• 제목/요약/키워드: Temporomandibular joint dislocation

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턱관절 탈구의 보존적 치료법에 대한 증례보고 (Conservative management of dislocated temporomandibular joints: A case report)

  • 박좋은;김혜경;최희훈;김미은
    • Journal of Oral Medicine and Pain
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    • 제38권4호
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    • pp.319-324
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    • 2013
  • 턱관절의 탈구는 과두가 관절와를 벗어나 환자 스스로 원래 위치로 정복하지 못할 때 발생한다. 양측성 전방 탈구가 가장 흔하며 탈구의 빈도와 발생 기간에 따라 급성, 만성, 재발성으로 분류하기도 한다. 턱관절 탈구의 치료법으로 수조작 같은 보존적 방법부터 수술적 접근법까지 다양한 방법들이 있으며 치료법의 선택은 주로 탈구가 발생한 기간에 따라 달라진다. 본 증례를 통해서 수조작을 시행하여 턱관절의 탈구를 성공적으로 치료한 증례와 과두의 정복에 실패했으나 만성적으로 적응된 환자에서 수술적 치료 대신 보철 치료로 교합을 회복시켜준 사례를 소개하고 그 의의에 대해 고찰해보고자 한다.

Evaluation of Articular Eminence Morphology in Patients with Spontaneous Temporomandibular Joint Dislocation Using Cone Beam Computed Tomography

  • Kim, Ji Hoo;Park, Hyun-Jeong;Seo, Yo-Seob;Ryu, Ji-Won;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • 제47권1호
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    • pp.27-37
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    • 2022
  • Purpose: This study aimed to broaden our understanding of the predisposing factor and treatment of dislocation by analyzing and evaluating the morphology of the articular eminence (AE) in subjects with temporomandibular joint (TMJ) dislocation using cone beam computed tomography (CBCT). Methods: The subjects were divided into two groups: dislocation (31 subjects) and control (32 subjects). CBCT was used to examine 126 TMJs in 63 subjects (26 males, 37 females). The height, width, and posterior slope of the AE were measured in the parasagittal plane. The posterior slope was measured using the "top-roof line angle (TR angle)" method and the "best-fit line angle (BF angle)" method. The AE on the left side (AEL) and the AE on the right side (AER) of the subjects in the dislocation group were separately analyzed and compared with the control group after taking measurements. The average value of both sides was used when comparing with subjects with bilateral dislocation. Results: Dislocations were more frequent in females (67.7%) than in males (32.3%). The dislocation group showed a gentler TR angle than the control group in the AER and in the average of AE on the both sides (AEB). The same group also showed a wider AE in the AEL and the AER (p<0.05). In subjects with unilateral dislocation, the width of the AE with dislocation was narrower and the TR angle and BF angle was steeper than the other side without dislocation (p<0.05). Conclusions: In subjects with unilateral TMJ dislocation, the posterior slope of the AE is steeper, and the width is narrower at the site of dislocation compared to the site without dislocation. However, in subjects with bilateral TMJ dislocation, AEB were wider, and the mean value of the posterior slope of AEB was gentler than that of the control group.

악관절탈구 환자의 임상 및 원인론적 고찰 (CLINICAL AND ETIOLOGICAL INVESTIGATION ON THE DISLOCATION OF TEMPOROMANDIBULAR JOINT)

  • 김종원;이상일;이종흔
    • 대한치과의사협회지
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    • 제9권5호
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    • pp.217-221
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    • 1971
  • Authors studied on the T.M.J. dislocation of 5 cases who were visit Dental College Infirmary, S.N.U. The results were obtained as follows. 1) The main symptoms are pain, cracking sound, discomfort of temporomandibular joint region and swelling. 2) All cases except only one case, no specific etiological factors were detected in related to habitual custom and hoby. 3) The patients are all female aged from 19 to 24 years old.

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악관절 장애 증상이 구강건강 상태와 정신건강 상태, 삶의 질에 미치는 영향 : 국민건강영양조사 2012년도 자료를 활용하여 (Effects of temporomandibular joint disorder symptoms on oral and mental health status and quality of life : using the 2012 data from Korea National Health and Nutrition Examination Survey)

  • 강현경;이지영;김유린
    • 한국치위생학회지
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    • 제21권6호
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    • pp.731-740
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    • 2021
  • Objectives: The purpose of this study was to examine the effects of oral and mental health status on temporomandibular joint disorders (TMDs) and the effects of TMD symptoms on quality of life using data from the 5th 2012 National Health and Nutrition Examination Survey. Methods: A total of 1,154 people were selected as subjects for the study. Temporomandibular joint (TMJ) sounds (672 persons), TMJ pain (227 persons), and TMJ dislocation (255 persons) were the factors studied. The complex sample chi-square test was performed to compare demographic characteristics according to the three groups of TMD symptoms. Complex sample logistic regression analysis was performed to confirm the effect of oral and mental health status on TMDs, and complex sample linear regression analysis was performed to check the effect of TMDs on the quality of life (EQ-5D). Results: After adjusting for demographic characteristics, those without TMJ sound symptoms had lower pain/discomfort (OR: 0.055, CI: -0.095 to -0.016) and anxiety/depression (OR: 0.053, CI: -0.092 to -0.014). Those without TMJ pain had lower pain/discomfort (OR: 0.119, CI: -0.192 to -0.046) and anxiety/depression (OR: 0.071, CI: -0.137 to -0.004). Pain/discomfort (OR: 0.063, CI: -0.125 to -0.001) was lower in those without TMJ dislocation symptoms. After adjusting for mental health status, pain/discomfort (OR: 0.088, CI: -0.161 to -0.014) was found to be lower in those without TMJ pain symptoms (p<0.05). Conclusions: Based on the results of this study, the treatment of TMDs, oral health, and also mental health, is needed to improve the quality of life.

하악관절융기 절제술과 악관절원판 성형술을 이용한 악관절 탈구의 외과적 치료 (SURGICAL TREATMENT OF RECURRENT TMJ DISLOCATION BY EMINECTOMY WITH DISCOPLASTY)

  • 김형곤;최희수;허종기;박광호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권2호
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    • pp.141-146
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    • 2002
  • Purpose: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. Materials and Methods: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. Results: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. Conclusion: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.

Treatment of Temporomandibular Joint Reankylosis by Submandibular Anchorage Technique with Temporalis Myofascial Flap

  • Kim, Jun-Young;Kim, Jae-Young;Jung, Young-Soo;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권2호
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    • pp.78-83
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    • 2014
  • Management of temporomandibular joint (TMJ) ankylosis is challenging for the oral and maxillofacial surgeon because it involves the mouth opening, dentofacial deformity, diet problem, and quality of life. Although surgical techniques to treat TMJ ankylosis have improved, reankylosis is a persistent problem. The temporalis myofascial flap provides good material for interpositional arthroplasty, because of its good vascular supply, anatomic proximity, and adequate thickness. This case report examines the efficacy of submandibular anchorage to prevent reankylosis by inhibiting flap dislocation.

측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 대한물리치료과학회지
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    • 제5권4호
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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일부지역 근로자의 직무스트레스와 측두하악장애에 관한 연구 (Research on Occupational Stress of the Some Local Workers and Temporomandibular Joint Disorder)

  • 이정화;박의정;최정미
    • 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).

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Unilateral intraoral vertical ramus osteotomy and sagittal split ramus osteotomy for the treatment of asymmetric mandibles

  • Lee, Jee-Ho;Park, Tae-Jun;Jeon, Ju-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권2호
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    • pp.102-108
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    • 2015
  • In surgery for facial asymmetry, mandibles can be classified into two types, rotational and translational, according to the required mandibular movements for surgery. During surgery for rotational mandibular asymmetry, a bilateral sagittal split ramus osteotomy (BSSRO) may cause a large bone gap between the proximal and distal segments as well as condylar displacement, resulting in a relapse of the temporomandibular joint disorder, especially in severe cases. The intraoral vertical ramus osteotomy has an advantage, in this respect, because it causes less rotational displacement of the proximal segment on the deviated side and even displaced or rotated condylar segments may return to their original physiologic position. Unilateral intraoral vertical ramus osteotomy (UIVRO) on the short side combined with contralateral SSRO was devised as an alternative technique to resolve the spatial problems caused by conventional SSRO in cases of severe rotational asymmetry. A series of three cases were treated with the previously suggested protocol and the follow-up period was analyzed. In serial cases, UIVRO combined with contralateral SSRO may avoid mediolateral flaring of the bone segments and condylar dislocation, and result in improved condition of the temporomandibular joint. UIVRO combined with contralateral SSRO is expected to be a useful technique for the treatment of rotational mandibular asymmetry.

비정형 안면통에서의 성상신경절 차단 치료 (Treatment of Atypical Facial Pain with Stellate Ganglion Block)

  • 전영훈;김지현
    • 대한치과마취과학회지
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    • 제14권3호
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    • pp.173-175
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    • 2014
  • Atypical facial pain is loosely used term to describe some chronic facial pain when the symptoms do not exactly and entirely fit one diagnostic criteria. In many cases of pain disorders, sympathetic system is involved, such as in conditions which symptoms mimic post-herpetic neuralgia or complex regional pain syndrome. We report a case of a patient with atypical facial pain following the reduction of temporomanidbular joint dislocation. The atypical pain which was resistant to analgesic medication was successfully managed with stellate ganglion block. Therefore we suggest that stellate ganglion block can be an effective treatment method for controlling atypical facial pain.