• The Journal of the Korean dental association
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• v.58 no.6
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• pp.364-376
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• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

• Journal of Korean Dental Science
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• v.8 no.1
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• pp.16-27
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• 2015

Purpose: The purpose of this study was to evaluate the correlation between the clinical symptoms of temporomandibular disorder and findings in the magnetic resonance imaging (MRI). Materials and Methods: Clinical data and MRI images were collected from a total of 240 German patients. Clinical symptoms were briefed as joint clicking, crepitus and pain. MRI findings were further defined according to the condyle position, condyle degeneration, disc positon, disc degeneration and the presence of osteophyte/sclerosis/synovitis. Hypermobility was separately recorded. Correlation analysis between parameters was performed. Result: Joint clicking had a positive correlation with unilateral disc degeneration, osteophyte, sclerosis and synovitis. Crepitus had a significant correlation with bilateral osteophyte. Pain was not correlated with any MRI findings except hypermobility. Conclusion: Selective correlations between the MRI findings and clinical symptoms were elucidated. The results of this study imply that condyle-disc deformities could be advanced without pain, and that joint clicking and crepitus could be clinical symptoms of condyle-disc degeneration.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.199-208
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• 2010

Objectives : To study the cervical lordosis and roentgenographic analysis of cervical disc space in neck pain with or without temporomandibular disorder(TMD). Methods : Radiographic measures of cervical lordosis, cervical disc space narrowing were collected, statiscally analyzed. Results : TMD group showed a significant increase in cervical lordotic angle as compared with non-TMD group, whereas no significant change in cervical disc degeneration. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's TMD.

• Journal of Oral Medicine and Pain
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• v.49 no.2
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• pp.29-34
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• 2024

Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

• Journal of Oral Medicine and Pain
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• v.44 no.4
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• pp.189-194
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• 2019

Perforation of articular disc of temporomandibular joint is a unusual condition and diagnosed through magnetic resonance imaging (MRI), arthrography or arthroscopic surgery. We attempted to investigate the suspicious findings of articular disc perforation through examination commonly used in temporomandibular disorder (TMD) patients. We retrospectively analyzed the clinical and imaging findings of five TMD patients whose articular discs were perforated based on MRI. The most meaningful finding was the abnormal width of the joint space in cone-beam computed tomography. Thus, the clinician should perform a thorough assessment of the joint space in TMD patients and conduct additional investigation to determine what caused the abnormal joint space.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.149-159
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• 2013

The purpose of this study was to investigate the relationship between horizontal morphology of lateral pterygoid muscle and onset of temporomandibular joint disorders. Randomly selected 150 subjects, assigned with equal number in terms of gender and age group, were included. The axial and sagittal images in their magnetic resonance images of the temporomandibular joints were used to measure the morphologic characteristics of lateral pterygoid muscles and temporomandibular joints. The measurement variables were maximal horizontal width and insertion angle to the condyle, position of the articular disc, condylar deformity, and joint effusion. In addition, presence or absence of the temporomandibular joint pain was examined through history and palpation of the joints. The relationships among measurement variables were analyzed and the results were as follow. The insertion angle of the lateral pterygoid muscle to the condyle was higher in the joint of anterior disc displacement without reduction than that in the joint of normal disc position. In addition, the maximal horizontal width of the lateral pterygoid muscle was significantly increased in joints with pain than those without pain. Also, the insertion angle was significantly higher in younger age group and the maximal width was significantly greater in male than in female. These results suggest that high insertion angle of lateral pterygoid muscle might be an important anatomic predisposing factor for anterior disc displacement in temporomandibular joint and muscular activity of lateral pterygoid muscle might be affected by preauricular pain. In conclusion, there might be a bi-directional interaction between lateral pterygoid muscle and joint in the progression of anterior disc displacement in temporomandibular joint.

• Imaging Science in Dentistry
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• v.43 no.4
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• pp.245-251
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• 2013

Purpose: This study was performed to evaluate the relationship between anterior disc displacement and effusion in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI). Materials and Methods: The study subjects included 253 TMD patients. MRI examinations were performed using a 1.5 T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the MRI findings, temporomandibular joint (TMJ) disc positions were divided into 3 subgroups: normal, anterior disc displacement with reduction (DWR), and anterior disc displacement without reduction (DWOR). The cases of effusion were divided into 4 groups: normal, mild (E1), moderate (E2), and marked effusion (E3). Statistical analysis was made by the Fisher's exact test using SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results: The subjects consisted of 62 males and 191 females with a mean age of 28.5 years. Of the 253 patients, T1- and T2-weighted images revealed 34 (13.4%) normal, DWR in 103 (40.7%), and DWOR in 116 (45.9%) on the right side and 37 (14.6%) normal, DWR in 94 (37.2%), and DWOR in 122 (48.2%) joints on the left side. Also, T2-images revealed 82 (32.4%) normal, 78 (30.8%) E1, 51 (20.2%) E2, and 42 (16.6%) E3 joints on the right side and 79 (31.2%) normal, 85 (33.6%) E1, 57 (22.5%) E2, and 32 (12.7%) E3 on the left side. There was no difference between the right and left side. Conclusion: Anterior disc displacement was not related to the MRI findings of effusion in TMD patients (P>0.05).

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.142-146
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• 2018

Patients with temporomandibular disorder often present with acute occlusal change and properly managed with conservative treatment. If such change is caused by unusual etiology, differential diagnosis may be challenged. This article describes the diagnosis of a patient exhibiting pain and acute posterior open bite on the ipsilateral side after chewing hard food. After initial conservative treatment failed to resolve the complaint, magnetic resonance imaging was ordered and confirmed partial perforation of articular disc. Disc perforation itself is usually chronic in nature, but sudden macrotrauma may also cause the disorder. However, occlusal discrepancy caused by disc perforation is rare and seldom reported. We present a case of acute malocclusion caused by disc perforation with a review of related literature.

• The Journal of the Korean dental association
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• v.57 no.4
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• pp.204-212
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• 2019

Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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• pp.173-179
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• 2012

Purpose: This study was to determine the effects of surgical induction of anterior disc displacement (ADD) on the distribution of glycosaminoglycan (GAG) and collagen fiber arrangement in the rabbit temporomandibular joint (TMJ) tissues including articular cartilage of condyle, disc, retrodiscal tissue, and articular eminence. Methods: We used van Gieson staining and Alcian blue critical electrolyte concentration (CEC) method to observe change of collagen fibers on disc and to measure GAG up to 10 weeks in TMJ tissues after surgical induction of ADD on 25 rabbits. Results: CEC measurements for GAG showed 0.3 M, 0.4 M, 0.6 M, and 0.8 M at 1 week, 2 weeks, 3, 4, and 8 weeks, 10 weeks, respectively. This result indicated that GAGs shifted to highly sulphated ones as time passed. Disruption of collagen fiber arrangement in the disk occurred at 10 days and aggravated at 3 weeks. Conclusion: Our study showed degenerative osteoarthritis changes in rabbit TMJ following surgical induction of ADD up to 10-week period.