• Title/Summary/Keyword: Temporomandibular joint disorder(TMD)

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Use of a botulinum toxin A in dentistry and oral and maxillofacial surgery

  • Park, Kyung-Soo;Lee, Chi-Heun;Lee, Jung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.151-157
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    • 2016
  • Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.

CLINICAL STUDY ON THE ETIOLOGY, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF TRISMUS (개구장애 환자의 병인, 감별진단 및 치료방식에 대한 임상연구)

  • Kang, Hee-Jea;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Kim, Jong-Ryoul;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.544-558
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    • 2006
  • Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture, and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.

Distribution and clinical features of patients with degenerative change of the mandibular condyle (측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포 및 임상적 특징)

  • Lim, Yong-Kyu;Kim, Min-Ji;Kim, Youn-Joong;Song, Yun-Heon;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.402-411
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    • 2006
  • Objective: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. Methods: Six thousand and seventy patients with TMD (temporomandibular cisorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. Results: The distribution. and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. Conclusion: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD.

Effect of Obesity and Psychological Stress on Oral Health (비만과 스트레스가 구강건강에 미치는 영향)

  • Kim, Soo-Hwa;Lee, Sun-Mi
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.119-128
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    • 2015
  • The purpose of this study is to understand the effects of obesity and stress on oral disease in Korean adults by using the data of the Fifth Korea National Health and Nutrition Examination Survey. The subjects of this study are 4,627 adults at the age of 19 to 64, and the data were analyzed by using SPSS Windows ver.18.0. The results are as follows: Obesity was higher in men and the age of 40 to 64 than the other. And the group with lower education or lower income level tended to show significantly higher obesity (p<0.05). As for stress, women, the age of 19 to 39 and the subjects with higher academic career tended to indicate significantly higher stress (p<0.05). As for the effects of obesity on oral disease, there were no significant difference between body mass index (BMI) or waist-hip ratio (WHR) and oral disease but there was statistically significant difference between stress and temporomandibular joint disorder (TMD) (p<0.05). Even when the subjects with stress were obese or abdominally obese, there was no significant difference in oral disease (p>0.05). As to correlation among variables, there were correlations between BMI and WHR, stress and TMD, masticatory problems and periodontal disease or TMD (p<0.05). About the effects of general characteristics, obesity, and stress on oral disease, age was the variable influencing TMD, and age and abdominal obesity were the variables influencing masticatory problems (p<0.05). In this society, the environment surrounding individuals is fairly complex, and the concept of health including quality of life has more complex meaning than in the past. Various factors are influencing obesity and stress, and they are also influencing oral health and behaviors. Accordingly, it will be needed not only to make efforts to reduce obesity and stress but also to employ approaches from different perspectives to improve oral health.