• The Journal of the Korean dental association
• /
• v.9 no.10
• /
• pp.611-615
• /
• 1971

The articular discs from temporomandibular joints of thirty men and women whose ages ranged between 20 and 70 years hve been used in this study. The articular discs of the temporomandibular joints of human postmortem material was examined individually by means of microscopic techniques. The following changes were seen: 1. With advancing age some of fibroblast was developed into chondroid cells. Which later may differentiate into true chondrocytes. 2. In young individuals the elastic fibers found only I relatively small numbers. With advancing age elastic fibers was increased in number. 3. With advancing age the arrangement of fibrous tissue are irregular and loosely separated. 4. In the discs, as well as in the fibrous tissue covering the articular surfaces, this cellular changes seems to be dependent upon mechanical influences.

• The Journal of Korean Academy of Prosthodontics
• /
• v.15 no.1
• /
• pp.34-42
• /
• 1977

The author attempted to observed the histological changes of the temporomandibular joints of rabbits by including malocclusion. Thirth-two healthy male rabbits were devided into two groups; control and experimental group. Eight rabbits were kept as control group, while metal crowns were seated on unilateral lower molar teeth of twenty-four rabbits as experimental group. And the interocclusal distance of the incisal edge was kept 1.5mm from the begining to the end of the experimental periods. Rabbits of each group, one of control group and three of the experimental gorup, were killed at the intervals of one day, three days, one week, two weeks, four weeks, six weeks, eight weeks, and twelve weeks after experiment. The temporomandibular joint including condyle head, articular disc and glenoid fossa were excised and decalcified. The decalcified sections were made histologic sections. The results obtained were as follows. 1. The regressive changes of the condylar head were the main reaction in this experiment that consist of decreasing or increasing thickness of the fibrocartilage zone with hyaline degeneration, decreasing of the cellularity of the proliferative zone, and the irregularity of the arrangement of chondrocytes and size of the lacunae of cartilage cells with chondroclasia and osteoclasia in hypertrophic zone. 2. The regressive changes of the condylar surface of the crown seated side were persisted to the end of the experiment. 3. On the non-crown seated side, severe aggressive changes occurred in initial stage, but hyperplastic changes of the condylar surface noted in the middle of the experimental periods. 4. Although aggressive changes occurred in initial stage of experiment on the non-crown seated side, hyperplastic changes of the condylar surface were noted in the middle of the experimental periods, and remodeling appeared at the termination of the experimental periods. 5. The articular disc exhibited pannus formation on both crown seated and non crown seated side from the beginning of the experiment. The pannus persisted throughout the experiment on the crown seated side, but on the non-crown seated side it disappeared from six week group.

• Journal of Oral Medicine and Pain
• /
• v.21 no.1
• /
• pp.103-113
• /
• 1996

The author examined the clinical signs and symptoms , routine radiographs, laboratory test and bone scan in 73 subjects with TMJ disorders and studied the responses of clinical test on patients, the distribution of signs and symptoms of joints, the simple uptake rate(SUR) of affected joints , the SUR of subclassified groups of TMJ disorders, active joints of subclassified groups of TMJ disorders and the SUR of joints with noises. The obtained results were as follows : 1. The percentage of joint pain on palpation, joint noises joint pain on function, mandibular dysfunction and active finding of bone scan in aptients with TMJ disorders were higher 2. The SUR was higher in joints affected by joint pain on function, joint pain on palpation, mandibular dysfunction and creptius. 3. The SUR of osteoarthrosis was the lowest. 4. The percentage of active joints were the highest in joints with discdisplacement without reduction, and followed by osteoarthritis, and disc displacement with reduction. 5. The SUR of TMJ showing joint noises only was lower.

• Journal of Korean Dental Science
• /
• v.13 no.1
• /
• pp.21-27
• /
• 2020

Purpose: The aim of this study was to investigate the types and frequency of the various incidental findings (IFs) on magnetic resonance images (MRI) taken from the patients with temporomandibular disorder (TMD) symptoms. Materials and Methods: Temporomandibular joint (TMJ) MRI taken from 1,013 patients with TMD symptoms were evaluated retrospectively. IF was defined as imaging features that were accidentally or unexpectedly found, rather than degenerative bony changes of TMJ complex or disc derangement. They were classified into two groups as TMJ site-specific findings and unexpected findings at other regions. The frequency of the sub groups was analyzed. Result: A total of 26 (2.57%) cases with IFs were classified into 13 cases with TMJ site-specific findings and 13 cases with unexpected findings at other region. TMJ site-specific findings included synovial chondromatosis in 6 cases, synovial cyst in 6 cases and osteochondroma in one case. Unexpected findings included salivary gland tumor in 3 cases, developmental cyst in 3 cases, vascular malformation in 2 cases, mastoiditis in 4 cases and sialadenitis on parotid gland in one case. Conclusion: When diagnosing TMD through TMJ MRI, clinicians should carefully read the image, considering the possibility of IFs because TMJ MRI can provide pathologic information in TMJ region and other oral and maxillofacial region.

• Journal of Oral Medicine and Pain
• /
• v.36 no.1
• /
• pp.71-79
• /
• 2011

Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.

• The Korean Journal of Nuclear Medicine
• /
• v.29 no.4
• /
• pp.511-517
• /
• 1995

Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement(13 unilaterally affected, 8 bilaterally affected), 25 patients with TMJ arthritis(23 unilateral, 3 bilateral), and 39 volunteers with no signs, symtoms, or history of TMJ disease. TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99mTc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were $1.673{\pm}0.606$ in TMJs affected with arthritis, $1350{\pm}0.351$ in TMJs affected with disc displacement, and $1.084{\pm}0.172$ in TMJs of controls. Significant differences were demonstrated among them(p<0.01) Difference of bith TMJ SUR was highest in patients with unilateral TMJ arthritis($0.608{\pm}$0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ dist displacement patients($0.062{\pm}0.063$ vs $0.122{\pm}0.100$). TMJ SUR of Joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(696% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan nay help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

• Korean Journal of Radiology
• /
• v.23 no.2
• /
• pp.218-225
• /
• 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 korean journal of orthodontics
• /
• v.23 no.4 s.43
• /
• pp.503-527
• /
• 1993

This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.37
• /
• pp.17.1-17.5
• /
• 2015

Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

• Journal of Oral Medicine and Pain
• /
• v.23 no.4
• /
• pp.369-377
• /
• 1998

A patient with TMJ osteoarthritis and anterior open bite was treated with an intermaxillary traction device. Pretreatment examination revelaed a pain in both TMJ during mouth opening, moderate tendernesso f left sternocleidomastoid and right trapezius muscles. Anterior open Bite was aobserved with interincisal distance of 2mm. Tomograms and MRI showed anterior disc displacement withouit reductoin of both temporomandibular joints, and the condyles were flattened and slightly eroded. A pair of full-coverage occlusal appliances was made on both maxillary and mandibular dentition, with pivoting fulcrum on the site of the second moalr. Traction force was gained by the intermaxillary orthodontic elastics which were hooked by orthodontic brackets on the labial surfaces of the upper and lower anterior and premolar teeth. After 8 weeks of traction treatment, the joint pain was subsided completely and the anterior open bite was closed to get an edge to edge relationship of anterior teeth.