• 제목/요약/키워드: Temporomandibular Joint Disorder

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구강내과에 내원한 신환에 관한 분석 연구 (The Analysis and Study of First Visit Outpatients in Oral Medicine)

  • 고명연;허준영;옥수민;김경희;정성희;안용우
    • Journal of Oral Medicine and Pain
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    • 제38권2호
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    • pp.137-142
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    • 2013
  • 구강내과는 측두하악관절장애 및 신경병성통증 등과 같은 구강안면 통증, 연조직 질환, 구취, 레이저 치료, 코골이와 수면 무호흡증, 법치의학적인 감정 분야 등을 포함하고 있다. 이상의 질환은 비교적 흔하게 발생되며 환자에게 큰 불편과 고통을 안겨주며 때로는 건강에 치명적인 위협을 초래하기도 한다. 구강내과학적인 측면에서 볼 때, 현대 사회로 갈수록 생활 패턴의 변화와 스트레스 증가 등의 원인으로 턱관절 장애를 포함한 구강 안면 통증 환자가 늘어나고 있으며 또한 연조직 질환, 코골이와 수면 무호흡증, 법치의학적인 감정 등과 같은 구강내과적인 전문성을 요구하는 분야의 수요가 가파르게 증가되고 있다. 따라서 치과학 중에서 구강내과의 역할과 전문성에 대한 요구가 갈수록 증가되고 있다. 연간 구강내과에 내원한 신환의 질병명에 따른 분포도와 증상의 이환 기간, 내원 경로 등을 분석하는 것은 향후 구강내과의 역할과 비중에 대한 정보를 제공해주며 환자를 위한 원활한 진단과 치료를 가능하게 한다. 따라서 본 연구에서 1년간 치과대학병원 구강내과에 내원한 신환을 분석하여 향후 구강내과의 역할과 전문성에 대하여 고찰해 보았을 때 다음과 같은 결과를 얻었다. 1. 구강내과에 내원하는 신환은 주로 측두하악장애, 연조직 질환, 신경병성 통증 환자로 나타났다. 2. 측두하악장애 환자는 신환중 가장 높은 비율을 보였으며 세부 진단순은 복합 장애 환자, 근육통 환 자, 관절원판 내장증 환자 순이었다. 3. 연조직 질환 환자 중 구강건조증 환자가 가장 높은 비율을 보였으며 그다음 편평태선 환자, 재발성 아프타성 궤양 순이었다. 4. 신경병성 통증 환자에서 구강 작열감 증후군이 가장 높은 비율을 보였다.

측두하악관절 골관절염 환자의 진단에서 단층촬영과 골스캔 검사의 유용성에 대한 예비연구 (A Pilot Study on the Usefulness of Tomography and Bone Scan in Diagnosis of Patients with TMJ Osteoarthritis)

  • 김철;김영준;문지회;박문수
    • Journal of Oral Medicine and Pain
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    • 제37권2호
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    • pp.125-133
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    • 2012
  • 측두하악관절 골관절염은 관절조직에 가해지는 과부하에 의해 관절면과 하부 골조직에서 일련의 퇴행성과정과 함께 관절부의 국소적 압통, 하악운동에 의한 관절의 염발음, 하악의 운동범위 제한, 심한 경우에는 과두지지가 없어져 구치부 과다접촉과 전치부 개교합이 나타날 수 있는 퇴행성질환이다. 일반적으로는 임상검사 후 파노라마방사선사진, 측두하악관절 파노라마, 경두개방사선사진을 촬영한 뒤 진단하게 되는데 이들 일반적인 방사선사진들은 질환 초기의 미세한 골변화를 평가하는데 제한적이다. 따라서 본 연구에서는 일반방사선학적 검사에서 골조직의 퇴행성변화가 의심되어 확진을 위해 단층촬영 및 골스캔 검사를 시행한 환자의 영상의학적 검사소견들 간의 일치도와 임상소견과의 관계를 평가하여 골관절염의 진단에서 이들 다양한 검사법들의 한계와 그 유용성을 평가하고 향후 추가연구를 위한 예비자료를 얻기위해 시행하였다. 골관절염의 진단에서 일반방사선사진과 단층촬영, 골스캔 검사의 결과 일치도가 비교적 높게 나타났지만 위음성 가능성이 존재하므로 임상검사소견에 따른 단계적인 영상의학적 검사 시행이 바람직할 것으로 사료된다.

안모비대칭을 동반한 하악전돌증 환자에서 악교정 수술 전후 교근과 전측두근의 근전도 변화 (ELECTROMYOGRAPHIC ANALYSIS OF THE MASSETER AND ANTERIOR TEMPORALIS MUSCLE AFTER ORTHOGNATHIC SURGERY OF PATIENTS WITH FACIAL ASYMMETRY)

  • 손성일;손정희;장현중;이상한;차두원;백상흠
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권3호
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    • pp.259-266
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    • 2005
  • The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

Three-dimensional finite element analysis of unilateral mastication in malocclusion cases using cone-beam computed tomography and a motion capture system

  • Yang, Hun-Mu;Cha, Jung-Yul;Hong, Ki-Seok;Park, Jong-Tae
    • Journal of Periodontal and Implant Science
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    • 제46권2호
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    • pp.96-106
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    • 2016
  • Purpose: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

마음챙김 명상관련 국내 임상연구 동향 분석 (Clinical Research Trends on Mindfulness Meditation in Korea)

  • 양영필;송익수;문진석;한창현;박지하;이상남
    • 한국한의학연구원논문집
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    • 제16권2호
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    • pp.57-64
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    • 2010
  • Background : Meditation is one of the healing therapies used to prevent and cure ailments and to improve health through regular practice. Although Meditation is within the paradigm of modern Western medical science, effects on the human body could be possible. Objectives : This study performed a systematic review of the literature published in Korea focused on mindfulness meditation (MM), which is being applied as mind-body therapy around the USA lately. Method : Three hundred sixty six articles were found after searching with keyword, 'mindfulness meditation (MM)' in 6 journals and web databases. Ninety papers related MM were analyzed trend, Seventeen randomized controlled trials (RCTs) and 38 controlled clinical trials (CCTs) were researched by systematic review. Result : Most of them were studies about relationship between MM and syndrome such as stress, depression, anxiety and MM was also applied to some disease like hypertension, temporomandibular joint disorder in some cases. In 55 studies, It was shown that MM has positive effects on various symptoms and sometimes the effect of MM showed at post and follow-up study although there was no significant difference between control group and experimental group in some cases according to outcome measurement. Interestingly, there was no study reported about side effects of MM after the application. Conclusions : MM is being clinically applied at both western and oriental hospital in Korea, but more clinical trials with the high quality are needed to support its scientific basis.

선천성 양측 특발성 오훼돌기 과형성으로 인한 개구장애의 증례보고 (Case reports on neonatal mouth opening limitation due to congenital bilateral idiopathic hyperplasia of the coronoid processes)

  • 백경원;명훈;서병무;황순정;이종호;정필훈;김명진;최진영
    • 대한구순구개열학회지
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    • 제7권2호
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    • pp.133-139
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    • 2004
  • Congenital bilateral idiopathic hyperplasia of the coronoid processes presents with limited mouth-opening without visible maxillofacial deformity or temporomandibular joint dysfunction / disorder. According to Blanchard et al and McLoughlin et al, it was lnitially described in 1853 by Langenbeck, and the first cases were reported by Holmes in 1956. Since then, there have been regular reports of a certain number of cases. In 1995, McLoughlin et al recorded 79 published cases of bilateral hyperplasia of the coronoid processes. Among them, Fabie et al have found only 3 published cases relating to children younger than 8 years, and have presented the first case of objectively diagnosed restricted mouth opening from birth by pediatricians. Authors have experienced 2 child patients with mouth opening limitation who was diagnosed congenital bilateral idiopathic hyperplasia of the coronoid processes without any other TNJ morphology in Dept of Oral and Maxillofacial surgery, Seoul National University Dental Hospital in 2004. Coronoidectomy was performed and postoperative active mouth opening exercise is indicated. Authors report 2 cases of congenital bilateial idiopathic hypeiplasia of the coronoid processes with literature liview.

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성인의 구강의료접근성의 관련요인 - 구강질환의 의사진단 및 처치율을 중심으로- (Factors associated with access to dental care among Korean adults)

  • 노희진;최충호;손우성
    • 보건행정학회지
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    • 제18권4호
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    • pp.170-184
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    • 2008
  • Objectives: The aim of this analysis was to investigate factors associated with dental visits in terms of getting diagnosis and receiving care for diagnosed dental diseases among Korean adults. Methods: Data used in this analysis were from the 2005 Korean National Health and Nutrition Examination Survey which involved a representative sample of 25,487 adults nineteen years of age and older who resided in Korea. This analysis used data of adults who had completed health interview survey (n = 25,215). Uni- and bi-variate analysis, Chi-square test, and logistic regression analyses. were conducted using SAS. Results: The percentages of people diagnosed (treated) dental canes, periodontal disease. and temporomandibular joint disorder were 70.4(77.1), 16.1 (55.7), and 0.6(37.4), respectively. The reception of treatment for diagnosed dental caries and periodontal disease was significantly associated with older age, high monthly household income, and high education attainment. Logistic regression model indicated that age, monthly household income, education attainment, type of health insurance, and chewing problem were significantly associated with getting diagnosis and treatments of dental diseases. Most frequently answered reason for non - or delayed treatments of diagnosed dental diseases during the last one year was cost of treatments. Conclusions: The findings indicated that socio-economic-status still significantly affected reception of needed dental treatments among Korean adults despite the national health insurance system. Oral health policy and programs should be augmented to provide further support to adults of low socio-economic-status who are more prone to dental diseases yet lack resources for needed dental treatments.

하악골(下顎骨) 한계운동내(限界運動內)에서의 저작운동(咀嚼運動)에 관(關)한 실험적(實驗的) 연구(硏究) (AN EXPERIMENTAL STUDY ON THE MASTICATORY MOVEMENT WITHIN THE MANDIBULAR BORDER MOVEMENT)

  • 강동완
    • 대한치과보철학회지
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    • 제20권1호
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    • pp.83-91
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    • 1982
  • The mandibular movement during mastication has been studied, however there is still much controversy, therefore the purpose of this study was to establish the fundamental data in order to provide the functional occlusion and information in prosthodontic treatment, and the diagnosis of temporomandibular joint disorder. The author analyzed the characteristics of the border and masticatory movements using the Mandibular Kinesiograph. The value, direction, deviation angulation of the border and masticatory movements were studied on the sagittal and frontal planes in 24 male subjects age of 22-28 without orofacial problems. The obtained results were as follows: 1. The values of border movement on the sagittal plane were an average of $25.81{\pm}5.14mm$ in vertical component and $24.37{\pm}3.76mm$ in ant-post component, and the posterior terminal hinge movement, $9.31{\pm}3.62mm$ in vertical component and $7.59{\pm}2.65mm$ in ant-post. component. 2. The distribution range of the masticatory movement within the border movement was an average of $19.2{\pm}12.81%$ of maximum ant-post, values and $55.5{\pm}16.1%$ of maximum values of border movement, and the movement path, for the most part, was directed to posterior deviation and ranged from 0.98 to 12.00mm, on an average of $5.15{\pm}3.49mm$. 3. On the frontal plane, a number of left and right deviation in 24 subjects was same, however, the right deviation was an average of $2.51{\pm}1.67mm$ compared with the left deviation. 4. On the frontal plane, the point of maximum lateral deviation was an average of $49.7{\pm}11.0%$ of maximum opening values. 5. The angulation between the terminal hinge movement path and the masticatory path was an average of $24.00{\pm}4.65$.

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광범위한 치질 상실로 인해 수직 고경 감소 환자의 전악 수복 증례 (Full mouth rehabilitation in a patient with loss of vertical dimension caused by severe tooth loss: a case report)

  • 윤아영;심혜원;안진희
    • 대한치과보철학회지
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    • 제52권1호
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    • pp.42-47
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    • 2014
  • 광범위한 치아 상실과 마모로 인한 교합면의 파괴로 수직고경이 감소된 경우 안모의 변화, 전방 유도의 상실로 인한 반대 교합을 보일 수 있으며, 또한 턱관절의 문제를 발생 시킬 수도 있다. 이러한 경우 교합 수직 고경의 증가를 통한 전악 수복을 고려할 수 있으며, 적절한 환자의 수직 고경 평가가 필요하다. 본 증례는 80세의 남자 환자로 전반적인 보철계획을 주소로 내원하였으며, 치아상실 및 마모에 따른 전치부의 반대 교합과 교합 수직 고경의 감소가 관찰되었다. 진단 모형과 방사선 사진, 임상적 검사를 이용하여 교합 관계를 분석하여 교합 수직 고경 증가를 결정하였다. 진단 wax up을 시행하였고 임시 보철물을 제작하였다. 3개월의 적응 기간 후 상악 고정성 보철물과 하악 임플란트 지지 피개의치로 최종 수복하였다. 장착 후 8개월경과 관찰 중이며 양호한 심미적 기능적 개선을 보였다.

유연성 운동과 건강관련 삶의 질 및 구강건강과의 관련성: 국민건강영양조사 2012년도 자료를 활용하여 (Relationship between Flexibility Exercise and Health-Related Quality of Life and Oral Health: Using the National Health and Nutrition Examination Survey 2012 Years)

  • 김유린
    • 융합정보논문지
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    • 제11권12호
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    • pp.265-274
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    • 2021
  • 본 연구는 유연성 운동이 삶의 질과 구강상태 및 구강건강관련 행위에 미치는 융합적인 관련성을 확인하기 위한 기초자료로 제공하고자 한다. 2012년 국민건강영양조사 자료를 사용하여 유연성 운동이 건강관련 삶의 질과 구강상태 및 구강건강관련 행위에 미치는 영향을 확인하기위해 선형회귀분석과 로지스틱 회귀분석을 시행하였다. 그 결과 인구 사회학적 특성을 통제하고, 유연성 운동을 하지 않는 사람은 삶의 질 하위항목 중 운동능력이 .027배 나빠졌고, 영구치 우식치아 수는 .152배 높았다. 유연성 운동을 하는 사람은 턱관절 장애 증상 중 통증 증상이 1.633배 높았다(p<.05). 따라서 유연성 운동이 전신건강 뿐만 아니라 구강건강과의 관련성을 제안했다는 점에서 그 가치가 있다고 생각된다.