• The Korean Journal of Pain
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• v.8 no.1
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• pp.86-92
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• 1995

Temporomandibular disorders typically present findings of limited or asymmetric patterns of jaw opening and joint sounds usually described as clicking, popping, grating, or crepitus. Recently, patients with temporomandibular disorders have received an increasingly aggressive treatment with a greater emphasis on surgical and dental reconstruction. Scientific studies have not clearly identified the specific causes of the temporomandibular disorders and therefore some of the treatments are empiric, without a firm scientific foundation. We carried out a study on the patients of pain clinic OPD and concluded that the causes of the temporomandibular joint(TMJ) pain are the prolonged contraction of the muscles of mastication, especially the masseter muscle. Therefore, the spasmolytic treatment of masseter muscle would be a better treatment for TMJ syndrome rather than the surgical and dental reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.134-137
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• 2017

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.67-78
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• 1996

This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

• Journal of Oral Medicine and Pain
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• v.37 no.3
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• pp.183-188
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• 2012

Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.367-374
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• 2007

Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.336-342
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• 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 Oral Medicine and Pain
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• v.38 no.3
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• pp.247-253
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• 2013

Renal osteodystrophy(RO) is characterized by skeletal changes in patients with renal disease and developed as a result of alterations in the metabolism of calcium, phosphate and secondary hyperparathyroidism. Bony changes in the craniofacial region include decreased bone density, radiolucent lesions(brown tumors), depletion of cortical bone and loss of lamina dura, but such changes rarely occur in the temporomandibular joint(TMJ). We report an uncommon case of bony changes and pain of both TMJs in a patient with RO. A 41-year-old man with RO came to our clinic due to TMJ pain and sounds. Occlusal change was also reported. Radiographs revealed degenerative changes of the both condyles. The patient had medical history of renal cancer therapy and hemodialysis. The patient was diagnosed with TMJ arthritis of RO and referred for systemic management through medication of calcium and vitamin D and parathyroidectomy. At 15-month follow-up, most of TMD symptoms disappeared and second radiographs revealed that bone density and cortical thickness of the mandible increased and the skeletal outline of the both condyles became relatively clear. As bony changes may begin in the early stage of the renal disease, dentists should be alert to detect the sign of the disease. In addition, it is important to differentiate TMJ arthritis of systemic cause because the treatment protocol is quite different.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.295-310
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• 2000

The relationship between symptoms of temoromandibular joint dysfunction(TMJD) and stomatognathic habit was studied in 500 adolescents(mean age 22.45). The severity of TMJD was determined by using a self-reported anamnestic questionnaire composed of 10 questions regarding common TMJD. The index of oromandibular habit was determined by using a self-reported anamnestic questionnaire composed of 17 questions. There was a positive correlation(p<0.01) between the index of TMJD and index of stomatognathic habit. The most frequent symptoms were clicking sounds from the TMJ(37.4%) and a feeling of pain in the jaws(33.3%). The most frequent stomatognathic habit were a chin support(69.8%) and one side chewing(68.0%).

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.327-335
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• 2006

Generally, Tension-Type Headache(TTH) patients exhibit muscle pain, but can also have TMJ pain, which includes mouth opening limitation or joint sounds. The purpose of our study is to observe the clinical pain characteristics between TTH patients with muscle pain and TMJ pain. One hundred sixty-seven patients were diagnosed with TTH according to the questionnaires based on the International Headache Society's proposal on the diagnostic criteria of TTH. The patients were classified into three group; arthralgia group (18 patients), myalgia group (50 patients) and arthromyalgia group (99 patients). TTH patients with pericranial muscle pain were classified in the myalgia group. TTH patients with temporal region pain were classified in the arthralgia group. TTH patients with both types of pain were classified in the arthromyalgia group. The parameters in the diagnostic criteria such as quality, intensity, laterality of pain, and aggravation due to physical activities were compared among the three groups. 1. There were no significant differences in the quality of pain among the three groups. 2. There were no significant differences in the intensity of pain among the three groups. 3. There were no significant differences in the laterality of pain among the three groups. 4. A higher percentage of patients in the arthromyalgia group experienced headaches that were aggravated due to physical activity (p=0.03) compared to the other groups. The results of this study show that TTH patients with both arthralgia (TMJ pain) and myalgia (pericranial muscle pain) are more aggravated by physical activity than TTH patients with either one.

• Journal of Korean society of Dental Hygiene
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• v.10 no.4
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• pp.683-693
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• 2010

Objectives : The purpose of this study was to examine the relation between stress and temporomandibular disorder(TMD) of first the child. Methods : 500(the first child -250, non first child -250) high school students living in Jecheon city, form November 4th to 5th 2009, were the subjects of this questionnaire. The questionnaire was made up of three contests: sociodemographic characteristic, symptom & dysfunction of TMD and stress of high school students. The data were analyzed by chi-square test, two sample t-test and Pearson correlation. Results : Only 443(the first child -209, non first child - 234) students were evaluated due to inadequate responses. The obtain results was as follow. 1. Subjective symptom of TMD reported by 443 students were joint sound(63.5%), pain on chewing(55.1%), pain on opening the mouth(55.1%). 2. Analysis of subjective symptom of TMD showed the first child group was statistical significantly higher on joint sounds and TMJ pain than non first child group(<0.05). 3. Analysis of bad habit and dysfunction showed the first child group was statistical significantly higher on clenching of the teeth, difficulties of bite, headache than non first child group(<0.05). 4. Analysis of stress showed the first child group was statistical significantly higher on stress with parents than non first child. especially on marks and disagreement(<0.05). 5. Stress were partly related to subject symptom of TMD(<0.05, <0.01). 6. Analysis of relation stress and bad habit & dysfunction showed stress were partly related to bad habit & dysfunction(<0.05, <0.01). 7. bad habit were partly related to TMD(<0.05, <0.01). Conclusions : The first child stress and symptom of TMD were higher than non-first child, also stress and symptom of TMD was positively associated. therefore management of the first child' stress is necessary and related study is necessary in the future.