• Journal of Oral Medicine and Pain
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• v.10 no.1
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• pp.105-112
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• 1985

The author has studied the duration of silent period of the masseter muscle using electromyography in order to obtain the information that is necessary to diagnose the patients with TMJ dysfunction syndrome objectively. The 55 normal subjects and the 40 patients with TMJ dysfunction syndrome were selected for this study. The results were as follows : Duration of silent period of the masseter muscles in normal subjects were 24.4 msec in males, 24.0 msec in females, and mean of $24.2\pm3.19$ msec. Duration of silent periods of the masseter muscles in patients with TMJ dysfunction syndrome were 39.4 msec in males, 41.3 msec in females, and mean of $40.5\pm7.01$ msec. There was no significant difference of the duration of silent periods between in the right and the left side of the masseter muscles, and between in the males and the females (p>0.05). Duration of silent periods of the masseter muscles in patients with TMJ dysfunction syndrome were significantly more prolonged than those in normal subjects (p<0.01). Borderline of silent periods of the masseter muscles between in normal and patients with TMJ dysfunction syndrome was 31.5 msec.

• Journal of Oral Medicine and Pain
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• v.10 no.1
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• pp.17-31
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• 1985

Personality characteristics of TMJ dysfunction patients was studied by means of MMPI test. 100 TMJ dysfunction patients and 100 healthy controls were subjected at the Department of Oral Diagnosis and Oral Medicine, Pusan National University Hospital, during the period from March 1983 to February 1985. All the patients were divided into 2 groups namely, acute group and chronic group by duration of path and discomfort problems for 6 months or longer. The obtained results were as follows : 1. Mean value of T-scores on each clinical scale was within normal range in both patient and control group. 2. There was significant difference in scales of Hs, D. Hy, Pt, Sc and IR between patient and control group. 3. As compared with control group by sexual subclass, scales of Hs, Hy and Pt of both sex, scales of Sc and M-DI of male and scales of D of female in patient group were significantly higher than those in control group 4. The longer was duration of TMJ problems, i.e., in increasing order of control, acute and chronic group, the higher was mean value of T-scores on scales of Hs, D, Hy, Pt, Sc, IR and M-DI. 5. Mean values of T-scores on scales of Hs, D and Hy were the highest in all the clinical scales of total class and subclasses(i. e. male group, female group, acute group and chronic group) with TMJ dysfunction and showed 1-:i-2 (Hs, -Hy, -D. ) profile pattern, conversion "V.ot;V.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.510-514
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• 2011

An intracapsular and pericapsular infection of the temporomandibular joint (TMJ) is rare. The invasion of bacteria into the joint space can occur through several routes. Among them, hematogenous spread is most common. This report describes three cases of abscess formation in the TMJ (intracapsular and pericapsular infection). The patients were treated with supportive care and surgical intervention (incision and drainage) under hospitalization, and their symptoms had improved. Pain of the TMJ is a typical symptom of temporomandibular joint disorders (TMD). On the other hand, an infection of the TMJ can also cause pain on the affected side, and can be misdiagnosed as routine TMD. Therefore, the possibility of an infection of the TMJ cavity should be considered when treating TMD.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.10 no.1
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• pp.47-55
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• 1980

The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological ylar head, articular eminence, and articular fossa were analized and discussed view point. The positional changes of condylar head and articular fossa relatation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthrotic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 106 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrom and osteoarthrosis of TMJ.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.21-29
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• 1993

The purpose of this study was to evaluation of temporomandibulr joint space according to increasing the occlusal force on working and non-working side during unilateral bite. For the study, 22 normal adults, age ranged from 23 to 25, who had no symptoms on TMJ area and masticatory muscles and had normal or class I molar relationship were selected. Transcranial TMJ radiograph was taken during unilateral biting with sensor of Bite force checker (Nihon Kohden Kygyo Co.Ltd., Japan) on each 1st molar teeth of right and left side which were forced each 0Kg, 10Kg, 20Kg and 30Kg by use of Accurad-200 (Denar Corperation's product). The radiographs were traced on the screen, which was magnified by 5. The size of temporomandibular joint space at anterior, superior and posterior compartment were measured with Dumas's method (reference line of between squamotympanic fissure and the most inferior point of articular eminence). On the basis of this study, the following results were obtained. 1. Size of anterior TMJ space was tend to decrease on the working side and increase on the non-working side according to increasing the occlusal force, but not significant statistically (p>0.05). 2. Size of superior TMJ space was tend to increase on the working side and decrease on the non-working side according to increasing the occlusal force (p<0.05). 3. Size of posterior TMJ space was tend to decrease on both working ad nonworking side, but non significant statistically.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.41-47
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• 2016

Purpose: The purpose of this study was to analyze the size and morphology of mandibular condyle and mandibular fossa between temporomandibular joint (TMJ) disc displacement (DD) patients and healthy subjects using cone-beam computed tomography (CBCT). Methods: Twenty healthy subjects and twenty TMJ DD patients participated in this study respectively. We made five measurements in mandibular condyle (medio-lateral dimension, antero-posterior dimension, condyle height, intercondylar distance and intercondylar angle) and two measurements in mandibular fossa (mandibular fossa depth and articular eminence angle) using CBCT image. Results: There was no difference between two groups in medio-lateral dimension. In case of antero-posterior dimension, average of healthy controls was larger than that of TMJ DD patients, but that was not significant statistically. There were no significant differences between two groups in condyle height. Comparing intercondylar distance and intercondylar angle between two groups, there was no significant difference between two groups. In comparison of mandibular fossa depth and articular eminence angle, there was no significant difference between two groups. Conclusions: We couldn't find any definite relationship between TMJ morphology and TMJ DD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.48-53
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• 2016

Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.