• Korean Journal of Radiology
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• v.23 no.2
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• pp.218-225
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• 2022

Objective: This study aimed to explore the feasibility of functional evaluation of the lateral pterygoid muscle (LPM) using diffusion tensor imaging (DTI) in patients with temporomandibular joint disorders (TMDs). Materials and Methods: A total of 119 patients with TMD (23 male and 96 female; mean age ± standard deviation, 41 ± 15 years; 58 bilateral and 61 unilateral involvements for a total of 177 joints) and 20 healthy volunteers (9 male and 11 female; 40 ± 13 years; 40 joints) were included in this prospective study. Based on DTI of the jaw in the resting state, the diffusion parameters, apparent diffusion coefficient (ADC), fractional anisotropy (FA), λ1, λ2, and λ3 of the superior and inferior heads of the LPM (SHLPM and IHLPM) were measured. Patients with TMD with normal disc position (ND), anterior disc displacement with reduction (ADWR), and anterior disc displacement without reduction (ADWOR) were compared. Results: Patients with TMD overall, and ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 in both the SHLPM and IHLPM than those in volunteers (p < 0.05 for all), whereas the ND subgroup only had significantly higher ADC and λ1 (p < 0.001). Meanwhile, significant differences in FA in the SHLPM and IHLPM were found between volunteers and ADWOR (p = 0.014 and p = 0.037, respectively). Among the three TMD subgroups, except for λ3 and FA in the ADWR subgroup, ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 and lower FA than those in the ND group (p < 0.050). There was no significant difference in diffusion variables between ADWR and ADWOR. In ADWOR, the osteoarthritis group had significantly higher λ3 and lower FA values in the IHLPM than those in the non-osteoarthritis group. Conclusion: DTI successfully detected functional changes in the LPM in patients with TMD. The unsynchronized diffusivity changes in the LPM in different subgroups of TMD signified the possibility of using diffusion parameters as indicators to identify the severity of LPM hyperfunction at various stages of TMD.

• The Journal of Korean Academy of Prosthodontics
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• v.27 no.2
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• pp.173-187
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• 1989

The purpose of this study was to evaluate the effects of stabilization occlusal splint by using a simplified condylar path recorder and a dental sound checker. For this study, 11 subjects (10 men and 1 woman) with TMJ disorder were selected from students at Chosun University, School of Dentistry. And they were treated with the stabilization occlusal splint. The condylar movement and the TMJ sound of each subject were recorded and analyzed by using a simplified condylar path recorder and a dental sound checker. The obtained results were as follows: 1. No statistically significant reduction of reduced PRI scores occurred before and immediately after wearing of stabilization occlusal splint. 2. The reduced PRI scores after wearing of stabilization occlusal splint showed statistically significant reduction with the lapse of time. 3. After stabilization occlusal splint therapy, Fisher angle and Bennett angle had almost no change. 4. TMJ sound disappeared in 4 out of 11 subjects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.39.1-39.6
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• 2015

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.161-175
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• 1991

To understand the biomechanics of the mandibular movement of the patients with T.M.J. disorder, it is necessary to analyze the mandibular movement by the least moving points of instantaneous center of rotation on computer screen. In this study, two subjects without T.M.J. disorder and with normal occlusion and few patients with T.M.J. disorder were selected for obtaining the processing data. The habitual opening and dosing movements were recorded by image recognition system of video and computer and then the mandibular movement and the least moving point were analyzed using computer program for image anaysis of specialized points. The results obtained were as follows: 1. The least moving points of control group during opening and dosing were dose to the mandibular foramen, but in the test group there were differences between two positions of the least moving points during opening and closing. 2. The variations of the least moving point were in the range of $0.02\sim0.05cm$ of X-coordinate and $0.07\sim0.10cm$ of Y-coordinate for control group, whereas in the range of $0.05\sim0.30cm$ of X-coordinate and $0.08\sim1.65cm$ of Y-coordinate for test group. 3. The index of variation during opening and dosing movements was shown in $0.8\sim1.0$ for the control group and in $0.56\sim2.6$ for the test group. 4. After the treatment of the test group No. 4 by occlusal splint the least moving point was dose to the mandibular foramen and the index of variation was changed from 25 to 05. 5. The tracing shape of the least moving point in the test group represented the irregularities compared to the control group. 6. The mandibular opening and dosing movements were simulated on the computer screen following the movement of the least moving point of instantaneous center of rotation.

• Journal of Oral Medicine and Pain
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• v.36 no.4
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• pp.235-243
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• 2011

Personal characteristics of female lichen planus patients were analyzed psychologically using the SCL-90-R. The subjects were 51 female lichen planus patients who visited Orofacial pain clinic of the Department of Oral Medicine, Pusan National University Yangsan Dental Hospital from 2009 to 2010. The female control group were collected from Pusan Kyungnam area. 45 female burning mouth syndrome patients, 36 female temporomandibular joint disorder patients, 23 female trigeminal neuralgia patients were subjected at Orofacial pain clinic of the Department of Oral Medicine, Pusan National University Hospital from 1998 to 2010. 1. Lichen planus patients group, burning mouth syndrome patient group, temporomandibular joint disorder patients group, trigeminal neuralgia patients group and the control group were within normal range. 2. The T-Scores of O-C, IS, DEP, ANX, HOS, PHOB in lichen planus patients group were significantly higher than in the control group. 3. The T-Scores of O-C, IS, DEP, ANX, PAR, PSY in chronic group was significantly higher than in acute group. 4. The T-Scores of SOM, O-C, DEP, ANX, in burning mouth syndrome patients group was significantly higher than in lichen planus patient group. 5. There was no significant T-score difference between lichen planus group and temporomandibular joint disorder patient group. 6. There was no significant T-score difference between lichen planus group and trigeminal neuralgia patient group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.420-430
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• 2022

Open bite is accompanied by decrease in tooth contact and overbite, and causes collapse of occlusal plane, mastication difficulties, speech disorders, changes in appearance, and lower occlusal force than normal. Open bite caused by temporomandibular joint disorder in adults with complete occlusion must be corrected after removal or stabilization of the causative factors. Orthodontic treatment, occlusal adjustment, prosthetic treatment, and surgical treatment can be the option of occlusal correction. This report describes about estimating the cause of occlusion change in two patients who developed an open bite due to mandibular displacement in adults with complete occlusion and different treatment approaches accordingly. In one patient, satisfactory result was obtained in functional and esthetic aspects through occlusal adjustment after stabilization of the temporomandibular joint.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.1
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• Journal of Oral Medicine and Pain
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• v.12 no.1
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• pp.85-93
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• 1987

The author studied on the effect of TMJ sounds to the patterns and ranges of mandibular border movements in horizontal plane with Pantograph (Denar Corp.). For study, 19 patients with TMJ sounds only and 16 students with no TM disorder were selected and classified as experimental group and control group, respectively. The subject performed right lateral movement, left lateral movement, and forward movement. Each movement were performed 3 times and the movement trajectory obtained with mechanical pantograph were observed for accordance of centric relation position, reproducibility and/or restriction of lateral movement paths, deviation of protrusive path in anterior table, restriction of protrusive condylar movement path in posterior horizontal table, presence of Fisher angle in posterior vertical table. And pantographic reproducibility Index (PRI) were obtained with pantronic by the same movement method as in the mechanical pantograph record. The obtained results were as follows : 1. In experimental group, PRI scores in those who show accordance of centric relation position were 14.4, and were 26.53 in those who did not show accordance of centric relation position. However, the PRI scores of the two subgroups show no statistically significant difference in control group. Therefore, in experimental group, the capability of accordance of centric relation position affected largely the PRI scores than in control group. 2. Deviation of protrusive path was opposite to the affected side in experimental group, and was left side in control group. 3. Restriction side of condylar movement in protrusion was ipsilateral to the deviation side in experimental group, but in control group, restriction side was not related to the deviation side. 4. PRI scores in experimental group were 23.2 (moderate dysfunction category), and in control group, were 17.8 (slight dysfunction category). The PRI scores in control group, however, implies that the evaluation of temporomandibular disorders by the PRI scores only may be unreasonable.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.329-338
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• 1998

The authors examined the condylar position and shape of condylar process from the transcranial radiographs and polytomographs of the 130 temporomandibular joints of 65 patients who complained symptoms of temporomandibular disorder and the followings were obtained; 1. The age and sex distribution of the 65 patients showed peak incidence in 2nd decade (27.7％) followed by 3rd (18.5％) and 4th decade (18.5％) and female predominance (87.7％). 2. In polytomography 64 joints (49.2％) showed consistent condylar position from lateral to medial and 39 joints (30.0％) of them showed agreement with those of transcranial radiographs. Among the 66 joints (50.8％) which showed changes in condylar position. 48 joints (36.9％) showed agreement with lateral and central tomographic and transcranial radiographic position. 41 joints (31.5％) showed disagreement in condylar position between the polytomographic and transcranial radiographic images. 3. When the condylar position was classified as anterior, central and posterior. the posterior position was the most frequent position, that is . 42.3％ of the transcranial radiography and 42.3％.49.2％ and 38.5％ of the lateral, central and medial polytomographic radiographs. 4. In polytomography 84 joints (64.6％) showed consistent condylar shape from lateral to medial and 74 joints (56.9％) of them showed agreement with those of transcranial radiographs. Among the 46 joints (35.4％) which showed changes in condylar shape. 40 joints (30.1％) showed agreement with lateral and central tomographic and transcranial radiographic shape. 41 joints (31.5％) showed disagreement in condylar shape between the polytomographic and transcranial radiographic images.