• 제목/요약/키워드: Temporomandibular Disorders

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Application of Diagnostic Laboratory Tests in the Field of Oral Medicine: A Narrative Review

  • Ji Woon, Park;Yeong-Gwan, Im
    • Journal of Korean Dental Science
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    • 제15권2호
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    • pp.101-111
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    • 2022
  • The purpose of laboratory tests in the field of oral medicine can be divided into two categories: (1) medical evaluation of patients with systemic diseases that are planning to receive dental care and (2) diagnosis of patients with certain oral diseases. First, laboratory tests are commonly used to evaluate patients with systemic diseases who need dental management. A combination of multiple tests is usually prescribed as a test panel to diagnose and assess a specific disease. Test panels closely related to oral medicine include those for rheumatoid arthritis, connective tissue disease/lupus, liver function, thyroid screening, anemia, and bleeding disorders. Second, laboratory tests are used as auxiliary diagnostic methods for certain oral diseases. They often provide crucial diagnostic information for infectious diseases caused by bacteria, fungi, and viruses that are associated with pathology in the oral and maxillofacial regions. Laboratory tests for infectious diseases are composed of growth-dependent methods, immunologic assays, and molecular biology. As the field develops, further application of laboratory tests, including synovial fluid analysis in temporomandibular joint disorders, salivary diagnostics, and hematologic biomarkers associated with temporomandibular disorders and orofacial pain conditions, is currently under scrutiny for their reliability as diagnostic tools.

일부 남자 고등학생의 측두하악장애 관련 증상의 유병률과 구강악습관 및 컴퓨터 이용시간과의 관계 연구 (Relationship between the prevalence of temporomandibular joint disorders in some male high school students and computer utilization)

  • 박의정;윤영주
    • 한국치위생학회지
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    • 제13권4호
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    • pp.651-657
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    • 2013
  • Objectives : The purpose of the study is to verify the correlation between teenagers' use of internet and temporomandibular joint disorders(TMJD) because TMJD patients gradually increase in high school students. Methods : Subjects were 221 male high school students attending liberal arts and commercial schools from 9 to 21 of April, 2012. Students completed self-reported questionnaire. Results : TMJD symptoms included crackling joint (32.1%), headache (18.6%), malocclusion (8.1%), and jaw fatigue and muscular aching (7.2%). Students having at least one symptom accounted for 49.8%. Students having at least one poor habit accounted for 83.7% and 34.0% of the students used internet for 3 hours.. Score of students experiencing shoulders and chest pain was $5.13{\pm}1.10$ (p<0.05). Score of TMD afflicting area revealed $4.67{\pm}2.73$ (p<0.05) in mastication pain ($4.13{\pm}2.73$ (p<0.05)) due to long hours of internet use. Score of jaw fatigue related to muscular pain was $4.31{\pm}1.96$ (p<0.01). Duration of computer use was related to perceived TMJD symptoms (r=.153). Long duration of computer use was related to poor oral cavity habits (r=.157). Conclusions : Male high school students can perceive slight TMD which needs self management and regular check-ups and try to prevent TMD by utilizing measurement tools on TMD. Also, this study helps to prevent from worsening TMD by shortening hours of computer utilization.

측두하악장애환자의 임상양태와 치료결과와의 관계 (Relations between Clinical Findings and Treatment Results in Patients with Temporomandibular Disorders)

  • Hee-Young Oh;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • 제20권2호
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    • pp.407-420
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    • 1995
  • This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

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측두하악장애환자에서 하악의 편심운동재현성에 관한 연구 (Reproducibility of Mandibular Eccentric Movements in Patients with Temporomandibular Disorders)

  • 서명석;한경수
    • Journal of Oral Medicine and Pain
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    • 제22권2호
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    • pp.295-307
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    • 1997
  • This study was performed to investigate the reproductibility of eccentric mandibular movements according to preferred chewing side, range of mouth opening, type of lateral guidance and involvement of temporomandibular disorders. 50 patients with temporomandibular disorders and 65 dental students without any signs and symptoms were randomly selected for this study as the patients group and the control group, respectively. For recording and observation of eccentric mandibular movement trajectory, BioEGN$^\textregistered$ of Biopak$^\textregistered$ system (Bioresearch Inc., USA) was used. Each eccentric movement to anterior, right and left side was performed three times similar to the movement pattern for Pantronic Reproducibility Index. mandibular path was analyzed by three dimensional positional change and the three paths from one direction were compared with one another. From this, reproducibility index of one-directional lateral movement could be calculated, and total reproducibility index, named BioEGN reproducibility index(BERI), was also computed from three-directional eccentric movement likewise. BioEGN reproducibility Index could have four value of score by small or large scale, and by outgoing or incoming movement. The data were analyzed by SAS/stat program and the results obtained were as follows: 1. Right side chewing subjects showed more consistent pattern In reproducibility index in comparison between patients group and control group than left chewing subjects have done, and reproducibility was low in patients group. However, there was no difference between the two stoups in bilateral chewing subjects. 2. There were no difference in reproducibility index between preferred chewing side and contralateral side in unilateral chewing subjects whereas reproducibility index in left side on outgoing movement were higher than in right side in bilateral chewing subjects. 3. Difference in total reproducibility index(BERI) between canine guidance group and non-canine guidance group were not observed though difference in reproducibility index on lateral movement were observed in part. 4. There were no difference in reproducibility index between affected side and contralateral side in unilaterally affected patients, and between unilaterally affected patients and bilaterally affected patients in patients group. 5. Highly significant positive correlationship were shown among the four 쇼pes of total reproducibility index(BERI) in total subjects, and range of clinical mouth opening was negatively correlated with BEBI on outgoing movements and with index on outgoing movement to preferred side.

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Relationship between stress levels and treatment in patients with temporomandibular disorders

  • Yoon, Hyung-Jun;Lee, Sung-Hee;Hur, Jun-Young;Kim, Hye-Sun;Seok, Jeong-Ho;Kim, Hyung-Gon;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권6호
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    • pp.326-331
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    • 2012
  • Objectives: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. Materials and Methods: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. Results: The high-risk group (PWI-SF${\geq}27$, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. Conclusion: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.

Anterior open bite with temporomandibular disorders treated with intermaxillary traction using skeletal anchorage system

  • Kim, Hye-Sun;Lee, Sang-Hoon;Youn, Taegyun;Kim, Hyung-Gon;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.284-294
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    • 2012
  • Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.

성장기의 편측 하악 과두 골절이 하악골 성장 및 기능에 미치는 영향에 대한 연구 (The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures)

  • 상진규;이재훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권6호
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    • pp.448-456
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    • 2011
  • Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

턱관절원판 전방 변위로 인한 개구 장애의 템플레이트 치료 (Template therapy for mouth opening limitation by temporomandibular joint disorders)

  • 이기철;신승우;표성운
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권4호
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    • pp.270-274
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    • 2010
  • Introduction: Limited mouth opening is a representative clinical symptom of temporomandibular disorders (TMD) with anterior disc displacement without reduction (ADDWOR). Various treatment methods have been proposed for patients with ADDWOR. This study examined the clinical effectiveness of template therapy for patients with mouth opening difficulty due to the ADDWOR. Material and Methods: A total of 14 patients (female 12, male 2, average age: $29.1{\pm}14.4$), who had been treated in the template clinic, Sooncheonhyang University Bucheon Hospital, from January of 2006 to December of 2008, were enrolled in this study. The subjects were selected according to the following criteria: more than 2 weeks after the onset of locking, mouth opening range <35 mm, and confirmed ADDWOR without a synovial pathology by magnetic resonance imaging (MRI). All patients were treated with the template appliance, instructed to wear it while sleeping and exercise for at least 10 hours per day. The maximum mouth opening (MMO) range and pain recognition scores before and after template therapy were recorded and compared. A paired t-test and Wilcoxon's signed rank test were used for statistical analysis. Results: After the periodical follow up, significant improvement in the opening range was observed in the template treatment group. The average MMO range before treatment was $30.2{\pm}3.5mm$ and the average MMO after treatment and follow up was $47.1{\pm}4.7mm$. The mean amount of mouth opening increment was $16.9{\pm}5.4mm$ (P<0.01) and the pain recognition scores before and after treatment was also improved.(P=0.001) Conclusion: The template appliance proved to be efficient for the treatment of TMD with a closed lock and painful joint due to ADDWOR.