• The Journal of Korean Physical Therapy
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• 제34권6호
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• pp.321-325
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• 2022

Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p<0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p<0.05), but ankle sways were not different between group. Conclusion: We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.

• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.161-168
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• 2016

Purpose: Patients who suffer from rheumatic arthritis, fibromyalgia, other various inflammatory diseases and musculoskeletal disorders, which are all similar to temporomandibular disorders (TMD), have been complaining about changes in the level and type of pain in response to changes in weather conditions for a long time. Through an investigation about pain perception in TMD patients in response to weather conditions, our primary objective was to develop base materials for future studies on change in pain in response to meteorological factors. Methods: Among patients who presented with TMD to Department of Oral Medicine, Pusan National University Dental Hospital from August to October 2016, one hundred consecutive TMD patients diagnosed with TMDs according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were recruited for the study and 28 patients were excluded according to exclusion criteria. Survey was done with the questionnaire and investigated whether there was any difference in incidence and level of pain in TMD patients between non-rainy and rainy days. Results: Among a total of 72 samples, 4 patients reported change in pain on rainy days rather than non-rainy days. Two patients from chronic group (joint and complex subgroup) reported increased pain on rainy days rather than non-rainy days but it was not statistically significant (p>0.05). One patient from chronic/muscle group reported the change in pain characteristics while pain intensity remained unchanged. One patient from acute/complex group reported decreased pain intensity. In comparison of the patients who reported increased pain on rainy days between acute and chronic groups, there were two reported cases and were both from chronic group only. There was a significantly higher chance of reporting increased pain on rainy days in chronic group than acute group (p<0.001). Conclusions: It is considered that TMD patients couldn't perceive the change in pain well in response to weather change on rainy days but some chronic patients could perceive the increase in pain in rainy days.

• Journal of Oral Medicine and Pain
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• 제38권1호
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• pp.69-76
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• 2013

목적 : 측두하악장애 치료에서 기존의 다른 치료 방법이 동일한 경우, 초진 시에만 서면으로 된 주의사항을 보고 읽어주며 교육했을 때와 내원 시마다 자가평가 설문지를 통한 반복적 주의사항 교육을 시행했을 때의 치료효과 차이를 알아본다. 방법 : 2012년 10월부터 12월까지 부산대학교치과병원 구강내과에 내원한 측두하악장애 환자(n=62, 실험군)와 2011년 10월부터 12월까지 내원한 측두하악장애 환자(n=156, 대조군)를 대상으로 하였다. 측두하악장애로 진단된 후 내원횟수, 치료방법을 동일하게 시행한 환자를 표본으로 선정하였다. 실험군은 자가평가 설문지를 통한 반복적 주의사항 교육을 초진일, 2주 후, 4주 후 시행하였고 또한 Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS를 조사했다. 대조군은 초진 시만 주의사항 교육을 하였고, 실험군과 동일 항목을 조사하였다. 실험 군과 대조 군간의 조사항목의 1,2회 내원 시 차이와 1,3회 내원 시 차이를 전체, 연령, 성별, 골 변화 유무별로 독립표본 T검정을 시행하였다. 결과 : 반복적인 주의사항 교육으로 인한 주의사항 준수는 약물치료를 중단한 후에도 MCO개선을 유지 및 증가 시켰다(p=0.001). 반복적인 주의사항 교육으로 인한 주의사항 준수로 인한 MCO개선 효과는 남자에서 두드러졌으며(p=0.001) 젊은 연령에서 크게 나타났다(p=0.004) 결론: 측두하악장애 환자의 행동조절을 위한 주의사항 교육은 반복적으로 시행할수록 치료효과가 크게 나타난다.

• 치과방사선
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• 제4권1호
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• pp.45-57
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• 1974

This report based on 300 cases of serious diseases in maxillofacial region by radiograms seen at the department of dental radiodontics, infirmary school of dentistry, Kyung Hee University from October 1971 to August 1974. The maxillofacial diseases were analysed upon the following items, such as 1) the frequency of dominant diseases, 2) sex-ratio of male to female, 3) predominant region of diseases, 4) comparison with the age, 5) the incidence of diseases in relative to the individual teeth. The results were obtained as follows. 1) Among the total of 300 cases of the patients, the frequency of dominant diseases of patients were fractures of facial bone (44.3±2.87%), inflammatory diseases (22.7±2.39%), cysts (11.1±1.62%), tumors (10.7±1.77%), maxillary sinusitis (7.9±1.56%), temporomandibular joint disorders(3.3±1.05%) in the order. 2) The ex-ratio of male to female in occurence of jaw fractures were 7.3:1, temporomandibular joint disorders were 2.1:1, inflammatory diseases were 1.8:1, maxillary sinusitis were 1.7:1, but tumors were equal to 1:1, while cysts were 1:1.2 in sex difference. 3) The predominant region of mandibular fractures were symphysis(17.3±3.27%), canine region (15.0±3.09%), and angle region (14.3:±3.04%) in the order. Inflammatory diseases were occured frequently in mandible and it's left side were a little dominant. Odontogenic cysts were observed frequently in maxilla, but regardless of right and left. Carcinomas were involved most frequently in maxilla, while sarcomas and ameloblastomas in mandible. Frequency of the maxillary sinusitis were dominant right side and molar area, also temporomandibular joint disorders were right side. 4) To study comparison with the age jaw fractures showed the highest ratio at the 2nd decade(32.3±4.06%), and 3rd decade (27.8±3.89%), 4th decade (19.6±3.44%), 6th decade (9.0±2.47%), 5th decade(6.0±2.06%), 1st decade (5.3±1.95%) in the order. But 7th decade were not involved entirely. Frequency of the inflammatory diseases were the highest in the age group of 3rd decade (28.0±5.44%), and those of cysts were 5th decade (24.2±7.22%), temporomandibular joint disorders were 3rd decade (60.0±15.49%). Tumors were occured frequently over the 4th decade especially malignint tumors over the 5th decade, but maxillary sinusitis were rearless of age except for 2nd decade. 5) About the incidence of diseases in relative to individual teeth, fractures of facial bone were most frequently involved the maxillary and mandibular anterior teeth, and mandibular 3rd molar region. Cysts were maxillary anterior region inflammatory diseases were mandibular molar region maxillary sinusitis were maxillary 1st molar, region but tumors were regardless of individual teeth.

• Journal of Korean Dental Science
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• 제1권1호
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• pp.15-21
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• 2008

Purpose : This epidemiological research was conducted to investigate the relationship between the groups of TMD and the behavioral, psychological, and physical symptoms through RDC/TMD. Subjects and Methods : The subjects of this research were the 286 patients who had visited Seoul National University Bundang Hospital; their common chief complaint was temporomandibular discomfort. The mean age of the patients was 32.9 from 11 to 85, and the number of men and women was 67 and 219, respectively. The patients were examined through clinical and radiological methods and diagnosed by 1 investigator. They were divided into 3 groups: myogenous group (group 1), arthrogenous group (group 2), and combined group (group 3). The behavioral, psychological, and physical symptoms were evaluated through questionnaires on RDC/TMD. Specific items were selected to calculate the graded chronic pain (characteristic pain intensity, disability points), jaw disability, depression, and non-specific physical symptoms (pain items included/excluded) in the questionnaire. One-way ANOVA, Kruskal-Wallis test, and chi-square test were applied as statistical methods. Results : As a result of classifying temporomandibular disorder in this study, the patients were distributed as follows: 9.1% of group 1, 79.7% of group 2, and 11.2% of group 3. In the analysis of graded chronic pain (characteristic pain intensity, disability points), jaw disability, and non-specific physical symptoms (pain items included/excluded), group 3 had the highest score, and the difference was significant (p<0.001). Moreover, the depression score of group 3 was significantly higher than groups 1 and 2 (p<0.05). Note that that the second order of jaw disability score was group 2, on the other hand, those of the other groups were group 1. Conclusion : Myofascial pain could be assumed to be related closely to the behavioral, psychological, and physical symptoms except jaw disability compared to joint pain through RDC/TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• 치과방사선
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• 제20권2호
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• pp.201-210
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• 1990

The purpose of this study was to observe the relationship between mandibular asymmetry and Temporomandibular Disorders by means of the cephalometry using the posteroanterior cephalogram and the submentovertex cephalogram which were taken in 35 Temporomandibular Disorder patients and 35 normal persons ranged from 20S to 30S. The results were as follows: 1. The angulation which was formed by the median line with the ANS-Menton line (MAP) was greater in patients group and there was statistically significant difference. 2. The angulation which was formed to the median line with the Menton-Odontoid process tip line (MES), the difference of the distances from the center of the posterior surface of the both condyles to the most anterior point of the chin (DD), the difference of the distances from the center of the both condyles to the horizontal reference line (DE), the difference of the angulations which were formed by the both condyles axes with the horizontal reference line (DCE), the difference of the lengths of the both condyles (CL) and the difference of the widths of the both condyles (DW) were greater in patients group and there were statistically significant differences. There was reversed correlation between MAP and the difference of the distances from the 3. bilateral points of the lateral margin of the both zygomaticofrontal sutures to the at the lateral inferior margin of the both antegonial protuberances in mandible (DH). There was reversed correlation between MES and DD, DE, DCE. 5. There was correlation between MAP and MES.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.140-145
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• 2014

Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권3호
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• pp.120-127
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• 2018

Objectives: The aim of this study was to reveal how collagenases (matrix metalloproteinase [MMP]-1, 8, 13) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are expressed in immunohistochemistry of retrodiscal tissue in temporomandibular joint disorder patients. Materials and Methods: This study was conducted on 39 patients who underwent discoplasty or discectomy. Immunohistochemical staining was undertaken and expression levels of MMP-1, 8, 13, and TIMP-1 were evaluated. The status of internal derangement of disc, osteoarthritis, and joint effusion were analyzed using magnetic resonance imaging (MRI). Disc status observed during operation was also categorized. Results: The more severe disc derangement was observed on MRI, the more increased expression of MMPs and TIMP-1 appeared. Regarding MMP-13 expression, 86.7% of late-stage disc displacement patients showed grade II or III. Expression level of MMPs or TIMP was not statistically significant associated with joint effusion level. In perforation and/or adhesion groups, all patients showed grade II or III expression of MMP-13. Once perforation occurred, MMP-13 showed increased expression with statistical significance. Conclusion: MMP-1 and MMP-13 expression seem to be related to progression of osteoarthritis whereas MMP-8 does not seem to have a specific role with regard to temporomandibular joint disorders. TIMP-1 is considered to be partly related to internal derangement rather than osteoarthritis, but it is not significant.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.27-33
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• 2018

Background: Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time. Methods: A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD. Results: The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate. Conclusions: The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.