• Title/Summary/Keyword: Total disc displacement

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A CLINICAL STUDY OF TEMPOROMANDIBULAR JOINT DISORDERS BY USING ARTHROGRAPHY (측두하악관절조영술을 이용한 측두하악관절장애의 임상적 연구)

  • Lee Seung-Hyun;Hwang Eui-Hwan;Lee Sang-Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.155-169
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    • 1998
  • The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed on eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows; 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41 %, 54%, 5% of total cases in this study, respectively. 2. The third decade(65%) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent ( 61 %) in this study. In joint sound, click(63%) was the most frequent in disc displacement with reduction group, but sound history(42%) and no sound (31 %) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44mm, 32.9mm, 44mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 53%, 79%, 40%, and the trauma history of each group was 50%, 40%,60%.

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Total Disc Replacement in Lumbar Degenerative Disc Diseases

  • Park, Chun Kun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.401-411
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    • 2015
  • More than 10 years have passed since lumbar total disc replacement (LTDR) was introduced for the first time to the world market for the surgical management of lumbar degenerative disc disease (DDD). It seems like the right time to sum up the relevant results in order to understand where LTDR stands on now, and is heading forward to. The pathogenesis of DDD has been currently settled, but diagnosis and managements are still controversial. Fusion is recognized as golden standard of surgical managements but has various kinds of shortcomings. Lately, LTDR has been expected to replace fusion surgery. A great deal of LTDR reports has come out. Among them, more than 5-year follow-up prospective randomized controlled studies including USA IDE trials were expected to elucidate whether for LTDR to have therapeutic benefit compared to fusion. The results of these studies revealed that LTDR was not inferior to fusion. Most of clinical studies dealing with LTDR revealed that there was no strong evidence for preventive effect of LTDR against symptomatic degenerative changes of adjacent segment disease. LTDR does not have shortcomings associated with fusion. However, it has a potentiality of the new complications to occur, which surgeons have never experienced in fusion surgeries. Consequently, longer follow-up should be necessary as yet to confirm the maintenance of improved surgical outcome and to observe any very late complications. LTDR still may get a chance to establish itself as a substitute of fusion both nominally and virtually if it eases the concerns listed above.

THREE-DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF THE JAWS AT THE SIMULATED BILATERAL AND UNILATERAL CLENCHINGS (양측성 및 편측성 이악물기시 상하악골 응력변화 및 변위에 관한 3차원 유한요소법적 연구)

  • Heo, Hoon;Kang, Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.1
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    • pp.71-92
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    • 1999
  • This study is to analyze the stress and displacement on the jaws during the bilateral and unilateral clenching task on three dimensional finite element model of the dentated skull. For this study, the computed tomography(G.E.8800 Quick, USA) was used to scan the total length of human skull in the frontal plane at 1.9mm intervals. The CAD data were extracted from the tomograms through digitizer(Summa Sketch III, USA) and then reconstructed by means of the spline method in the CAD program. In this project, a commercial software I-DEAS(Master Series ver-sion 3.0, SDRC Inc, USA) was used for three-dimensional stress analysis on the finite element model. which consists of articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. The results are as follows. ; 1. During the bilateral clenching, each major muscle forces caused high stresses on various areas of skull: masseter muscle on articular disc and teeth ; temporal muscle on mandible and periodontal ligament ; medial pterygoid muscle on the temporomandibular joint. During the unilateral clenching, masseter muscle induced the maximum stress ; medial pterygoid muscle the minimum stress. 2. During the bilateral clenching, higher compressive stresses on articular disc were generated by the masseter muscle and higher deformation occurred on the most front outer sites. And during the unilateral clenching, temporal muscle and medial pterygoid muscle exerted their forces to twist temporomandibular joint area of the balancing side and induced a higher compressive stresses on the front outer sites of articular disc. 3. During the bilateral clenching, the masseter muscle bended the mandible outwardly, and then caused tensile stresses on the lingual surface of mandibular symphysis. And the medial pterygoid muscle caused tensile stresses on the labial surface of mandibular symphysis. 4. When each muscles were simultaneously applied on jaws, a high stress and displacement took place on mandible rather than on the maxilla. Also, a high stress and displacement took place during the unilateral clenching rather than during the bilateral clenching.

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Analysis of Power Loss of an Optical Disc Drive due to the Tilting Motion of a Rotating Disc (ODD 회전 디스크의 틸팅 각운동에 의한 소모전력 해석)

  • Chong, H.Y.;Sung, S.J.;Jang, G.H.
    • Transactions of the Society of Information Storage Systems
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    • v.6 no.2
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    • pp.57-62
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    • 2010
  • This paper measured and analyzed the source of total power loss of an ODD of a notebook computer. It shows that the biggest power loss is the windage loss due to the friction between rotating disk and surrounding air. It measured the power loss by the tilting motion of a rotating disc which is originated from the unbalanced mass of the rotating disc or the squareness between case-rotor and shaft. The power loss of rotating disc due to tilting motion was also calculated by using FLUENT, and it was correlated with the measured one. This paper shows that the one of the effective methods to reduce the power loss of an ODD is to reduce the tilting motion of a rotating disc.

Magnetic resonance evidence of joint effusion in patients with temporomandibular joint disorders (측두하악관절장애 환자의 자기공명영상에서 관찰되는 악관절 삼출)

  • Ko Jee-Young;Kim Kee-Deog;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.31 no.2
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    • pp.73-84
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    • 2001
  • Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

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Assessment of functional improvement with temporalis myofascial flap after condylectomy in elderly patients with anterior disc displacement without reduction and an erosive condylar surface

  • Kang, Young-Hoon;Bok, Jung-Suk;Park, Bong-Wook;Choi, Mun-Jeoung;Kim, Ji-Eun;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.23.1-23.8
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    • 2015
  • 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.

Correlation between clinical symptoms and magnetic resonance imaging findings in patients with temporomandibular joint internal derangement

  • Jung, Young-Wook;Park, Sung-Hoon;On, Sung-Woon;Song, Seung-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.3
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    • pp.125-132
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    • 2015
  • Objectives: The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion: We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.

The Effect of Joint Space Pumping Treatment in Patients with Reducible Disc Displacement Accompanied by TMJ Sound and Pain (악관절잡음 및 동통을 동반한 정복성 관절원판 변위환자에 대한 관절강 Pumping 효과)

  • Kim, Hyeon-Cheol;Choi, Jong-Hoon;Park, Hye-Suk;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.24 no.1
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    • pp.9-24
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    • 1999
  • Pumping into the upper joint cavity of the TMJ was done on patients who had reducible disc displacement with pain. This article discusses the change in TMJ sounds before and after the Pumping treatment. 20subjects(mean age of $32.1{\pm}10.2yr$)were selected among those who visited the department of Oral Medicine of Yonsei University for the treatment of craniomandibular dysfunctions. Through a thorough history taking, clinical exam and X-ray taking these subjects were diagnosed as reducible disc displacement patients, and they were subdivided into two groups as acute and chronic according to the time the TMJ sound was made. Sonopak was used to measure the TMJ sound before, right after and one-week after the Pumping treatment. VAS was used to measure the degree of subjective TMJ complaints(sounds and pain) before and one-week after the Pumping treatment. Vibration related items included total integral, high integral, low integral, ratio of high integral to low integral, peak amplitude, peak frequency and median frquency. 1. It was not statistically significant between the acute and chronic groups before the treatment. However, total integral, high integral, low integral, peak amplitude, peak frequency, median frequency showed to be greater in the chronic group. 2. In all the subjects, just after the Pumping treatment was done, total integral, high and low integral, peak amplitude and peak frequency significantly decreased (p<0.05). Even after one week, low integral, peak frequency and median frequency significantly decreased (p<0,05), and the TMJ sound diminished accordingly. 3. Comparing the two groups(before and right after the Pumping treatment), there was the following difference ; in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05). In the chronic group, total integral, high integral, low integral, ratio, peak amplitude and peak frequency significantly decreased(p<0,05). It was not statistically significant between the acute and chronic group. 4. Comparing the two groups(right after and one week after the Pumping treatment), there was the following difference : in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05), In the chronic group, low integral significantly decreased(p<0.05). However, although it was not statistically significant, after one week, there was an increase in total integral, ratio, peak amplitude and peak frequency compared to right after the treatment group. 5. In the VAS of before and one week after the Pumping treatment of the TMJ pain and sound, the TMJ pain significantly decreased(p<0.05) in both the acute and chronic group. However, it was not statistically significant between the two groups. There was a statistically significant decrease(p<0.05) in the TMJ sound in the acute group after one week of Pumping treatment, but no change was notable in the chronic group and it was not statistically significant between the two groups. From the above results, we can conclude that Pumping into the upper joint cavity of patients having reducible disc displacement is effective in reducing clicking and pain. Therefore, it can be applied in diverse clinical fields.

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A Numerical Study on the Flow Characteristics through an Industrial Safety Relief Valve (산업용 안전 릴리프밸브 유동특성에 관한 수치연구)

  • Kang, Sang-Mo;Lee, Bong-Hee
    • Journal of Advanced Marine Engineering and Technology
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    • v.33 no.5
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    • pp.696-704
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    • 2009
  • In this paper, the flow characteristics through an industrial safety relief valve used to protect the crankcase room in a large-sized marine engine have been numerically investigated using the moving-mesh strategy. With the room pressure higher than the cracking one, the spring-loaded disc becomes open and then the air in the room blows off into the atmosphere, resulting in the reduction of the room pressure and then the shutoff of the disc. Numerical simulations are performed on the compressible air flow through the relief valve (${\phi}160mm$) with the initial room pressure (0.11 bar or 0.12bar) higher than the cracking one (0.1 bar). The numerical method has been validated by comparing the results with the empirical ones. Results show that the disc motion and flow characteristics can be successfully simulated using the moving-mesh strategy and depend strongly on the spring stiffness and the flow passage shape. With increasing spring stiffness, the maximum disc displacement decreases and thus the total disc-opening time also decreases. In addition, the flow passage shape makes a significant effect on the velocity and direction of the flow.

Opening Exercise Therapy with Locking-free Appliance(LA) : Preliminary Study (Locking-free Appliance(LA)를 이용한 개구운동치료 : 예비실험)

  • Jung, Won;Lee, Kyung-Eun;Sun, Sae-Ah;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.29-34
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    • 2013
  • Objective: All patients who have the disc displacement with reduction (DDwR) are always not progressive but some of them with significant catching or locking progress to disc displacement without reduction (DDw/oR). In this study, we suggest opening exercise therapy using Locking-free Appliance (LA) to be helpful to prevent progressive derangement. Methods: Retrospectively, a total 37 patients who received exercise treatment using LA was analyzed from January 2010 to December 2011. Patients had been instructed in proper exercise technique to practise for opening and closing of mouth wearing the appliance 30 times a day in locking-free position. Results: None of the patients took a turn for worse to DDw/oR (37 patients). The 16 patients (43.2%, locking-free group) of them could open their mouth without intermittent condylar locking. Measurement of data was analyzed using and Mann-Whitney test. There was no statistically significant difference for age, gender, presence of palpational pain, locking period, VAS quantitative pain score between locking-free group and locking group. Conclusions: In this study, some patients could open their mouth without intermittent locking and did not take a turn for worse to DDw/oR after opening exercise therapy with LA. Furthermore, LA had advantages which were short wearing time, low costs and minimizing patients' uncomfortable compared to conventional treatment method. This therapy can be more appropriate new treatment to prevent progress to DDw/oR.