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

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Comparison of the Biopsychosocial Features of Myofascial Pain to Local Myalgia in Patients with Temporomandibular Disorders

  • Choi, Hee Hun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • v.47 no.3
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    • pp.117-125
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    • 2022
  • Purpose: This study aimed to investigate whether and how the biopsychosocial features of myofascial pain (MFP) differ from those of local myalgia (LM) in temporomandibular disorder (TMD). Methods: Patients with TMD were retrospectively evaluated using the Diagnostic Criteria for TMD. All patients completed a series of self-administered questionnaires on pain severity and pain interference (Brief Pain Inventory, BPI), pain disability (Graded Chronic Pain Scale, GCPS), psychological distress (Symptom Check List-90-Revised, SCL-90R), pain cognition (Pain Catastrophizing Scale, PCS), and subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI). Among all the TMD diagnoses, muscle pain was classified into the MFP group and LM group. Results: This study included 917 patients with myalgia (MFP: 266, LM: 651). Significant differences were observed in the female ratio (78.9% for MFP, 60.9% for LM, p<0.001) and the mean pain duration (MFP: 25.3 months, LM: 15.8 months, p=0.001) between the two groups. Patients with MFP exhibited higher pain severity (p=0.003) and pain interference (p<0.001) of BPI than those with LM. Furthermore, the global scores of the PCS (p<0.001) and PSQI (p<0.001) were higher in the MFP group than in the LM group. The MFP group had higher global symptom index (p=0.017) and five subscales of the SCL-90R than the LM group. Compared with the LM group (33.4%), the greater proportion of high disability of GCPS was observed in the MFP group (44.9%) (p<0.001). Multiple regression analysis revealed that sex (p=0.002), pain duration (p=0.019), pain disability (p=0.010), and subjective sleep quality (p=0.008) significantly differed between the two groups. Conclusions: The findings of this study indicated that MFP presents a higher biopsychosocial burden than LM in TMD.

A Study on the Temporomandibular Joint Disorder and School Life Stress of High School Student by Department (계열별 남자고등학생의 학교생활스트레스와 측두하악장애에 관한 연구)

  • Lee, Jung-Hwa;Choi, Jung-Mi
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.179-185
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    • 2007
  • The purpose of this study targeted on high school student in the department of liberal arts, industry in Daegu metropolitan city, is to get basic data necessary for the development of dental educational program, to discern prevention and treatment of temporomandibular joint disorder by observing the situation temporomandibular joint disorder and contribution element, of relationship of school life stress The results are as follows.: 1. The percentage of occurring temporomandibular joint disorder in the high school resulted in a joint noise at 61.8% and joint dislocation 6.9%, sharp pain 47.5% at time of chewing. 29.8% at the time of the non-chewing, lockjaw 11.3%, a headache appeared at 40.4%.2. In the contribution factor of occurring temporomandibular joint disorder, the cause of joint noise was the clench one's teeth, lip and cheek clench, For the pain at the time of chewing clench one's teeth, one side chewing, over-chewing, lip clench, sideways sleeping showed the difference. (P < 0.01) For the pain at the time of non-chewing, clench one's teeth, bruxism, one side chewing, lip and cheek clench were similar, and for the lockjaw, clench one's teeth, bruxism, sideways sleeping showed the difference. The plum evil thing period at time of the fault writing that statistically showed the difference. For the headache, the contribution factors were the all bad habits mentioned above excluding one side sleeping.(P < 0.01, P < 0.05). 3. The rate of experiencing temporomandibular joint disorder by oral and maxillofacia was 13.4% in industrial department, and 19.6% in liberal arts. And for the factor of wound was that exercise 26.8%, others 24.4%, fall-down 19.5%. And for the industrial, exercise 44.4%, fall-down 22.2%, others 14.9%. The treatment experience appeared at 5.0% in industrial department, 2.9% in liberal arts. And for the medical institutions, liberal arts were dental clinic 50%, orthopedics 50%, and the industrial department orthopedics 40%, oriental medicine clinic 30%, dental clinic 30%. 4. In case of temporomandibular joint disorder, there were no difference by grades or educational background. And at the time of chewing or non-chewing showed similar difference.(P < 0.01). 5. Compared to stress in the high school, it generally showed higher in liberal arts than in industrial department due to school record. Its scope was $3.75{\pm}1.14$ in liberal arts, $3.01{\pm}1.23$ in industrial department. 6. The school record, school life, stress problems by teachers, chewing/non-chewing pain of temporomandibular joint disorder, joint noise had a similar correlation.(P < 0.01, < 0.05).

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An unusual abscess formation in the masticator space after acupressure massage: a case report

  • Ko, In-Chan;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Bae, Jung-Ho;Lee, Kwon-Woo;Chin, Young-Jai
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.52-56
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    • 2015
  • Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis

  • Mena, Mariam;Dalbah, Lana;Levi, Lauren;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.337-356
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    • 2020
  • This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

Evaluation of Temporomandibular Disorders with Tension-Type Headache by Age (연령에 따른 측두하악장애 환자의 긴장성 두통 양상)

  • Muhn, Kyung-Hwan;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.103-114
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    • 2009
  • This study was designed to evaluate the Temporomandibular Disorders(TMD) with Tension-Type Headache(TTH) by age. Patients with TMD and/or TTH visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study. Experimental group(n=170) is composed of TMD with TTH and control group(n=222) is composed of TMD without TTH. Evaluation list was pain quality, pain intensity, pain laterality, pain increase by routine physical activity and then it was analyzed statistically. The results were as follows ; 1. In the control group, pain quality was not significantly different by age. But, in the experimental group, pain quality was significantly different by age(p=0.042). 2. In the control group, pain intensity was significantly different by age(p=0.000). And, in the experimental group, pain intensity was significantly different by age(p=0.004). 3. In the control group, pain laterality was not significantly different by age. And, in the experimental group, pain laterality was not significantly different by age. 4. In the control group, pain increase by routine physical activity was not significantly different by age. And, in the experimental group, pain increase by routine physical activity was not significantly different by age. Therefore, it is considered that not temporomandibular disorder patients without tension-type headache but temporomandibular disorder patients with tension-type headache was influenced by age in the pain quality.

The Function and Quantitative Somatosensory Correlation Analysis of Temporomendibular Joint according to Forward Head Posture (전방머리자세에 변화에 따른 턱관절 기능 및 정량적 체성감각의 상관분석)

  • Lee, Eun Sang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.645-651
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    • 2019
  • This study examined the correlation between the forward head posture (FHP), temporomandibular joint disorder (TMD), and temporomandibular joint quantitative somatosensory sensation. This study examined the correlation between the temporomandibular joint function and somatosensory sensation according to the change in FHP after the intervention on the head posture in 62 subjects (22.15 ± 2.56 years) Biofeedback training was administered to the FHP, which was performed 12 times for a total of four weeks. To assess the FHP, the craneovertebral angle (CVA) was examined. The temporomandibular joint (TMJ) function was measured by the Therapeutic Range of Motion Scale and the left and right lateral deviation, and the sensation of vibration threshold was measured to confirm the change in somatic sensation. Multiple regression analysis was performed to confirm the influence of each variable and Pearson's correlation analysis was performed to assess the correlation. Changes in the temporal joint function (p<.001) and somatic sensation (p<.001) were correlated significantly with the changes in CVA. These results show that there is a significant correlation between the frontal head position, TMJ function, and somatosensory sensation. These results provide a new paradigm for the treatment of jaw joints for patients suffering from TMD and provide a basis for the future treatment of the temporomandibular joint.

Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder (편측성 측두하악관절장애 환자에서 골스캔을 이용한 교합안정장치 치료효과 예측)

  • Lee, Sang-Mi;Lee, Won-Woo;Yun, Pil-Young;Kim, Young-Kyun;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.143-149
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    • 2009
  • Purpose: It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders(TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Materials and Methods: Between January 2005 and July 2007, 55 patients(M:F=9:46; mean age, $34.7{\pm}14.1$ y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint(TMI) was quantitated using a $13{\times}13$ pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Results: Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index(p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve($1.32{\pm}0.35$ vs. $1.08{\pm}0.04$, p=0.023), Conclusion: The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment.

Ultrasound-guided Platelet-rich Plasma Prolotherapy for Temporomandibular Disorders

  • Moon, Seong-Yong;Lee, Sun-Tae;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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    • pp.140-145
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    • 2014
  • Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.

Comparative Clinical Study between the Acupuncture Treatment and the Chuna Treatment on Temporomandibular Disorder (측두하악 증후군에 대한 침치료 군과 추나치료 군의 임상적 고찰)

  • Kim, Tae-Soo;Kim, Chang-Yun;Lee, Ki-Ha;Um, Tae-Woong;Jung, Yung-Hoon;Kho, Yung-Tak
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.51-60
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    • 2006
  • Objectives : The purpose of study was to compare and analyze the effects of the distance Acupuncture and the Chuna on Temporomandibular Disorder. Methods : Clinical studies were done on 31 patients who were treated with Temporomandibular Disorder at Dept. of Acupuncture & Moxibusition of Hospital of Ha-na Oriental Medicine from May 23 2005 to Apr 30 2006. Subjects were divided Into two group, Distance acupuncture group and Chuna group. In Distance acupuncture group, we treated patients with Wijungyug(胃正格) or Damjungyug(膽正格). In Chuna group, we treated patients with Distraction & Translation technique. For evaluating Function of Temporomandibular joint of Patients, we use the Modified Craniomandibular Index(mCMI) before treatment and after 6th treatment. Results : In Mandibular Movement(MM) of patients, the patients of Acupuncture Group were more effective than Chuna group. In TMJ noise(TN) of patients, the patients of Chuna Group were more effective than Acupuncture group. Conclusions : The Distance acupuncture may be better effect on Mandibular Movement and The chuna maybe better effect on TMJ noise.

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A RESEARCH FOR THE RELATIVE SIGNAL INTENSITY OF THE RETRODISCAL TISSUE IN THE TEMPOROMANDIBULAR JOINT DISORDER PATIENTS ON MRI (턱관절 질환환자의 MRI상 원판후 조직의 상대적 신호강도에 대한 연구)

  • Ha, Won-Suk;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.211-216
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    • 2007
  • Temporomandibular joint disorders (TMD) often show muscular disorder, internal derangement and degenerative change of articular surface of the condyle. It is important to choose adequate diagnostic method for obtaining data for the diagnosis and treatment. Magnetic Resonance Imaging (MRI) has some advantages, because it shows good resolution image for the soft tissue and it is not invasive to the human body. We have performed serial research about the retrodiscal tissue of the TMJ according to the progress of the disease, using T2 weighted image, since 2002. In this study, we applicated resized observation area to compare signal intensity between the retrodiscal tissue of the TMJ and cerebral gray matter, using T2 weighted image.