• 턱관절균형의학회지
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• 제8권1호
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• pp.11-15
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• 2018

Recently, clinical efficacies of the intraoral balancing appliance therapy have been reported by several researchers, and it has been found that there are various kinds of diseases that can be effectively applied. However, studies on cerebrovascular disease, one of the main diseases with a high mortality rate, are still poorly reported, and studies of temporomandibular joint disorder (TMD)-induced changes in brain function suggest that cerebrovascular disease is more appropriate as an adaptive disorder of the temporomandibular joint (TMJ) balancing device. In the developed countries, the importance of research on the structure and function of the brain has been recognized and spurred on the related research. In Korea, the research on brain function and cognitive disorders should have promoted more massively. In order to regain its former reputation in the Korean medicine in the field of cerebrovascular disease, it should be spurred on basic research and clinical case studies. In addition, extensive and in-depth studies including animal studies are needed to establish the basis of underlying mechanisms of the TMJ balancing therapies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• 한방재활의학과학회지
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• 제33권3호
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• pp.149-160
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• 2023

Objectives This study is for reporting current status and strategies of thread embedding acupuncture (TEA) in temporomandibular joint disorder (TMD) using web-based survey. Methods Survey was conducted online via E-mail among Korean medicine doctors registered with the Association of Korean Medicine. The questionnaire is developed by Korean medicine doctor in Kyung Hee University Hospital at Gangdong. The survey consisted mainly of multiple-choice questions on the current status and strategies of TEA for TMD. Results Total of 427 doctors responded. TEA was mostly used for 'Cosmetic purpose and others' with 287 respondents (67.2%), and 102 respondents (23.9%) having experience with TEA for TMD. The most common purpose for TEA for TMD was 'Improving muscle contraction and tension' with 290 respondents (67.9%). The average interval was reported 2.12 weeks, and the most common response for the number of treatments was five sessions with 127 respondents (29.7%). The most common criterion for determining the treatment site was based on anatomical structure, accounting for 92.7%. The most effective anatomical structure was the 'Masseter muscle' with 83.1%, followed by the 'Temporal muscle' with 51.8%. TEA direction for TMD was dominant in 'affected side' for all muscles. Conclusions Through a survey, we can investigate clinical usage of TEA for TMD. This study can be helpful in creating standardized criteria for TEA on TMD in the future.

• Journal of Oral Medicine and Pain
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• 제44권4호
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• pp.160-168
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• 2019

Purpose: To search the salivary factors that objectively indicate an pain in myalgia patients with temporomandibular joint disorder (TMD) and determine the possibility of the factors as pain-biomarkers. Methods: Participants consisted of pain-free 15 persons (male 7, female 8, mean age±standard deviation (SD); 26.8±16.04 years) and 45 myalgia patients with TMD (male 21, female 24, mean age±SD; 27.98±13.01 years). They were divided into a pain-free group (numerical rating scale [NRS] score 0), a mild pain group (NRS 1-4), a moderate pain group (NRS 5-6), and a severe pain group (NRS 7-10) and members of all groups were age, sex matched. Interleukin-8 (IL-8) and matrix metalloprotease 9 (MMP-9) were selected as pain biomarkers, by searching the Gene Expression Omnibus database and analyzing pain-related genes. Enzyme-linked immunosorbent assays were used to measure the concentration of IL-8 and MMP-9 in the patients' saliva. Results: IL-8 and MMP-9 levels were statistically significantly higher in pain groups than in the pain-free group. Greater differences were observed in patients with acute pain (with painful duration under 3 months) than in the control group and in female patients than in male. Conclusions: Salivary IL-8 and MMP-9 may play a role as biomarkers of myalgia in patients with TMD.

• Journal of Korean Dental Science
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• 제13권1호
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• pp.21-27
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• 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.

• 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.

• The Korean Journal of Pain
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• 제20권2호
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• pp.163-168
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• 2007

Background: Temporomandibular joint disorder (TMD) is a group of musculoskeletal conditions characterized by pain in the pre-auricular area, limitation of jaw movement and palpable muscle tenderness. Thermography is a nonionizing, noninvasive diagnostic alternative for the evaluation of TMD. This study was conducted to evaluate the usefulness of thermography in the assessment of TMD. Methods: Thermography was conducted on the 61 patients who had been diagnosed with TMD, and on the 34 normal symptom-free volunteers. The temperature differences between opposite sides of the temporomandibular joint (${\Delta}T_{TMJ}$) and the masseter muscle (${\Delta}T_{MST}$) were calculated. The sensitivity and specificity of thermography was calculated at the cut off values of 0.2, 0.3, and $0.4^{\circ}C$. Results: In the patient group, the ${\Delta}T_{TMJ}$ was $0.42{\pm}0.38^{\circ}C$ and the ${\Delta}T_{MST}$ was $0.38{\pm}0.33^{\circ}C$, whereas in the control group the ${\Delta}T_{TMJ}$ was $0.10{\pm}0.07^{\circ}C$ and the ${\Delta}T_{MST}\;0.15{\pm}0.10^{\circ}C$. In addition, the patient group demonstrated a significantly lower level of thermal symmetry than the control group (P < 0.001) in both the temporomandibular joints and the masseter muscles. The sensitivity of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 67.2, 49.2, and 42.6% in the temporomandibular joint (TMJ) and 60.7, 49.2 and 37.7% in the masseter muscle, respectively. The specificity of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 88.2, 100, and 100% in the TMJ and 61.8, 91.2 and 100% in the masseter muscles, respectively. The accuracy of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 74.7, 67.4, and 63.2% in TMJ and 61.1, 64.2 and 60.0% in the masseter muscles, respectively. Conclusions: Temperature differences exist between the opposite sides of the TMD and masseter muscles in patients with TMD. Although the sensitivity of thermography in the diagnosis of TMD is low, it has high specificity in the evaluation of TMD, and is therefore applicable to patients with TMD.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권5호
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• pp.457-462
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• 2005

The aim of this study is to evaluate the relative signal intensity of TMJ retrodiscal tissue in T2-weighted MRI as diagnostic marker of temporomandibular disorder(TMD). 58 temporomandibular joints from 29 TMD patients (14 men & 15 women) were evaluated. The relative signal intensity of retrodiscal tissue in T2-weighted MRI was referenced to brain gray matter same size of the region of interest(ROI). The collected data was compared to disc positions (normal, anterior disc displacement with reduction, anterior disc displacement without reduction), the presence of joint effusion. The relative signal intensity of retrodiscal tissue was significantly increased when the disc was displaced without reduction. And the relative signal intensity of retrodiscal tissue was significantly increased when joint effusion was present. The results suggest that evaluating the relative signal intensity of TMJ retrodiscal tissue using a T2-weighted MRI is valuable as a non-invasive tool for diagnosing the procession of TMD.

• PNF and Movement
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• 제20권3호
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• pp.451-459
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• 2022

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.