• Title/Summary/Keyword: TMJ pain

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Masticator Space Tumor Mimicking Temporomandibular Disorder Presenting Facial Swelling and Trismus: A Case Report

  • Jeong, Koo-Hyun;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • v.44 no.2
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    • pp.65-68
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    • 2019
  • Temporomandibular disorders (TMD), involving the masticator system of temporomandibular joint (TMJ) and masticator muscle, can be characterized with the cardinal signs and symptoms of jaw pain, noises and limitation of mandibular range of motion. However, TMD requires differential diagnosis due to its heterogeneous characteristics with various causes despite the similar clinical profiles. Oral cancer involving TMJ and the masticator system, although infrequent, can be one of these causes and should be considered one of the most life-threatening disease mimicking TMDs. This report introduces a case of masticator space tumor originally diagnosed as TMD in a 73-year-old Korean female with previous history of brain tumor. The clinical signs and symptoms closely mimic that of TMD which may have disrupted differential diagnosis. We discuss here key points for suspecting TMDs of secondary origin, namely, that of cancer and the implications it has on dental clinicians.

A CLINICAL STUDY ON THE CHANGE OF TMJ SYMPTOMS FOLLOWING IVRO IN THE MANDIBULAR PROGNATHISM (IVRO를 이용한 하악골 전돌증 환자의 수술전후 악관절 증상 변화에 대한 임상적 평가)

  • Kim, Jin-Kwon;Park, Kwang-Ho;Kim, Hyung-Gon;Kim, Sang-Soo;Kim, Ki-Young;Huh, Jong-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.1-13
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    • 1997
  • Preoperative and postoperative TMJ symptoms were observed in mandibular prognathism of 30 patients operated on by Le Fort I osteotomy and intraoral vertical ramus osteotomy. The alterations of TMJ symptoms were investigated and the relationship between changes of TMJ symptoms and some cephalometric values including occlusal plane angle, mandibular plane angle, posteior ramal height and a degree of deviation of mandibular incisor midline to facial midline were observed. The results are as follows. The incidence of patient with TMJ symptoms before orthognathic surgery was 40% and after orthognathic surgery was 20%. The most frequetly encountered symptoms in orthognathic TMJ dysfunction patients were TMJ pain and/or clicking. After surgery 66% of the preoperative symptomatic patients reported improvement TMJ symptoms. On the orther hand 2 patient (6%) of the preoperative asymptomatic patients developed TMJ symptoms after surgery. Preoperatively, 60% of the facial asymmetric patients with mandibular prognathism had TMJ symptomas. The more severe facial asymmetry was, the higher incidence of TMJ symptoms was. The alteration of occlusal plane angle and mandibular plane angle seems to be one of the contributing factors which make to change TMJ symptoms in orthognathic patients. But its amount seems to be low significance. Increase or decrease of posterior ramal height have influence on the change of TMJ symptoms.

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Condylar repositioning using centric relation bite in bimaxillary surgery

  • Lee, Chang-Youn;Jang, Chang-Su;Kim, Ju-Won;Kim, Jwa-Young;Yang, Byoung-Eun
    • The korean journal of orthodontics
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    • v.43 no.2
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    • pp.74-82
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    • 2013
  • Objective: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. Methods: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A sur vey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. Results: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). Conclusions: Due to its simplicity, this method may be fea sible and useful for repositioning condyles.

A RADIOGRAPHIC STUDY ON THE CONDYLAR POSITION IN TEMPOROMANDIBULAR JOINT DYSFUNCTION PATIENTS (악관절기능장애환자의 하악과두위에 관한 방사선학적 연구)

  • Bang Sea Howan;Kim Jae Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.17 no.1
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    • pp.223-232
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    • 1987
  • The author obtained the transcranial-oblique lateral radiograms from 78 patients(26 male, 52 female) with temporomandibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54㎝ mouth opening with clicking, TMJ pain and mouth opening limitation repectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follows: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p<0.01) 2. In 2.54㎝ mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p<0.01) 3. Examined experimental group, the degree of condylar horizontal movement of affected ide was lesser than that of the normal side in 2.54㎝ mouth opening.

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A Study on the Mandibular Movements in the Patients with TMJ Lock Closed (악관절 폐구성 과두걸림 환자의 하악운동에 관한 연구)

  • Ji-Won Lee;Sung-Chang Chung
    • Journal of Oral Medicine and Pain
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    • v.15 no.1
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    • pp.79-89
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    • 1991
  • The author examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane and obtained the following results. 1. In the frontal trajectory, the mean amount of maximum mouth opening was 24.4mm and the opening paths were deviated to the affected side in 87.1% of the patients. The mean amount of maximum laterotrusion to the affected side was 10.4mm and that of non-affected side was 7.5mm. There was a significant difference between them(p<0.001). 2. In the sagittal trajectory, the mean amount of the maximum protrusion was 7.0mm, the mean amount of the maximal retrusion was 1.0mm 3. In the horizontal trajectory, the pattern of laterotrusion showed asymmetry: the mean length of non-affected side was smaller than that of the affected side. Protrusive path were deviated to the affected side in 64.5% of the patients, the mean degree of deviation was 16.4$^{\circ}$. The mandibular movements of TMJ lock-closed patients can be characterized by decreased range of mouth opening, protrusive movement, and laterotrusive movement to the non-affected side and also characterized by deviated opening and protrusive path to the affected side.

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A Study on the Effects of Immediate Side Shift to the Pantographic Reproducibility Index (Immediate Side Shift가 Pantographic Reproducibility Index에 끼치는 영향에 관한 연구)

  • Nam, Cheon Woo;Han, Kyung Soo
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.75-83
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    • 1987
  • This study was designed to investigate the effects of TMJ incoordination to condylar movements, especially, the ISS. The sounds are one of the symptoms in TMJ incoordinated disorder, and it may cause the changes of mandibular movement trajectory. 19 students with only TMJ sounds and 16 students with no TMJ problems participated in this study. The subject performed Rt. lateral, Lt. lateral and protrusive movements, and repeated 3 times on each movement. Pantronic was used to record the measures of condylar movement paths. The obtained results were as follows : 1. The mean values of RISS and LISS in control group were 0.29mm, 0.36mm respectively, and those in experimental group were 0.49mm, 0.41mm repectively. The mean values of RISS was higher in experimental group than that of RISS in control group. 2. Correlation coefficients between PRI and RISS, LISS were slightly higher in experimental group than those in control group, therefore, PRI was more likely to be affected by ISS in experimental group. 3. In control group PRI was correlated to RISS, LORB, RPRO and LPRO, but in experimental group PRI was not correlated to those items. From the study, the author knew that the condylar movements was stable in control group.

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A Novel Treatment of Recurrent Temporomandibular Joint Dislocation with Intermaxillary Fixation Using Microimplant: A Case Report

  • Kee, In-Kyung;Byun, Jin-Seok;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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    • pp.156-162
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    • 2014
  • Dislocation of temporomandibular joint (TMJ) is troublesome condition which was most commonly shown far anteriorly displaced mandibular condyle to the articular eminence, thereby make it impossible to close one's mouth. It is often referred to as 'open lock' in clinically. Although anatomical modification of the articular eminence through eminectomy has been considered most satisfactory and efffective treatment for managing the recurrent dislocation, it seldom performs clinically due to its invasiveness and patient's reluctance. We thought a shortterm intermaxillary fixation could be of benefit to the patient suffering from recurrent dislocation. A 21-year-old male patient with recurrent TMJ dislocation which had developed after excessive mouth opening, was successfully treated with intermaxillay fixation using microimplant for 2 months. It is more conservative and less complicated method than eminectomy in treating recurrent TMJ dislocation. Transient intermaxillary fixation using microimplant and elastics could be one of treatment options for recurrent TMJ dislocation.

PRIMARY SYNOVIAL CHONDROMATOSIS OF THE TEMPOROMANDIBULAR JOINT WITH TEMPORAL INVOLVEMENT (측두골을 포함한 원발성 악관절 활막 연골종증)

  • Kim, Il-Kyu;Baek, Min-Kyu;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.3
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    • pp.176-181
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    • 2009
  • Synovial chondromatosis is a rare, benign, monoarticular arthropathy that is characterized by the development of highly cellular, metaplastic cartilaginous nodules in the synovial membrane. It commonly affects larger joints such as the knee, elbow, wrist, shoulder, and hip. Synovial chondromatosis of the temporomandibular joint(TMJ) is rare. Moreover, the temporal involvement of synovial chondromatosis without connection with joint is greatly rare. A 44-year-old women had experienced pain of the right TMJ area and limitation of mouth opening. MRI and CT revealed multiple calcified loose bodies and widening in right upper joint space of TMJ and osteolytic lesion in right temporal bone. Treatment consisted of removal of multiple loose bodies, resection of the osteolytic lesion through the preauricular approach. She was diagnosed with primary transitional synovial chondromatosis of TMJ with involvement of temporal bone. In spite of remaining of the loose bodies, pain and mouth opening improved and there have been no recurrence of signs and symptoms for 5 years follow up.

A comparison of clinical symptoms and magnetic resonance images in temporomandibular joint disorders (측두하악관절 장애 환자의 임상증상과 자기공명영상에 관한 비교 연구)

  • Choi Yong-Suk;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.33 no.2
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    • pp.107-112
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    • 2003
  • Purpose : To determine the relationship between clinical symptoms and magnetic resoncance (MR) images in patients presenting with temoporomandibular joint (TMJ) disorders. Materials and Methods: This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. Results : There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. Conclusion: In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joints did not necessarily imply that the joints are normal according to MR image findings.

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미세직경 악관절경을 이용한 악관절 closed lock 환자의 치료

  • Lee, Sang-Hwa;Choie, Mok-Kyun;Chung, Hoon
    • The Journal of the Korean dental association
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    • v.41 no.12 s.415
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    • pp.818-824
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    • 2003
  • Visually guided irrigation and lysis(VGIL) using temporomandibular joint(TMJ) arthroscope is useful for decreasing pain and increasing the functional mobility of TMJ. Also it demonstrated similar effectiveness comparing with arthrocentesis. Arthroscopy permits intracapsular inspection that is imperative not only for identification of morphological characteristics of joint space, but also for adequate irrigation and lysis of specific joint space. Conventional 2.3mm diameter arthroscope with 2.7mm catheter was too wide. So it was traumatic and uncomfortable to manipulate on temporomandibular joint space, especially on TMJ internal derangement patient with reduced space. We report our clinical experience on 6 TMJ closed lock patients who were treated with new 1.2mm fiberscope at Chung Hoon Dental Clinic between March 2003 and August 2003. Also we present clinical advantage & disadvantage of new system with literature review.

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