• The Journal of Korean Physical Therapy
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• 제19권5호
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• pp.43-49
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• 2007

Purpose: The purpose of this study was to the effects of temporomandibular joint movement restriction on treatment of SCM muscle pain. Methods: The Subjects(n=20) were males(n=7) and females(n=13) that had SCM muscle pain and movement restriction at one side oftemporomandibular joint. The massage and Taping performed on the SCM muscle during 4 weeks. The measured items of SCM pain were pressure-pain scale, DITI. The measured items of temporomandibular joint movement restriction were VAS, ROM, deviation. Results: SCM muscle of pressure-pain scale is lower in ipsilateral than counterlateral, But temperature is higher in ipsilateral than counterlateral. Pressure-pain scale was statistical significance (p<0.05). After studying, the pain and temperature of SCM muscle was decreased and statistical significance(p<0.05). After studying, VAS of Temporomandibular joint was decreased, ROM was increased, deviation was decreased. All of measured items of Before and after studying found a statistical significance(p<0.05). Conclusion: This study showed that SCM muscle pain related TM joint pain and movement restriction. The patient with TM joint movement restriction that may take effect on reducing SCM muscle pain.

• 한국산학기술학회논문지
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• 제12권5호
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• pp.2203-2208
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• 2011

턱관절의 물리치료를 통한 훈련으로 모음 조음에 관여하는 구강 공명강을 증가시켜, 턱관절의 정상적인 발성패턴을 유지하도록 하여 턱관절장애 환자의 모음의 음향학적 특성 변화를 보고자 하였다. 연구 대상은 턱관절장애로 진단 받은 3명의 20~30대 성인 남자를 대상으로 하였다. 실험방법은 대상자간 중다기초선 설계를 이용하여 기초선 단계, 치료 단계, 유지 단계로 진행하였다. 치료는 한 회기를 30분으로 하여 주 3회 실시하였고 3회기를 한 평가단위로 5회의 중간평가를 실시하였다. 평가방법은 Praat 음성 분석프로그램을 이용하여 /ㅏ/ 모음의 연장 발성에 대한 제 1포먼트 주파수(F1), 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)를 분석하였다. 물리치료를 통한 훈련 프로그램을 실시한 결과 턱관절장애 환자의 제 1포먼트 주파수(F1), 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)는 치료 전 보다 증가하는 변화를 보였고, 이는 모음의 개구도와 관계된 제 1 포먼트 주파수(F1) 뿐만 아니라 모음의 전후설, 성대의 움직임과 관련이 있는 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)의 변화도 함께 보임으로써 턱관절과 모음 및 음성 산출의 연관성을 보여주었다.

• 대한치과의사협회지
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• 제46권4호
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• pp.232-242
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• 2008

관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral>300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절 잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰 되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제25권1호
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• pp.87-97
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• 2000

This study was performed to investigate the effects of repetitive mandibular opening movement and change of head posture on the vibration of temporomandibular(TM) joint. For this study, 23 patients with internal derangement of TM joint were selected. All they had clinically noticeable TM joint sound. Observation of the joint vibration were performed in four head postures, namely, natural head posture (NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For recording of joint sound vibration, Sonopak of Biopak system(Bioresearch Inc., Milwaukee, USA) was used, The author could take results related to integral higher than 300Hz, integral lower than 300Hz, ratio of integral higher than 300Hz to integral lower than 300Hz, total integral which was sum of higher and lower integral, peak amplitude, and peak frequency in each opening movement, which was carried out three times in each head posture. Integral means amount of vibration. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In NHP, total integral in right TM joint was 5O.3Hz in the first opening, 67.9Hz in the second opening, and 74.0Hz in the third opening movement, bur there was no significant increase of total integral with repetitive opening movement. This finding was similar in left TM joint. Integral lower than 300Hz were higher than integral higher than 300Hz in almost every opening movement. 2. There was no significant difference of total integral between right and left side of TM joint, but there was a tendency of higher total integral in right TM joint than that in left TM joint except for results in DHP. 3. Peak amplitude in NHP ranged from 2.0 to 4.7, and peak frequency in NHP were 101.4-170.0Hz. And there was no consistent findings related to increase or decrease of these value according to repetitive opening in each head posture. 4. Change of head posture did not result any difference in integral, peak amplitude, and peak frequency. In conclusion, change of head posture and repetitive mandibular opening movement did not make any significant effect on the vibration of temporo-mandibular joint, especially, on total integral, peak amplitude, and peak frequency.

• The Journal of Korean Physical Therapy
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• 제19권4호
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• pp.43-51
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• 2007

Purpose: The purpose of this study was to determine the effects on improvement of the range of motion in the TM joint. Methods: 26 subjects who have TM joint limitation were divided to passive movement group(n=13, $21.3{\pm}2.95$ years) and active movement group(n=13, $20.62{\pm}1.39$ years). All of the subjects were treated 5 to 10 minutes per one time, five times once a week for 4 weeks by the physical therapist. The open bite and cross bite were investigated at before, during(2 wks) and treatment(4 wks). Results: In order to assure the statistical significance of the result, a Repeated measures ANOVA were applied at the 0.05 level of the significance. There was a significant difference in terms of the rates of open bite mean change in within-open bite effects among pre-test, post-test 2weeks and post-test 4weeks in each group(P=0.029). There was no significant difference in the rates of mean change in between-open bite effects(P=0.441) but interactions between two types of effects(P=0.025) were statistical significance among pre-test, post-test 2 weeks and post-test 4 weeks in each group. There was no significant difference in the rates of mean change in within-close bite effects(P=0.112), between-cross bite(P=0.179) and interactions between the two types of effects(P=0.098) among pre-test, post-test 2 weeks and post-test 4 weeks in each group. Conclusion: The results of this study showed that passive movement and active movement were effect on increase of TM joint ROM about open bite and cross bite.

• 대한핵의학회지
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• 제31권3호
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• pp.388-394
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• 1997

악관절 동통은 여러 가지 원인에 의해 발생하는 것으로서 동통을 호소하는 환자에서 Bone SPECT의 유용성을 알아보았다. 악관절 동통을 호소하여 Bone SPECT를 시행한 34명을 대상으로 하였으며 모든 환자에서 단순 촬영, planar 골스캔, Bone SPECT를 시행하였다. Bone SPECT에서 동위원소의 섭취 증가 정도에 따라 3가지로 분류하였다. Grade 0은 정상, Grade I은 후두골과 비슷한 섭취 증가, Grade II는 상악동과 비슷한 섭취 증가가 있는 것으로 정하여 각각 섭취 증가 정도에 따라 환자의 임상 증상과 치료 방법을 비교 분석했다. 34예중 27예 (80%)에서 악관절 Bone SPECT 시행시 섭취 증가가 있었고, 이중 21예 (78%)에서 하악과두에 섭취 증가가 있었고 나머지 6예 (22%)에서 하악궁과 상악궁에 섭취가 있었는데 이들은 치주질환으로 확인되었다. 총 34예중 Grade 0인 7예 (20%)에서는 관절 잡음이 3예 있었고 4예에서 약물 치료로 증상이 호전되었고 나머지 3예에서 치료 없이 증상이 호전되었다. Grade I 인 4예(12%)에서는 관절잡음이 3예 있었고 모두 약뭍 치료로 증상이 호전되었다. Grade II 23예(68%)중 관절 잡음은 7예 있었고 14예에서 약물치료 및 관절천자와 같은 감압술을 병행하여 증상이 호전되었다. 6예에서는 치주 치료로 증상이 호전되었다. 총 34예중 평면 골스캔에서는 11예(32%)에서 섭취 증가가 있었다. 단순 촬영에서는 16예(47%)에서 관절내강 협소 혹은 팽대, 골리란, 관절운동 제한 등이 관찰되었다. one SPECT는 악관절 동통 환자에서 유용하게 사용할 수 있는 진단적 방법이며, 치료방법을 결정하는 데 도움이 되었다. 동위원소 섭취 증가가 많을 수록 환자 치료에 보다 적극적인 치료를 필요로 하였으나 임상 증상과 동위원소 섭취증가는 밀접한 관계는 없었다.

• Journal of Oral Medicine and Pain
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• 제18권2호
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• pp.43-53
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• 1993

The aim of this study was to investigate the relationship between the presence or absence of anterior tooth contact and the changes in temporomandibular joint space. The study sample consisted of 32symptom-free dental students and 79 craniomandibular disorders patients with unilateral joint dysfunction. The two groups were categorized into control group or experimental group, respectively. Recordings of the number and distribution of occlusal contacts were made by T-Scan system. Transcranial radiographs were taken with using of accurad-100 head positioner. Measured items in transcranial radiographs were anterior, superior, posterior joint space and relative condylar position to deepest position of glenoid folla. According to the presence or absence of anterior tooth contact, each group was subdivided and compared with each other with respect to TM joint space. Data were processed and tested with SPSS/PC + package. The results of the study showed that the joint space in control group were wider than those of experimental group and the difference of the width of joint space was more remarkable in subjects with anterior contact between control group and experimental group. However, in same group whether the presence of anterior tooth contact could hardly affect the difference of the width of joint space. And anterior tooth contact in grouip are more frequent than in experimental group.

• 한국콘텐츠학회논문지
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• 제18권7호
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• pp.628-634
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• 2018

턱관절 디스크 검사 시 MRI는 유용한 검사법으로 디스크의 정확한 위치변화를 관찰하고자 개구상태에서 오랜 시간 검사가 필요하다. 이에 3D프린팅 기술을 이용하여 개구상태를 유지시켜 줄 고정 장치(TMJ device)를 제작하고 이를 기존 고정 장치와 비교하여 유용성을 평가하고자 하였다. 기존 TMJ device를 사용한 영상에 비해 3D 프린터로 자체 제작한 TMJ device를 사용한 영상에서 SNR이 다소 낮은 결과를 보였지만 임상적으로 사용하는데 큰 결함이 없고 환자 개인별 특화된 맞춤형 제작이 가능하고 더불어 3D 프린팅 기술을 활용하여 유사도구 제작에 기여함으로서 비용대비 편익이 상승될 것이라 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.221-225
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• 1989

Arthrography is one of highly accurate diagnostic tools for internal derangements of the temporomandibular joint (TMJ). Both TM joints are connected by the mandible and one may have influence upon the other. We performed bilateral TMJ arthrograms in 42 patients with TMJ disorders to evaluate the bilaterality of internal derangements of the TMJ. The results were as follows : 1. We could not find any specificity in clinical symptoms according to each state of internal derangements of the TMJ. 2. The bilaterality of internal derangements of the TMJ was 61%. 3. Statistically, significant correlation was found in the aspects of the presence of arthrographic abnormality in both TMJ and each state of internal derangements in them. Therefore, the patients, who are diagnosed as any internal derangement of the TMJ, need to have assured examination in the contralateral joint.

• Journal of Oral Medicine and Pain
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• 제24권4호
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• pp.439-453
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• 1999

This study was performed to investigate the masicatory efficiency in patients with temporomandibular disorders (TMDs), especially internal derangement of temporomandibular (TM) joint. For this study, 26 patients after treatment and 33 dental students who had no signs and symptoms of TMDs were selected as the patients group and as the normal group, respectively. Mean treatment duration of the patients was. 5.1 months. Verbal rating scale(VRS) and Visual analogue scale(VAS) were used for recording of subjective symptoms. Treatment index (VAS Ti) derived from VAS was calculated for evaluation of treatment progress and clinical examination was also performed for objective symptoms. BioEGN(Bioresearch Inc., Milwaukee, USA) was used for observation chewing movement pattern on peanut, caramel candy, and gum chewing. Chewing time in second and symptoms after chewing were recorded, and pattern of chewing stroke between in affected side and in contralateral side or between in right in left side were compared, and especially, gum chewing pattern between before and after treatment were also compared in the patients group. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. Subjective symptoms evaluated by VAS showed no difference between the two groups, but those by VRS showed slight difference for TM joint pain, head not neck symptoms, and chewing ability. 2. There were no difference at the level of subjective symptoms between the subgroups divided by treatment duration of five months in the patients group. However, value of VAS Ti of pain was higher in subgroup of long treatment duration than that of subgroup of short treatment duration. 3. There were no difference in chewing time for peanut or caramel candy between the two groups, but on caramel candy chewing, the patients group complained slight discomfort after swallowing. Chewing velocity and range of motion on gum chewing after treatment in the patients group showed significant difference and greatly improved compared to those to before treatment, and which were not differ from those of normal subjects. In conclusion, treatment of temporomandibular disorders about for five months would greatly improve chewing ability and movement pattern in most of the patients with TMDs.