Objectives : Therapeutic effect of Balance Appliance of functional crebrospinal technique (FCST for meridian and neurologic yinyang balance was observed in two refractory torticollis cases. Methods : A unidentified severe torticollis two cases with several months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after $3{\sim}5$ months of therapy, which effect was reported to maintain for 6 months. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.
Background: The purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ). Methods: A total of 15 joints from 11 elderly patients (71-78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated. Results: No patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period. Conclusion: Although nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.
Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..
Jo, Chang-Hwan;Lee, Young-Jun;Kim, Jung-Hyun;An, Joung-Jo;Jo, Hyun-Kyung;Kim, Yoon-Sik;Seol, In-Chan;Yoo, Ho-Rhyong
The Journal of the Society of Stroke on Korean Medicine
/
v.12
no.1
/
pp.68-72
/
2011
Objective : Therapeutic effect of Balance Appliance of functional cerebrospinal technique (FCST) for meridian and neurologic yinyang balance was observed in one neck pain case. Method : A neck pain one case with 3 months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after 1 months of therapy. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.
Seo, Jong Cheol;Kim, Shin Young;Seo, Yeon Ju;Park, Jong Hyeon;Lee, Yoon Joo;Ryu, Hye Min;Lee, Seung Jeong;Yoon, Hyun Min;Song, Chun Ho;Lee, Young Jun;Kim, Cheol Hong
Korean Journal of Acupuncture
/
v.33
no.4
/
pp.183-193
/
2016
Objectives : The purpose of this study is to find out the effect of Postural Yinyang Correction of TMJ(Functional Cerebrospinal Therapy; FCST) on Bell's palsy. Methods : We reviewed the medical records of 41 patients who were treated for Bell's palsy at the Dept. of Acupuncture and Moxibustion, Dong-Eui University from January $1^{st}$, 2016 to August $31^{st}$, 2016. The patients were divided into 2 groups: Group A(n=21), and Group B(n=20). Patients in Group A were treated by Korean Medical Treatments with FCST using ABA(Accurate Balancing Appliance), a standard intra-oral appliance. Patients in Group B were treated by Korean Medical Treatments without FCST. To estimate the efficacy in recovering palsy, we analyzed the House-Brackmann Grading Scale and Yanagihara's Unweighted Grading System. Results : In both groups, H-B grades were improved significantly during each period except the period from the first visit to one week later(P01). The improvement of H-B grade during each period in Group A is higher than Group B except the period from one week later to two weeks later, but statistically insignificant. In Group A, Y-score was significantly improved during each period except during P01. In group B, Y-score was significantly improved during each period except during P01 and the period from the first visit to two weeks later. The improvement of Y-score during each period in Group A is higher than Group B, but statistically insignificant. Conclusions : FCST using Standard Intraoral Appliance may be helpful in treating Bell's Palsy, but the further researches are needed.
Journal of Dental Rehabilitation and Applied Science
/
v.28
no.1
/
pp.87-101
/
2012
Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.
To evaluate the treatment outcome after conservative treatment in patients with osteoarthritis of the TMJ(OA), the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as osteoarthritis of the TMJ, and treated with conservative methods from 1994 to 2006. 101 patients with diagnosis of osteoarthritis of the TMJ were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorders(MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subject's status at the first and the last visit. The results were as follows : 1. In the OA group, satisfactory treatment outcome was obtained with conservative methods. But, at the last visit, the symptoms of the OA group were not improved enough compared with those of the MMD group. 2. In the OA group, radiographic findings of panorama view and transcranial projection were positive by about 60 percent. But, computed tomography and single photon emission computed tomography were positive by more than 90 percent. 3. At the last visit of the OA group, the joint noise was reduced significantly. 4. In the majority of the OA group, satisfactory treatment outcome was obtained with conservative methods such as medication, physical therapy, and occlusal stabilization appliance. In the majority of the MMD group, satisfactory outcome was obtained with medication and physical therapy. 5. It took the OA group from 6 months to 2 years to be cured well while the MMD group within 6 months.6. The OA group needed more than 10 times' treatment for satisfactory outcome while the MMD group needed less than 10 times' treatment.
Keum Ki Chang;Kim Gwi Eon;Lee Sang Hoon;Chang Sei Kyung;Lim Jihoon;Park Won;Suh Chang Ok
Radiation Oncology Journal
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v.16
no.4
/
pp.399-408
/
1998
Purpose : This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. Materials and Methods : The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. Results : The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2$\%$ over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6$\%$ with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. Conclusion : This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning. but prospective studies are required to define the true clinical benefit.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.3
/
pp.327-336
/
2011
Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.
Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.
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