$-weighted spin echo sequence. According to disk position, ability to reduction, and the presence of osteoarthritis, the joints were categorized into three groups. A group 1 was anterior disk displacement with reduction; a group 2 was anterior disk displacement without reduction; a group 3 was anterior disk displacement without reduction and condyle had osteoarthritic change. The control group was determined by the clinical absence of any signs or symptoms of current or past TMJ pain and dysfunction. Calculated the relative value of MR signal intensity in posterior attachment and disk to cerebral cortex of temporal lobe by means of computer program, we have compared them with each groups. The result showed statistically little significant difference of disk signal intensity among each groups. but, signal intensity from posterior attachment in group 2 and 3 were significantly(p<0.05) decreased than control group. this might reflect an fibrosis or hyalinization of posterior attachment, which was part of remodeling process that occurs in disk displacement without reduction. However, this study could not demonstrate histologic confirmation of the decreased signal intensity in the posterior attachment. So, further investigation could be needed to understand the association between them.

• 턱관절균형의학회지
• /
• 제13권sup호
• /
• pp.27-33
• /
• 2023

본 증례의 환자는 자가 경부 마사지로 인한 척수부신경병증으로 경추부 근력 불균형 및 그에 따른 피로를 호소하였다. 자가 마사지로 인한 일시적 신경 압박은 7일에 걸쳐 자연 회복되었으며, 턱관절균형요법을 통해 자세와 척추 구조의 균형점을 회복시켜 환자의 피로와 자세 불균형을 개선할 수 있었다.

• Journal of Yeungnam Medical Science
• /
• 제12권1호
• /
• pp.141-148
• /
• 1995

본 교실에서는 측두하악관절주위의 동통, 관절 잡음동의 증상을 주소로 내원한 환자들에 있어서 역동적 자기공명영상의 촬영을 시행하여 관절원판의 전방변위와 형태적 이상 및 주위 구조물들과의 관계를 분석한 결과 근육성 동통기능장애와의 감별뿐만 아니라 환자의 중상에 따른 관절 내부 장애의 정도를 파악할 수 있었으며 악기능시의 구조적 이상, 장애의 원인 등을 판독하여 치료의 방침을 세우는데 있어 매우 유용한 정보를 얻을 수 있었기에 보고 하는 바이다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제19권1호
• /
• pp.37-44
• /
• 2019

Objective: Arthrocentesis is a minimally invasive surgical procedure that is used to alleviate the symptoms of temporomandibular joint (TMJ) disorders. The aim of this study was to investigate the effect of arthrocentesis on the blood supply to the retinal structures. Materials and Methods: Arthrocentesis was performed on 20 patients with TMJ disorders, and choroidal thickness (CT) in patients was measured to evaluate retinal blood circulation. The blood volume of the retinal structures was evaluated ipsilaterally before and after arthrocentesis, and these measurements were then compared with measurements obtained from the contralateral side. Results: Before arthrocentesis, there were no differences in retinal blood volumes between the ipsilateral and contralateral sides (P = 0.96). When ipsilateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was found to have significantly decreased after arthrocentesis (P = 0.04). When contralateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was also found to have decreased after arthrocentesis, but not significantly (P = 0.19). Conclusion: The solution of local anesthesia with epinephrine applied before the arthrocentesis procedure was found to reduce the blood volume of the retinal structures. To the best of our knowledge, this is the first study that has investigated the blood volume of the retinal structures following arthrocentesis.

• Journal of Oral Medicine and Pain
• /
• 제32권4호
• /
• pp.413-419
• /
• 2007

다양한 종류의 정량적 통각검사들의 연관성을 알아보기 위하여 56 명의 측두하악장애 환자를 대상으로 측두근, 교근, 측두하악관절 부위, 그리고 경골근의 냉통각역치 (Cold Pain Threshold, CPT), 열통각역치 (Heat Pain Threshold, HPT), 열통증인내역치 (Heat Pain Tolerance Threshold, PTT), 압력통각역치 (Pressure Pain Threshold, PPT)를 측정하였으며, 각기 다른 통각 역치 간의 상관관계와 측정 부위 별 통각 역치 간의 상관 관계를 분석하였다. CPT, HPT, PTT를 포함한 온도통각역치의 성별간 차이는 나타나지 않았다. 그러나 PPT는 여성이 남성에 비하여 모든 부위에서 유의하게 낮은 역치를 나타내었다. CPT, HPT, PTT를 포함한 세 가지의 온도통각역치들은 모든 측정 부위에서 약정도에서 강정도 (mild to high)의 상관관계를 나타내었다 (r= 0.324-0.754, p<0.05). PPT 값은 각각의 온도통각역치와 통계적으로 유의한 상관관계를 나타내지 않았다. 모든 측정 부위의 통각역치값들은 서로간에 약정도에서 강정도 (mild to high)의 상관관계를 나타내었다 (r= 0.284-0.878, p<0.05). 측두하악장애 환자의 온도통각역치와 열통각인내역치 사이에는 유의한 상관관계가 존재하나 온도통각역치와 압력통각역치 간에는 상관관계가 나타나지 않는 것이 관찰되었으며, 각기 다른 부위에서 측정된 통각역치 간에는 비교적 높은 상관관계가 나타났다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제39권
• /
• pp.19.1-19.6
• /
• 2017

Background: The aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs). Methods: Two hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse). Results: Degenerative bony changes were the most frequent in the age groups of 10~19, 20-29, and 50~59 years. The most frequent pain intensity was "none" (NRS 0, 34.6%) followed by "annoying" (NRS 3-5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). "Ero + Fla" was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age. Conclusions: Osp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. "Six months to 2 years" may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.