• 치과방사선
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• 제23권1호
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• pp.49-66
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• 1993

The purpose of this study was to investigate the early effects of irradiation on the temporomandibular joint in rats. Male rats were singly irradiated with the dose of 5 Gy or 10 Gy to their head and neck region by /sup 60/Co X ray. Experimental animals were sacrificed at each of the following time intervals -1, 2, 3, 5, 7 and 14 days. The specimens were examined with a light microscope, and treated with H & E staining and immuno-histochemical staining. The results were as follows, 1. By light microscopic findings, proliferative and hypertrophic zone were narrowed and hematopoietic cells were few in number at 5 days after irradiation. Repair signs were seen at 7 days after irradiation when decrease in osteoclast, increase in hematopoietic cells and increase of proliferative zone were noted. The 10 Gy irradiated group showed more severe histopathologic change than the 5 Gy group, and their repair was more slow. 2. In the S -100 antibody, positive cells were examined in the glenoid fossa. Positive cells of irradiated group showed more slight decrease in number than the control group. Low radiosensitivity and slow repair was noted in the glenoid foosa. 3. The interarticular disc was high radioresistant, and any histopathologic changes were not seen in disc. 4. Repair was examined clearly with the response to the antibodies. Especially by 5 days after irradiation 5 Gy group showed S-l00 positive cells in hypertrophic zone next to proliferative zone, chondroitin-4-sulfate positive cell in erosive zone next to hypertrophic zone, type-1 collagen positive cell in subchondral bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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• pp.16-20
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• 2014

Mandibular condylar hyperplasia is an uncommon condition of excessive unilateral growth of the condyle causing facial asymmetry and occlusal alterations. The etiology of condylar hyperplasia is unclear, but several factors are suspected, including previous trauma, hormonal disturbances, and abnormal functional loadings. Acute or chronic recurrent dislocation of temporomandibular joint (TMJ) is common, but long-standing dislocation is rare. We present two cases of the exophytic condylar hyperplasia that lasted for over 20 years with TMJ dislocation. In both cases, we performed a condyloplasty to restore normal occlusion and facial symmetry, with satisfactory results.

• 대한치과의사협회지
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• 제51권6호
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• pp.302-312
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• 2013

It has been established that disk displacement of the temporomandibular joint(TMJ) can cause mandibular asymmetry in growing subjects. One of the causes of internal derangement of TMJ seems to be the result of poor positioning of the joint structure in unilateral cross bite, and the subsequent occlusal trauma transferred to the functioning unit of the mandible, the joint and disc. Transverse discrepancy of the maxillary and the mandibular posterior dentoalveolar units was often found in mandibular asymmetric subjects. Most of the asymmetry in growing subjects becomes worse with further growth if left untreated. However once sufficient posterior overjet is gained through orthodontic treatment, many cases have shown improvement in facial asymmetry. Furthermore, the position of condyles in computed tomogram(con-beam CT) changed from anatomically unfavorable position to more concentric position.

• Journal of Oral Medicine and Pain
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• 제23권1호
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• pp.21-36
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• 1998

The purpose of this study was analyse the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified patients with internal derangement of the temporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandibular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandibular movements, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group. The results were as follows : 1. Pain was more frequently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle's classifications had not significant correlations between the experimental groups. 2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experiment groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was no significant difference in the range of the maximum lateral movement between toward affected side and toward unaffected side. 3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to control group. There was no significant difference in maximum opening velocity and maximum velocity of Terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other. 4. In the frontal plane of the MKG, the frequency of complex deviation type(F-2)pattern was significantly increased in the anterior disc displacement with out reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type(S-1)was decreased in the same group. 5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3)in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement with out reduction group, but the frequency of no-peak type (OV-3)was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group. Compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.

• Imaging Science in Dentistry
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• 제37권1호
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• pp.15-18
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• 2007

Purpose : Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. Materials and Methods MRI and transcranial radiographs of both TM joints from 67 patients with temporemandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. Results. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position, 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.9%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. Conclusion : On MRT, most oi the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.1-7
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• 2009

Purpose: The purpose of this study is to investigate the therapeutic use of Hepatocyte growth factor(Adv.CMV.HGF) in temporomandibular joint disc defect. Materials and methods: Twelve New Zealand white rabbits, weighing 2.5 - 3.0 kg, were used in this experiment. Defects(2 mm in diameter) were created in their TMJ discs. Recombinant Adv.CMV.HGF with gelatin sponge($Gelfoam^{(R)}$) as carrier was implanted in the defects. We divided the rabbits into four batches according to the duration of the implantation - of 1, 4, 8, 12 weeks - and both left and right TMJ of each rabbit in all groups were used in the research : left joints were used as experiment group and right were control group. Each batch of rabbits was killed one, four, eight and twelve weeks after the experimentation respectively, and called Group A, B, C, and D. (Group A = 1 wk, B = 4 wks, C = 8 wks, and D = 12 wks) Results: The experimental group showed a significant increase in the number of chondroblasts and active cell differentiation at the margin of the defects. Compared to the control group, in the experiment group chondroblasts increased and chondrocytes showed a columnar arrangement, which is witnessed at the time of cell differentiation. Conclusion: This study supports the case that Avd.CMV.HGF may be useful in the repair of articular disc of the rabbit TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.55-65
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• 2005

Most patients with temporomandibular disorder can be treated conservatively. However, open TMJ surgery can be needed in some patients. We analysed the patients with TMD which open surgery has performed since 1998. Open surgery was carried out in 8 patients. Age ranged from 22 to 61 years, with a mean of 42.8years. All patients were male. Final diagnosis was obtained based upon clinical, radiographic and operative finding as follows; habitual luxation, bony ankylosis, traumatic arthritis, disc displacement with destructive change, disc displacement and adhesion. Etiologic factors included trauma(4), infection(2), and unknown(2). Open surgery included arthroplasty with either of condylectomy, eminectomy, meniscoplasty, capsurrohaphy. All patients were recovered uneventfully without severe complications. Some mouth opening limitation and mouth opening deviation remained. Postoperative aggressive physical therapy and careful follow up were performed. In conclusion, open TMJ surgery must be considered in organic disease such as ankylosis, tumor and TMD without favorable recovery after long-term conservative therapy.

• Imaging Science in Dentistry
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• 제36권1호
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• pp.17-24
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• 2006

Purpose : The objective of this study was to investigate the effect of TMJ disc displacement on the TMJ disc configuration and surrounding osseous structure. Materials and Methods : The proton density and 72-weighted MR images of 57 TMJs were retrospectively studied. These TMJs were divided into three groups according to the anterior disc displacement status on MR sagittal images, those were the normal, anterior disc displacement with reduction (ADWR), anterior disc displacement without reduction (ADWOR). The frequency of disc configuration and surrounding bony change, the border status between articular disc and retrodiscal tissue were investigated according to the positional change of articular disc. Results : There were significant statistical differences of chi-square statistics of TMJ disc configurational type between normal and ADWR/ADWOR group, respectively. Surrounding bony change frequently appeared in ADWOR and a statistically significant difference of chi-square statistics of bony change frequency between normal and ADWOR group was observed. Conclusion : These results suggested that the disc configuration and bony change of TMJ are strongly related to TMJ disc displacement.

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.143-147
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• 2013

측두하악장애 중 개구제한은 일반적으로 저작근, 측두하악관절의 통증, 비정복성 관절원판변위, 측두하악관절의 유착이나 강직, 저작근의 근경축 등에 의해 발생한다. 하지만 이비인후과적인 질환, 신경 및 혈관질환, 종양, 염증, 감염 등에 의해 측두하악장애와 유사한 통증 및 개구제한이 유발 될 수 있다. 따라서 병력 조사 및 임상 검사 시 이러한 이차적 질환에 대한 고려가 필요하다. 특히 초진 시 전형적인 측두하악장애의 소견을 보인다고 할지라도 적절한 치료 및 환자의 자기 관리에도 불구하고 증상의 호전이 없거나 지속적인 악화 소견을 보이는 경우에는 염증, 감염, 종양 등의 가능성에 관한 포괄적인 재평가가 필수적이다. 본 증례에서는 제 3 대구치의 치근단 농양이 익돌하악간극(pterygomandibular space)으로 확산되어 발생한 내익돌근(medial pterygoid muscle)의 통증 및 개구제한에 관하여 경험하였기에 이를 보고하고자 한다.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.379-385
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• 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.