• PNF and Movement
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• v.20 no.3
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.289-294
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• 2019

Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

• Journal of Korean society of Dental Hygiene
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• v.21 no.6
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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.

• Journal of dental hygiene science
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• v.9 no.1
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• pp.9-15
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• 2009

Aimed at office workers at their height of Temporomandibular joint disorder(TMD), organized self-filling questionnaires were distributed from January 7 to 26, 2008 to 216 workers in the fields of service, office work, and production in D metropolitan city, to get a proper recognition about prevention and treatment of TMD by observing how strongly occupational stress influence on them. The findings of the study were as follows: 1. For subjective symptoms of joint noise as TMD, occasional was 45.8% and often 12.0%, while for joint dislocation often was 12.0%. 41.2% said they feel pains while chewing, while 24.1% said they occasionally feel pains while not chewing. 2.8% said they often experience mouth-opening disorder. 2. For joint noise, answers were significantly different according to their ages, while 30's are at their height (P < 0.05). For joint dislocation, the shorter they worked the more they have it, so less than a year worker was 37.9%, while less than 3 years 31.0%, and less than 5 years 20.7%. For work type, daytime workers have more dislocation, 58.6%, than shift-workers 34.5% (P < 0.05, P < 0.01). For pains while chewing, the shorter they worked, the more they experienced, which is the same as mouth-opening disorder (P < 0.01). 3. Workers with mouth-opening disorder have much stress on occupational autonomy (P < 0.05) and workers with dislocation and pains while chewing have much stress on relation trouble (P < 0.05, P < 0.01). Workers with highly occupational insecurity has much trouble on dislocation and pains while chewing, while workers with dislocation have significantly much stress on unproper compensation (P < 0.05). 4. For who have joint dislocation, they have much stress on relation-trouble, occupational disorder, and un-proper compensation (P < 0.01, P < 0.05). Workers with pains while not chewing showed significant difference about occupational insecurity and relation troubles (P < 0.05, P < 0.01). Who have mouth-opening disorder showed significant difference about occupational autonomy (P < 0.05).

• Journal of the Korean Society of Physical Medicine
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• v.4 no.4
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• pp.257-267
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• 2009

Purpose：The purpose of this study is to examine the effectiveness of ultrasound and myofascial release in patients who have opening mouth limitation and temporomandibular disorder. Methods：Twenty students were randomly assigned to a myofascial release group(n=10) or an ultrasound group(n=7). Each group was treated for 15 minutes per a every treatment session for four weeks. Cervial range of motion(CROM) was used to measure cervical R.O.M., and a mm(millimeter) graduated ruler was used to measure opening mouth limitation. Results：Results of the follows : 1. The neck extension of range of motion of both groups was significantly increased in length of time (p<.05). 2. The neck flexion of range of motion of both groups was significantly increased (p<.05). 3. The quantity of opening mouth of temporomandibular joint of both groups was significantly increased (p<.05). Conclusion：These data suggest that myofascial release and ultrasound are beneficial to increasing a functional recovery of neck(flexion and extension) and opening mouth.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.1
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• pp.13-27
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• 2017

Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.87-95
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• 2023

Purpose: To quantify the relationship between perceived pain intensity and psychological variables in a sample of participants with temporomandibular disorder, with or without central sensitization (CS). Methods: A cross-sectional study with nonprobability convenience sampling was conducted from January 1, 2022, to June 30, 2023. Pain intensity (Numeric Pain Rating Scale), anxiety (State-Trait Anxiety Questionnaire, STAI), catastrophizing (Pain Catastrophizing Scale, PCS), perceived stress (Perceived Stress Scale, PSS), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were assessed. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Co.), which included descriptive and normality analyses and the calculation of strength of multiple correlational regression. Results: A total of 52 (n=34 female 65.4%; n=18 male 34.6%) subjects with diagnosis of temporomandibular disorders (TMD) were finally included. A total of 26 participants (n=26, 50.0%) were cases suffered from CS (TMD-CS mean=46.62±11.24) while the remaining participants (n=26, 50.0%) were the controls (TMD-nCS mean=26.77, standard deviation [SD]=8.42). The pain intensity was moderate in both groups TMDCS (mean=7.62, SD=0.83) and TMD-nCS (mean=7.05, SD=0.86), anxiety (TMD-CS STAI mean=53.27, SD=11.54; TMD-nCS STAI mean=49, SD=11.55), catastrophizing (TMD-CS PCS mean=46.27, SD=9.75; TMD-nCS PCS mean=26.69, SD=4.97), perceived stress (TMDCS PSS mean=30.35, SD=4.91; TMD-nCS PSS mean=26.12, SD=6.60) and sleep quality (TMD-CS PSQI mean=15.81, SD=3.65; TMD-nCS PSQI mean=12.77, SD=2.76) levels were measured in both groups. In TMD-CS and TMD-nCS, higher anxiety levels were moderately and significantly associated with greater pain intensity β=0.4467 (t=2.477, p=0.021) and β=0.5087 (t=2.672, p=0.014). Nevertheless, catastrophizing, perceived stress and sleep quality were not associated to pain intensity in neither of group. Conclusions: In both TMD-CS and TMD-nCS patients, elevated anxiety levels were moderately and significantly associated with increased pain intensity. However, heightened levels of pain catastrophizing, perceived stress, and poor sleep quality were not significantly associated with increased pain intensity in either of the two analyzed groups.

• Journal of Oral Medicine and Pain
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• v.37 no.1
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• pp.61-72
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• 2012

Temporomandibular disorder(TMD) is relatively prevalent disease, and quality of life may be impaired in TMD patients. Like general population, dental hospital workers are also exposed to the risk of TMD. But, many of them tend to overlook or tolerate their symptoms for lack of time and interest. Therefore, problems may become more serious, causing interference of performing task and decrease of quality of life. The aim of this study were to obtain data for TMD prevalence in dental hospital workers and to evaluate quality of life according to TMD symptoms. Subjects were recruited from Wonkwang University Dental Hospital. After consent, subjects completed quality of life questionnaire and were evaluated for subjective and objective signs and symptoms of TMD. Subjects were classified into 4 groups : (1) normal group (2) joint disorder group, (3) local myalgia group, and (4) myofascial pain group. The result of the study indicated that TMD negatively influences the quality of life in dental hospital worker. TMD symptoms can deteriorate quality of life in dental hospital worker. Future effort to make protocol for proper management is needed.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.161-168
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• 2016

Purpose: Patients who suffer from rheumatic arthritis, fibromyalgia, other various inflammatory diseases and musculoskeletal disorders, which are all similar to temporomandibular disorders (TMD), have been complaining about changes in the level and type of pain in response to changes in weather conditions for a long time. Through an investigation about pain perception in TMD patients in response to weather conditions, our primary objective was to develop base materials for future studies on change in pain in response to meteorological factors. Methods: Among patients who presented with TMD to Department of Oral Medicine, Pusan National University Dental Hospital from August to October 2016, one hundred consecutive TMD patients diagnosed with TMDs according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were recruited for the study and 28 patients were excluded according to exclusion criteria. Survey was done with the questionnaire and investigated whether there was any difference in incidence and level of pain in TMD patients between non-rainy and rainy days. Results: Among a total of 72 samples, 4 patients reported change in pain on rainy days rather than non-rainy days. Two patients from chronic group (joint and complex subgroup) reported increased pain on rainy days rather than non-rainy days but it was not statistically significant (p>0.05). One patient from chronic/muscle group reported the change in pain characteristics while pain intensity remained unchanged. One patient from acute/complex group reported decreased pain intensity. In comparison of the patients who reported increased pain on rainy days between acute and chronic groups, there were two reported cases and were both from chronic group only. There was a significantly higher chance of reporting increased pain on rainy days in chronic group than acute group (p<0.001). Conclusions: It is considered that TMD patients couldn't perceive the change in pain well in response to weather change on rainy days but some chronic patients could perceive the increase in pain in rainy days.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.218-225
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• 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.