• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.140-145
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• 2015

Purpose: Bruxism is commonly considered a major risk factor for temporomandibular disorders (TMD), and the psychosocial factors had been one of the etiologic factor of bruxism. But there are still unsolved issues on the relationship between sleep bruxism and TMD and the etiologic factors of bruxism. This study is aim to evaluate the clinical and psychosocial characteristics according to diagnostic grade of bruxism in TMD patients. Methods: Three hundred subjects were enrolled who were under the stabilization splint therapy for TMD. Recently international consensus proposed a diagnostic grading system of "possible", "probable", and "definite" sleep or awake bruxism for clinical and research purpose. According to their suggestion, we classified these subjects as self-reported bruxism (SRB) and wear facet bruxism (WFB). We investigated the clinical characteristics (sex, age, chief complaint, pain duration, visual analogue scale), sum of tenderness (temporomandibular joint, masticatory muscles, cervical muscles), diagnosis of TMD according to research diagnostic criteria (the Research Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD), headache, subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), and psychosocial characteristics (Symptom Checklist-90-Revised, SCL-90-R) in enrolled subjects. We compared the clinical and psychosocial characteristics between these bruxism groups. Results: There were no significant correlation between self-reported and WFB (p=0.13). SRB subjects more reported pain as a chief complain than subject who did not report bruxism (p=0.014). The mean score of global PSQI was significantly higher in SRB than in did not report positively subjects (p=0.045). The mean score of anxiety and phobic anxiety was significantly higher in SRB than in did not reported positively subjects (p=0.045, p=0.041). Conclusions: Although bruxism is regarded as risk factor of TMD, this study showed inconsistent result between SRB and clinically detected bruxism by wear facet on slpint. We suggest that the clinician should consider with extreme caution when they assess SRB.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.1
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• pp.43-57
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• 2005

Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory nuscles, and associated structures. There have been many different contributing factors of TMDs which were traumatic, occlusal, pathophysiological and psychosocial. Among there factors, the effect of occlusion on TMDs have been a controversy for a long time. The purpose of this study was to investigate the effect of occlusal factors and oral habits on TMDs. In this study, 140 subjects with signs and symptoms of TMDs and diagnosed of TMD in the Orofacial Pain clinic of Yonsei University Dental Hospital though March to July 2004 were selected for the TMDs group and 50 subjects without any signs and symptoms of TMDs as the control group. The subjects were evaluated clinically in TMDs' Occlusal and Prosthodontic Restoration examinations. TMDs' examination was composed of the TMJ pain, sound, locking, temporal or masseter muscle palpation, mandibular movement, oral habits and headache. Occlusal examination was made of overjet, overbite, lost teeth number, nonfunctional interference, midline shift, then pattern of lateral movement and attrition. prosthodontic restoration examination had the existence of restoration, placement, then number of crown or bridge and Satisfiable index which estimated the quality of occlusal state of prosthodontic restorations. Following results were obtained : 1. The prevalence of TMDs was higher in their 20s & 30s, female of the TMD patients group. 2. The clenching frequency in the TMDs group(40.71%) was higher than those in the control group(18.00%), and there was a significant statistical difference(p<0.05). 3. The frequency of Nonfunctional interference in the TMDs group(10.00%) was higher than those in then Control group(2.00%), and there was a significant statistical difference(p<0.05). The result of this study indicated TMDs prevalence was higher in their 20s, 30s, female group of TMDs patients similar to the previous studies. Clenching and nonfunctional interference were estimated as the contributing factors of TMDs.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.35-40
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• 2016

Purpose: This study aimed to investigate the characteristics of the symptoms of temporomandibular disorders (TMD) in Korean children and adolescents using representative samples and questionnaires. Methods: A survey involving the interview of 10-, 12-, and 15-year-old children and adolescents regarding the symptoms of TMD was conducted as a part of the 2010 National Oral Health Surveys. The study population included 18,112 subjects (male, 9,734; female, 8,378). The interview involved three questions related to the symptoms of TMD. The prevalence of symptoms of TMD, correlation of the symptoms with sex and age, and the difference in the number of symptoms according to sex and age were analyzed. Results: Among the symptoms of TMD in children and adolescents, the prevalence of temporomandibular joint (TMJ) sounds during mouth opening was 13.0%, while those of TMJ pain and limitation were 3.1% and 4.3%, respectively. While the prevalence of TMJ sounds during mouth opening did not show any statistically significant difference between the sexes, the rates of prevalence of TMJ pain and limitation of mouth opening in were higher in the female subjects than the male (p<0.05). It was also observed that the older the subjects, the higher the prevalence of TMJ sounds, TMJ pain, and limitation of mouth opening (p<0.05). The number of symptoms of TMD was found to be increased among female subjects as well as the older ones (p<0.05). Conclusions: There are variations in the prevalence of symptoms of TMD among Korean children and adolescents according to sex and age, which is consistent with the results of previous studies. It is necessary to conduct a national cohort study to evaluate the risk factors for TMD in children and adolescents.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.155-169
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• 1998

The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed on eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows; 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41 ％, 54％, 5％ of total cases in this study, respectively. 2. The third decade(65％) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent ( 61 ％) in this study. In joint sound, click(63％) was the most frequent in disc displacement with reduction group, but sound history(42％) and no sound (31 ％) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44mm, 32.9mm, 44mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 53％, 79％, 40％, and the trauma history of each group was 50％, 40％,60％.

• Physical Therapy Korea
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• v.26 no.1
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• pp.28-36
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• 2019

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.125-130
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• 2018

Purpose: The etiology of temporomandibular disorders (TMDs) is complex and multifactorial including trauma, anatomical, pathophysiological, social and psychological factors. Psychological factors can induce or sustain TMDs in various ways. And psychological problems, such as anxiety and depression can be occurred due to TMDs. Therefore, evaluation of psychological factors in patients with TMDs is important. Although disc displacement (DD) is crucial in clinical situation, most of studies have focused on the relationship of psychosocial factors and myofascial pain. And also, Subtypes of DD can cause different degrees of discomfort, it is necessary to evaluate the psychological states of the patients according to the subtype. The Hospital Anxiety Depression Scale (HADS) is one of the self-report questionnaire to evaluate the psychological factors. HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) are assessed through 14 questions. The purpose of this study was to evaluate anxiety and depression assessed by HADS in patients diagnosed with subtypes of DD according to diagnostic criteria for TMDs. Methods: Four hundred thirty nine patients were diagnosed as one of the subtypes of DD. One hundred fourty nine subjects with no symptoms were set as control groups. All of them answered the HADS for Koreans. The cut-off score for anxiety and depression was set a score of 8. The chi-square test was performed to evaluate association between DD and anxiety/depression. Results: There was a significant difference in HADS-D between five groups (p<0.01). However, there was no significant difference in HADS-A. All the DD groups showed a significant difference in HADS-D compared with the control group except the DD without reduction without limited opening group. The DD without reduction with limited opening group showed the highest rates in HADS-D (40.4%). Conclusions: Based on the above results, it is necessary to consider the depression in treatment of the patients with DDs.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.92-102
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• 2019

Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

• 대한치과보철학회:학술대회논문집
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• 1995.12a
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• pp.69-70
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• 1995

• The Journal of the Korean dental association
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• v.39 no.8 s.387
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• pp.610-621
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• 2001

• The Journal of the Korean dental association
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• v.29 no.6 s.265
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• pp.420-422
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• 1991