• Title/Summary/Keyword: Temporomandibular(TM) Joint

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Magnetic resonance imaging-based temporomandibular joint space evaluation in tempormandibular disorders (측두하악관절증에서 자기공명영상을 이용한 측두하악관절의 관절강 평가)

  • Nah, Kyung-Soo
    • Imaging Science in Dentistry
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    • v.37 no.1
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    • pp.15-18
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    • 2007
  • Purpose : Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. Materials and Methods MRI and transcranial radiographs of both TM joints from 67 patients with temporemandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. Results. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position, 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.9%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. Conclusion : On MRT, most oi the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.

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Positional change of the condylar heads after wearing complete denture on dental cone beam CT (치과용 콘빔 CT영상에서 총의치 장착 후 하악과두의 위치변화)

  • Lee, Bong-Ho;Kim, Jae-Duk;Chung, Chae-Heon
    • Imaging Science in Dentistry
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    • v.38 no.1
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    • pp.23-27
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    • 2008
  • Purpose: The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). Materials and Methods: CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB $Mercuray^{TM}$ (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with $Vimplant2.0^{TM}$ (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. Results: The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p< 0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was $79.6{\pm}2.7^{\circ}\;and\;80.1{\pm}5.7^{\circ}$ respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. Conclusion: We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

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CONDYLAR ANKYLOSIS : UNILATERAL POSTTRAUMATIC CONDYLAR PSEUDOANKYLOSIS (악관절 과두강직 : 편측성 과두강직을 동반한 안모비대칭 치료 증례)

  • Hong, Sung-Gyu;Hong, Sung-Joon
    • The korean journal of orthodontics
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    • v.23 no.3 s.42
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    • pp.427-445
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    • 1993
  • The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

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A Study on the Mandibular Rotational Movement using Biopak Sysytem (BIOPAK을 이용한 하악의 회전운동에 관한 연구)

  • Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.193-203
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    • 1994
  • The author performed this study for investigation of the magnitude of mandibular positional change caused by joint sound during mandibular opening and closing movement. There have been many studies stated mandibular border movement or other functional movement, and there also have been many studies reported clicking sound related to mandibular movement speed, trajectory and clinicl course of temporomandibular disorders(TMDs), but there have not been so many studies stated spatial mandibular position accompanied by joint sound. For this study 46 TM joint from the patients with TMDs were used and they were compared by character and occuring phase of the joint sound. Synchronized data which were amplitude and frequency of joint sound and amount of mandibular positional change were collected through sonopak and BioEGN rotate of Biopak system, respectively. Mandibular position was analyzed for translational and rotational movement change between before and after joint sound. The obtained data were processed with SAS program and summary of this paper were as follows : 1. Mean value of the amount of translational movement in whole joints were 6.0mm in vertical direction, 3.3mm in anteroposterior direction and 0.8mm in lateral direction between before and after joint sound. 2. Mean value of the amount of translational movement in clicking joinnts showed slightly increased tendency than in popping joints. 3. The amount of mandibular change in translational movement during closing phase were more than during opening phase. 4. The amount of mandibular rotational change in whole joints were $1.1^{\circ}$, 1.0mm in frontal plane and $0.9^{\circ}$, and 0.8mm in horizontal plane. 5. The amount of rotational movement were more in clicking joints than in popping joints and were more during closing phase than during opening phase, but statistically significance were showed only in frontal plane.

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A Pantographic Study on the Mandibular Movements in Patients with Temporomandibular Joint Sounds (Pantograph를 이용한 악관절잡음자의 하악운동에 관한 연구)

  • Lee, Pung Ho;Han, Kyung Soo
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.85-93
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    • 1987
  • The author studied on the effect of TMJ sounds to the patterns and ranges of mandibular border movements in horizontal plane with Pantograph (Denar Corp.). For study, 19 patients with TMJ sounds only and 16 students with no TM disorder were selected and classified as experimental group and control group, respectively. The subject performed right lateral movement, left lateral movement, and forward movement. Each movement were performed 3 times and the movement trajectory obtained with mechanical pantograph were observed for accordance of centric relation position, reproducibility and/or restriction of lateral movement paths, deviation of protrusive path in anterior table, restriction of protrusive condylar movement path in posterior horizontal table, presence of Fisher angle in posterior vertical table. And pantographic reproducibility Index (PRI) were obtained with pantronic by the same movement method as in the mechanical pantograph record. The obtained results were as follows : 1. In experimental group, PRI scores in those who show accordance of centric relation position were 14.4, and were 26.53 in those who did not show accordance of centric relation position. However, the PRI scores of the two subgroups show no statistically significant difference in control group. Therefore, in experimental group, the capability of accordance of centric relation position affected largely the PRI scores than in control group. 2. Deviation of protrusive path was opposite to the affected side in experimental group, and was left side in control group. 3. Restriction side of condylar movement in protrusion was ipsilateral to the deviation side in experimental group, but in control group, restriction side was not related to the deviation side. 4. PRI scores in experimental group were 23.2 (moderate dysfunction category), and in control group, were 17.8 (slight dysfunction category). The PRI scores in control group, however, implies that the evaluation of temporomandibular disorders by the PRI scores only may be unreasonable.

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Electromyographic Activity, Firing Time and Sequence of the Anterior Temporalis and the Masseter on Chewing Stroke (저작운동시 전측두근과 교근의 근활성 및 활성시기에 관한 연구)

  • Her, Moon-Il;Han, Kyung-Soo
    • Journal of Oral Medicine and Pain
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    • v.24 no.4
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    • pp.421-437
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    • 1999
  • This study was performed to investigate the electromyographic(EMG) activity, firing time and sequence of the mandibular elevator muscle on gum chewing. For this study, 28 patients with temporomandibular disorders(TMD), especially internal derangement of TM joint, and 16 dental students without any signs and symptoms in the masticatory system were selected as the patients group and as the normal group, respectively. The patients group was composed of 14 right and 14 left side affected patients. For recording of EMG activity(${\mu}V$) of the anterior temporalis(TA) and the masseter muscle(MM), and measuring of firing time(millisecond) from the start of mandibular opening movement to the firing of the muscles, BioEMG, BioEGN, and Combo program integrated in the Biopak system(Bioresearch Inc., Milwaukee, USA) were used. Gum chewing stroke was performed in both right and left side for several times, and the first and the second chewing strokes were analysed and compared with regard to EMG activity, firing time, firing sequence, correlation between EMG activity and firing time. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In the patients group, chewing on the affected side showed higher EMG activities in the masseter of the side than those of the contralateral side, but chewing on the unaffected side showed higher EMG activity in the masseter and in the anterior temporalis of the side than those of the contralateral side. 2. There were no difference of firing time between both sides on chewing on the affected side, but firing time in the chewing side were earlier than that of contralateral side on chewing on the unaffected side in patients group. 3. In the normal group, EMG activities in the masseter and in the anterior temporalis in the chewing side were always higher than those of the contralateral side, and there were no difference of firing time between the two sides. 4. In general, firing sequence of four muscles of both sides were ipsilateral TA, ipsilateral MM, contralateral TA, and contralateral MM in earlier order of time in both groups. Correlation coefficients between EMG activity and firing time were negative value, and more significant correlation were appeared in the normal group than in the patients group.

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