• Title/Summary/Keyword: Temporomandibular Disorders

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Can pterygoid plate asymmetry be linked to temporomandibular joint disorders?

  • Guerrero, Maria Eugenia;Beltran, Jorge;de Laat, Antoon;Jacobs, Reinhilde
    • Imaging Science in Dentistry
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    • v.45 no.2
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    • pp.89-94
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    • 2015
  • Purpose: This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. Materials and Methods: Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age-and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. Results: Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was $17.01{\pm}3.64mm$ on the right side and $16.21{\pm}3.51mm$ on the left side, and in patients without TMD, it was $11.86{\pm}1.97mm$ on the right side and $11.98{\pm}1.85mm$ on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). Conclusion: Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment.

A Study on the Effects of Maximum Voluntary Clenching on the Tooth Contact Points and Masticatory Muscle Activities in Patients with Temporomandibular Disorders (측두하악장애환자에 있어서 수의적 악물기시의 치아접촉점 및 저작근 활성에 관한 연구)

  • Jae-Kap Choi;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.15 no.1
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    • pp.105-115
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    • 1991
  • The purpose of the study was to evaluate the occlusal stability at the moment of dynamic occlusal tooth contact and to investigate the correlation between the occlusal stability and the masticatory muscle activities. It also evaluated the effect of short-term use of occlusal splints on the occlusal stability and the masticatory muscle activities in patients with temporomandibular disorders during maximum voluntary clenching by synchondronized with temporomandibular disorders during maximum voluntary clenching by synchronized use of the T-Scan system(Tekscan, Inc, USA) and K6-Diagnostic system(Myo-tronics Research, Inc, USA) The author measured its distance from retruded contact position(RCP) to intercuspal position(IP), average of contact intervals(ACI), total left-right statistics(TLR), average muscle activities of masseter and anterior temporal muscles during maximum voluntary clenching in 20 patients with temporomandibular disorders and 22 dental students as a control group. The data were compared between two groups and investigated for any correlations between the parameters. The results were as follows : 1. Both of the mean average of contact intervals and the mean absolute value of total left-right statistics during maximum voluntary clenching were increased in the patient group when compared with the control group. 2. Muscular disharmony of anterior temporal muscles of patient group is significantly greater than that of control group. However, muscular disharmony of masseter muscles of patient group is not significantly greater than that of control group. 3. There were significant correlations between muscular disharmony of anterior temporal muscles and average of contact intervals as well as total left-right statistics, and also between muscular disharmony of masseter muscles and total left-right statistics. 4. There were not any significant correlations between distance from RCP to IP and any other parameters. 5. There were a significant decrease in total left-right statistics and muscular disharmony of anterior temporal muscles during maximum voluntary clenching after a 1week use of occlusal splint in the patient group.

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Vocational Preference Inventory of Korean College Students with Symptoms of Temporomandibular Disorders

  • Park, Hye Sook
    • Journal of Oral Medicine and Pain
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    • v.42 no.1
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    • pp.8-15
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    • 2017
  • Purpose: The purpose of this study was to assess the association of vocational interest and personality with temporomandibular disorders (TMD). Methods: Four hundred and fourteen college students in Gyeonggi-do completed Vocational Preference Inventory L form and a questionnaire and collected data were analyzed by R program. Results: The percentage of subjects who responded that they had at least one contributing factor for TMD was significantly different among 27 two-letter Holland codes (p<0.05). The two-letter Holland codes of which the first-letter was social (S) (S artistic [A], S investigative [I], S realistic [R], S conventional [C], S enterprising [E]) or C (CE, CS, CA, CI) had tendency of having the relatively higher prevalence of symptoms and contributing factors for TMD. Among 6 one-letter Holland codes, the prevalence of a symptom of frequent fatigue in the jaw and a habit of gum chewing showed the significant difference (p<0.05). E code seemed to have lower prevalence of a symptom of frequent fatigue in the jaw than other codes. S code appeared to use chewing gum more frequently than other codes. High scorers on emotional instability showed the significantly higher prevalence of TMD symptoms (p<0.05) and contributing factors for TMD (p<0.001) than low scorers. Furthermore, high scorers on emotional instability had significantly higher mean scales of the number of positive answers of TMD symptoms (p<0.01) and of contributing factors for TMD (p<0.001) than low scorers. Conclusions: Symptoms and contributing factors for TMD were related to emotional instability. Vocational Preference Inventory L form might be utilized in assessing emotional factors of persons with TMD symptoms.

Analysis of treatment patterns of temporomandibular disorders (측두하악장애 치료유형 분석)

  • Cha, Yong-Hoon;Kim, Bum-Joon;Lim, Jae-Hyung;Park, Kwang-Ho;Kim, Hyung-Gon;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.520-527
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    • 2010
  • Introduction: This study examined the treatment patterns of temporomandibular disorders (TMD) including conservative and surgical procedures. Materials and Methods: Patients with TMD who visited Gangnam Severance Hospital from June 2007 to May 2008 were enrolled in this study. All patients were examined from the orthopantomogram, temporomandibular joint (TMJ) tomography, and a clinical examination. The patients who required a further evaluation were examined by magnetic resonance imaging and/or computed tomography. The treatment patterns were divided into counseling, medication, splint therapy, botulinum toxin injection (BTI) and surgical treatment. Results: Among the 2,464 patients, the average age was 31.8 years (ranging from 6 to 93); 764 (31.0%) were male and 1,700 (69.0%) were female. 2,355 (95.6%) patients were treated with conservative therapy; 1,460 (62.0%) patients were treated with medication, 931 (39.5%) patients were treated with splint, and 46 (2.0%) were treated with BTI. There were 109 (4.4%) patients treated surgically. Eight (0.3%) patients were treated with total temporomandibular joint replacement surgery. Conclusion: Almost all patients with TMD were treated using conservative methods. Those patients who received surgical treatment because of an ineffective response to conservative treatment had definite problems with the internal derangement and/or osteoarthritis or had severe clinical symptoms.

The Spiral Taping Treatment on Temporomandibular Disorder in oral Medicine (구강내과영역에서 측두하악장애 환자의 Spiral Taping 치료)

  • Kim, Myung-Hee;Lee, Jeong-Hun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.65-70
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    • 2011
  • The purpose of this study is introduce the spiral taping treatment on Temporomandibular Disorder in oral Medicine. The taping treatment is relatively simple and dosen't have any adverse effect, so it has high stability and superior effect of treatment. In this study, using the spiral taping treatment as one of the effective taping treatments, non-stretched tape was attatched to the muscles which set limit to the range of joint movement and cause pain to temporomandibular joint. With that treatment this study tried to make effective results of treatment of temporomandibular disorder. These results suggest spiral taping treatments contribute to the improvement of tempermandibular disorders. Further this study is needed for the confirmation of this effect of spiral taping treatments on temporomandibular disorders.

Comparison of Clinical Symptoms and Psychological Profiles of Temporomandibular Joint Osteoarthritis between Juveniles and Adults

  • Kim, Hyoung-Jun;Jang, Ji-Hee;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.41 no.2
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    • pp.48-53
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    • 2016
  • Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.

THE APPEARENCE OF PROINFLAMMATORY CYTOKINES IN TEMPOROMANDIBULAR JOINT DISORDERS AFTER ARTHROCENTESIS AND LAVAGE (측두하악장애환자에서 악관절 세척술후 관절활액의 전구염증성 Cytokines의 발현)

  • Kim, Cheol-Hun;Hwang, Hie-Sung;Shin, Sang-Hoon;Chung, In-Kyo;Hwang, Tae-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.5
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    • pp.370-378
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    • 2005
  • The purpose of this study is that evaluate the distribution and biological roles of TNF-a, interleukin-1${\beta}$(IL-1${\beta}$), interleukin-6(IL-6) and tissue inhibitors of metalloproteinase-1(TIMP-1) in the synovial fliud of patients with non-inflammatory chronic temporomandibular joint(TMJ) disorders in relation to pain during joint movements and magnetic resonance imaging(MRI) findings. TMJ synovial fluids aspirates were obtained from 36 patients (36 joints) with chronic TMJ disorders and from 8 controls(8 joints). Patients were divided to four groups. The control group was from healthy volunteers(8 joints), group I(18 joints) was patients with anterior disc displacement with reduction, group II(5 joints) was patients with disc displacement without reduction and group III (5 joints) was osteoarthritis. The TNF-${\alpha}$, IL-1${\beta}$ and IL-6 levels in the aspirates were determined by using an enzyme-linked immunosorbent assay and the TIMP-1 level was measured by an enzyme immunoassay. Following examinations for pain during joint movements and MRI observations, these cytokines' level and frequencies of detection were compared. The level of IL-1${\beta}$was not significant different in all groups. but the level of TNF-${\alpha}$, IL-6 and TIMP-1 were significant different among groups. The level of IL-6 and TIMP-1 were correlated to pain during movement(p<0.01) and the level of TNF-a(p<0.05). Also, the level of IL-6 was correlated to the level of TIMP-1(p<0.01). Especially, The level of the TIMP-1 level was significantly correlated to the pain during movement and showed very high levle of Pearson's correlation coefficient (r=0.833)(p<0.001). The results indicated that the TNF-${\alpha}$, IL-6 and TIMP-1 levels in the TMJ aspirates of patients with chronic TMJ disorders have been raised. Especially, IL-6 and TIMP-1 were very high levels in the patients who were degraded in the TMJ. Also, TNF-${\alpha}$, IL-6 and TIMP-1 showed the significant correlation in the chronic temporomandibular joint disorders. Therefore I suggest that these cytokines were also correlated to the pain during movement in the chronic temporomandibular joint disorders.

Clinical Consideration of Trigger Point Injection/Dry Needling Therapy: A Narrative Review

  • Jung, Jae-Kwang;Byun, Jin-Seok;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.42 no.3
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    • pp.53-61
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    • 2017
  • Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, spray-and-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.

Physical Therapy on Temporomandibular Joint Dysfunction (측두하악관절 장애의 물리치료)

  • Oh, Duck-Won;Kim, Ki-Song;Lee, Gyu-Wan
    • Physical Therapy Korea
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    • v.7 no.1
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    • pp.101-120
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    • 2000
  • This paper offers an approach to physical therapy and rehabilitation procedure for the temporomandibular joint dysfunction (TMD). Forms of physical therapy are used in the treatment of chronic musculoskeletal pain conditions that include TMD joint disorders. However, there still remains a void in the study as to the various rehabilitative protocols used on those patients with TMD. Recent evidence in clinical trials show that physical therapy is helpful for patients with TMD. Exercise programs designed to improve physical fitness had beneficial effects on TMD pain and dysfunction. This study establishes treatment procedures of physical therapy and provides a method of evaluation for patients with TMD disorders.

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Functional Disorders of the Temporomandibular Joint and the Masticatory System - Distribution of Symptoms and Symptoms in Relation to Impaired Mobility of the Mandible - (악관절 및 저작계 기능장애에 관한 연구)

  • 정성창;임용한
    • Journal of Oral Medicine and Pain
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    • v.7 no.1
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    • pp.32-40
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    • 1982
  • Functional disorders of the temporomamdibular joint and masticatory system were investigated in 209 men and 110 women, ranging form 20 to 30 years old, with a method devised by Agerberg and Carlsson. The investigated persons were dental students of the School of Dentistry, Seoul National University and student nurses of the School of Medicine, Seoul National University. The obtained results were as follows : 1. Facial pain and headache were reported by 32%. 2. Pain on gaping was localized mainly to the temporomandibular area and was noted in 8%. 3. Chicking of the temporomandibular joints was reported by 26%, somewhat more often by males. 4. Clenching of the teeth was relatively common in men and biting of the lip was comman in women. 5. Prevalence of mandibular dysfunction was found in 53%.

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