• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권1호
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• pp.52-56
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• 2015

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.337-356
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• 2020

This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

• Korean Journal of Radiology
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• 제23권2호
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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.

• Journal of Periodontal and Implant Science
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• 제47권4호
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• pp.211-218
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• 2017

Purpose: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.

• Journal of Acupuncture Research
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• 제22권5호
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• pp.133-140
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• 2005

Objectives : This study was to evaluate the effect of Chuna on Temporomandibular Disorder Patients with idiopathic Scoliosis, utilizing Cobb's angle to determine the degree of curvature progression in the thoracic and lumbar regions. Methods: From October 1st 2004 to June 31st 2005, the clinical comparison study was carried out 40 cases of Temporomandibular Disorder Patients with idiopathic Scoliosis treated by both Chuna and General oriental method(Experimental Group) & only General oriental method(Control Group), who had been treated at Dept. of Acupuncture and Moxibustion Daejon Oriental Medical Hospital. Results : The results obtained as follows; 1. The facial pain of Experimental Group and Control Group was improved significantly. but the difference of two groups is not significant.(p<0.05) 2. The function of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly.(p<0.05) 3. The limitation of activity of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly. (p<0.05) Conclusion : This result sugests that the Chuna be effective treatment modality on Temporomandibular Disorder Patients with idiopathic Scoliosis. So further research is needed continuously.

• 대한치과교정학회지
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• 제54권2호
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• pp.89-107
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• 2024

Objective: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. Methods: The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). Results: Forty-nine articles met the inclusion criteria. The metaanalysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. Conclusions: Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.431-439
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• 2007

본 연구에서는 치아교모도에 의한 연령감정법을 이용하여 측두하악장애환자의 치아연령을 일반 정상인과 비교하고, 측두 하악장애환자의 구강습관이 치아교모에 미치는 영향을 조사하고자 하였다. 단국대학교 치과병원 구강내과에 측두하악장애를 주소로 내원한 환자 65명을 실험군으로 하고, 측두하악장애증상이 없는 정상인 22명을 대조군으로 하였다. 문진 및 설문조사를 통해 대상자의 구강습관을 조사하였으며, 임상 및 방사선검사후 치아교모도를 조사하여 치아연령을 산출하였다. 실험군과 대조군의 치아교모도의 차이 및 각각의 구강습관이 치아교모에 미치는 정도를 분석하기 위해 t-test 및 one-way ANOVA, multiple comparison t-test를 이용하였다. 연구 결과 대조군에 비해 실험군의 치아교모도가 유의성 있게 증가했으며, 조사된 구강습관중 이갈이, 이악물기, 식사습관(단단하고 질긴 음식)순으로 치아교모도에 영향을 주었다. 따라서, 측두하악장애환자의 연령감정시 증가된 치아교모도에 의해 나타날 수 있는 실제 연령과의 차이를 고려해야 한다. 특히, 20-30대의 연령감정시에 측두하악장애환자의 경우 약 3.5세, 이중 특히 이갈이의 습관이 있는 경우에는 약 5.3세의 감정연령의 증가가 있을 수 있음을 감안해야 한다. 또한, 측두하악장애환자는 일반 정상인보다 치아 교모가 심한 경향이 있고 이는 치아와 턱관절에 더 많은 하중이 가해지고 있음을 의미하므로 측두하악장애환자의 치료시에는 반드시 이러한 요인을 제거하는 치료술식을 병행해야 할 것으로 사료된다.

• 대한치과의사협회지
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• 제57권4호
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• pp.222-232
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• 2019

Injection therapy can be used to treat the refractory and chronic pain situations that are not well responded to conventional therapy in TMD-patients. The target of injection is the intra-articular- and peri-articular tissue of joint and adjacent tissue like muscle. For the success of injectional therapy, selection of injection solution and technique is essential, so discussion will be done about that and one of the promising techniques of intra-articular injection, US-guided TMJ Intrar-articular injection, is also discussed.

• 치위생과학회지
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• 제9권1호
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• pp.9-15
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• 2009

측두하악장애의 절정기 연령인 직장인을 대상으로 직무스트레스가 측두하악장애에 얼마만큼 영향을 미치는지를 관찰함으로서 측두하악장애의 예방과 치료에 관한 기초자료를 제공하고자 2008년 1월 7일부터 1월 26일까지 D광역시에 근무하고 있는 서비스직, 사무직, 생산직 근로자 216명을 대상으로 구조화된 자기기입식 설문지를 이용하였다. 분석방법으로는 SPSS 10.0을 이용하여 연구대상자의 일반적 특성과 측두하악장애의 주관적 증상, 일반적 특성에 따른 스트레스 요인별 정도, 측두하악장애 유무에 따른 직무스트레스 차이, 직무스트레스정도와 측두하악장애에 관한 상관관계 등을 분석하여 다음과 같은 결과를 얻었다. 1. 측두하악장애의 주관적 증상에서는 관절잡음에서 가끔 그렇다 45.8%, 자주 그렇다 12.0%였고, 관절탈구는 가끔 그렇다 12.0%였다. 저작시동통에서는 41.2%, 비저작시동통에서도 24.1%가 가끔 경험하고 있었다. 개구장애에서는 2.8%가 자주 경험한 것으로 나타났다. 2. 관절 잡음에서는 연령에 따라 30대에서 가장 높이 나타나 유의한 차이를 보였고(P < 0.05), 관절탈구에서는 근무기간이 1년미만 37.9%, 3년미만 31.0%, 5년미만 20.7%로 근무기간이 짧을수록 많았으며, 근무 형태에서는 교대 34.5% 보다는 주간 근무 58.6%가 높게 나타났다(P < 0.05, P < 0.01). 또한 저작 시 동통에서도 근무기간이 낮을수록 유병율이 높게 나타났으며, 개구장애에서는 근무기간이 낮을수록 높게 나타나 유의한 차이를 보였다(P < 0.01). 3. 개구장애가 있는 근로자는 직무자율성에서 스트레스를 더 높게 나타났고(P < 0.05), 탈구유무와 비저작시 동통과는 관계갈등 부분에서 스트레스가 더 높게 나타났다(P < 0.05, P < 0.01). 직무불안정이 높은 근로자일수록 탈구유무와 비저작시 동통에 문제가 있었으며, 탈구에 문제를 가진 근로자가 보상부적절에 관한 스트레스가 유의하게 높게 나타났다(P < 0.05). 4. 관절탈구가 있을 경우 관계갈등, 직무불안정, 보상부적절에 대한 스트레스가 높게 나타났으며(P < 0.01, P < 0.05), 비저작시 동통이 있는 근로자 일수록 관계갈등, 직무 불안정에 대한 스트레스가 유의한 차이를 나타내었다(P < 0.05, P < 0.01). 개구장애가 있을수록 직무자율성에 대한 스트레스가 유의한 차이를 보였다(P < 0.05).

• 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.