• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권1호
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• pp.35-42
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• 2003

Purpose: This study was aimed to investigate the relationship between the mandibular asymmetry and the internal derangement of temporomandibular joint. Materials and methods: One hundred and sixty eight patients had been assessed through clinical examinations, panoramic radiographs and magnetic resonance imagings (MRIs), were selected. The samples were classified into three subgroups according to the severity of the mandibular asymmetries in the panoramic radiographs and the status of TMJ discs on the MRI were compared among each groups. Results: In an apparent asymmetry group, there was a significant difference in the number of temporomandibular disk displacement without reduction between the long and short side (66.7%, 18/27 joints on the short side) when the ratio of condylar process and coronoid process was used (p<0.05), but there was no statistically significant difference when the ratio of condyle and ramus was used. Conclusion: The probability of the disc displacement without reduction was higher at the side with relatively shorter condylar process on the panoramic radiograph, and also it might be more effective to use ratio of condylar process and coronoid process in the assessment of mandibular asymmetry. Therefore, a careful assessment on the temporomandibular disorders is necessary to diagnose and establish the treatment plans for the patients with a mandibular asymmetry and the panoramic radiograph can be used effectively on that way.

• 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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• 제27권1호
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• pp.55-65
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• 2005

Most patients with temporomandibular disorder can be treated conservatively. However, open TMJ surgery can be needed in some patients. We analysed the patients with TMD which open surgery has performed since 1998. Open surgery was carried out in 8 patients. Age ranged from 22 to 61 years, with a mean of 42.8years. All patients were male. Final diagnosis was obtained based upon clinical, radiographic and operative finding as follows; habitual luxation, bony ankylosis, traumatic arthritis, disc displacement with destructive change, disc displacement and adhesion. Etiologic factors included trauma(4), infection(2), and unknown(2). Open surgery included arthroplasty with either of condylectomy, eminectomy, meniscoplasty, capsurrohaphy. All patients were recovered uneventfully without severe complications. Some mouth opening limitation and mouth opening deviation remained. Postoperative aggressive physical therapy and careful follow up were performed. In conclusion, open TMJ surgery must be considered in organic disease such as ankylosis, tumor and TMD without favorable recovery after long-term conservative therapy.

• Journal of Yeungnam Medical Science
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• 제12권1호
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• pp.141-148
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• 1995

본 교실에서는 측두하악관절주위의 동통, 관절 잡음동의 증상을 주소로 내원한 환자들에 있어서 역동적 자기공명영상의 촬영을 시행하여 관절원판의 전방변위와 형태적 이상 및 주위 구조물들과의 관계를 분석한 결과 근육성 동통기능장애와의 감별뿐만 아니라 환자의 중상에 따른 관절 내부 장애의 정도를 파악할 수 있었으며 악기능시의 구조적 이상, 장애의 원인 등을 판독하여 치료의 방침을 세우는데 있어 매우 유용한 정보를 얻을 수 있었기에 보고 하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.191-196
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• 2000

Purpose This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. Patients and Methods The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. Results The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. Conclusion The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권1호
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• pp.97-104
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• 2000

The temporomandibular joint arthrocentesis is indicated the 'closed lock' due to anterior disc displacement without reduction. It can be easily carried out under local anesthesia with little complications. We performed arthrocentesis to the 24 patients, 9 patients who suffered from acute or chronic closed lock with anterior disc displacement, 2 patients from temporomandibular joint dysfunction related to systemic disease and 13 patients from joint dysfunction with pain. We present the common clinical aspect of arthrocentesis that operator can be easily faced with and possible modifications of this method.

• Imaging Science in Dentistry
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• 제36권1호
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• pp.17-24
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• 2006

Purpose : The objective of this study was to investigate the effect of TMJ disc displacement on the TMJ disc configuration and surrounding osseous structure. Materials and Methods : The proton density and 72-weighted MR images of 57 TMJs were retrospectively studied. These TMJs were divided into three groups according to the anterior disc displacement status on MR sagittal images, those were the normal, anterior disc displacement with reduction (ADWR), anterior disc displacement without reduction (ADWOR). The frequency of disc configuration and surrounding bony change, the border status between articular disc and retrodiscal tissue were investigated according to the positional change of articular disc. Results : There were significant statistical differences of chi-square statistics of TMJ disc configurational type between normal and ADWR/ADWOR group, respectively. Surrounding bony change frequently appeared in ADWOR and a statistically significant difference of chi-square statistics of bony change frequency between normal and ADWOR group was observed. Conclusion : These results suggested that the disc configuration and bony change of TMJ are strongly related to TMJ disc displacement.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.412-420
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• 2013

The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.227-230
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• 2016

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.