• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권2호
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• pp.191-199
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• 1997

Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

• 대한통합의학회지
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• 제3권3호
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• pp.43-47
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• 2015

Purpose : The aim of this study was to report a follow-up study on the prognosis following the arthrocentsis for the painful temporomandibular dysfunction not responsible to the conservative splint therapies. Arthrocentsis of TMJ is a simple precedure that can be performed in the out-patient clinic under the local anesthesia without any reported complications. Method : Seventy patients had been followed after the arthrocentsis for over 6 months. Maximum mouth opening, TMJ pain, TMJ noise, and their changes by time were examined and compared statistically. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predictors which was analyzed were age, duration of painful locking, MMO, the degree of pain, preoperative clicking and the amounts of irrigation fluid. Result : The result of this study were as follow; 1) Mouth opening was improved from 32.6 mm to 42.4 mm in the maximum inter-incisal distance. 2) TMJ pain was decreased in 45.7%. 3) TMJ clicking and noise disappeared in 60.0%, but recurred in 40.0%. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Journal of Oral Medicine and Pain
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• 제44권3호
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

• 대한관절경학회지
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• 제3권2호
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• pp.138-141
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• 1999

목 적 : 화농성 주관절염의 치료 방식 중의 하나인 관절경적 처치를 제시하고, 경과를 평가하고자 하였다. 대상 및 방법 : 급성 화농성 주관절염 환자 7례를 대상으로 하였으며, 연령 분포는 6세에서 32세로 다양한 양상을 보였다. 관절 천자와 임상 검사에 의해 확진되면 즉시 응급으로 관절경적 변연 절제술 및 세척술을 시행하였고, 환자의 경과 관찰을 시행하였다. 결 과 : 혈액 검사상 백혈구 수치 및 적혈구 침강 속도와 c-반응성 단백의 정상화는 소아에서 8.4일, 성인에서 12.3일 소요되었다. 1년 추시 결과 전례에서 주관절 운동 제한은 없었고, 혈액 검사상 정상 소견을 보였으며, 그 외 후유증이나 합병증은 관찰되지 않았다. 결 론 : 화농성 관절염의 치료는 적절한 배농과 항생제 처치가 원칙이며, 이러한 관점에서 본다면 관절경적 변연 절제술 및 세척술은 다른 방식에 비해 관절 연골을 보호하고 전체적인 병리 상태를 관찰하면서 시행할 수 있는 유용한 방식 중의 하나로 사료된다.

• Journal of Oral Medicine and Pain
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• 제39권4호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.113-118
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• 2008

Temporomandibular joint disorder (TMD) can induce severe pain but, its pathogenic mechanisms remain poorly understood. In this study, we analyzed proteomes of human synovial fluid in the superior joint space in the patients with TMD, which is obtained during the treatment arthrocentesis. We've got this result that one of the spots was consistently down-regulated in synovial fluid of patients with TMD from analysis of protein pattern. Its molecular weight was estimated to be 33 kDa. Synoviolin was identified in our proteomics analysis of LC/MS/MS. This protein was recently reported as one of the proteins that might affect rheumatoid arthritis (RA). Synoviolin that might be associated with RA was detected in synovial fluid of patients with TMD. We can conclude that synoviolin might be involved not only in the pathogenesis of RA but also in TMD. In result, synoviolin might be involved in the pathogenesis of TMD and can be candidates as new therapeutic targets of TMD or early detection biomarkers.

• 대한관절경학회지
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• 제4권2호
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• pp.144-147
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• 2000

목적 : 화농성 고관절 질환에 대한 치료 중 관절경적 처치의 방식을 제시하고, 경과를 평가하고자 하였다. 대상 및 방법 : 급성 성인형 화농성 고관절염 환자 9례를 대상으로 하였으며. 관절 천자와 임상 검사에 의해 확진되면 즉시 응급으로 관절경적 변연 절제술 및 세척술을 시행하였고, 술후 적혈구 침강 속도 및 C-반응성 단백의 수치를 검사하면서 경과 관찰을 시행하였다. 결과 : 혈액 검사상 적혈구 침강 속도의 정상화는 11.9일, C-반응성 단백은 평균 8.9일이 소요되었다. 1년 추시 결과 전례에서 관절 기능이 정상이었으며, 혈액 검사상 감염의 증거를 발견 할 수 없었다. 결론 : 화농성 고관절염 환자에서 시행되는 관절경적 변연 절제술 및 세척술은 개방적 관절 절개 술식에 비해 관절 주변의 구조물 손상을 최소화하면서도, 좋은 결과를 얻을 수 있는 유용한 방식 줌의 하나로 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.497-506
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• 2000

This study is comprised of data obtained from the files of 346 patients with temporomandibular disorders. All patients were diagnosed, treated and followed in the Department of Dentistry at the Inha university hospital, Incheon, Korea. The patients had treated with medications, physical therapy, occlusal splint and arthrocentesis. The study data were obtained from the medical records and telephone interviews that were conducted by research assistants. The results were as follows 1. The patient's main complaint was pain(77%), and mouth opening limitation was 17%. 2. An analysis of the medical records of the 346 patients disclosed that 82% were improved and 17% had no improvement when they were dismissed. 1% of the patients had become worse during therapy. 3. A success rate of 82% was achieved when medication assisted physical therapy was included. In the current status at the telephone interview, 270 patients(89%) reported that they were doing well with 56% describing themselves as asymtomatic and 32% experiencing only minor residual or recurrent symptoms. 11% regarded themselves as unimproved and worse. 4. In the current status of the unsuccessfully treated patients by medications and physical therapy, 64% of patients were doing well(3% as asymptomatic and 56% as only minor residual or recurrent symptom). But 36% of patients was reported as unimproved and worse. 5. TMJ has a remarkable adaptive potential and TMJ disorder has a natural history of spontaneous fluctuations and favorable prognosis during the subsequent natural course. 6. In the treatment of the temporomandibular disorders, there is a treatment ladder, starting with the simplest and least expensive treatment, that is ascended until resolution of the patient's symptoms occur. These findings suggest that conservative reversible therapies are both sufficient and appropriate for management of temporomandibular disorder in most patients. Major alterations of mandibular position or dentoalveolar relationships do not appear to be necessary for obtaining either short term or long term success and therefore they can be generally regards as inappropriate treatment for this disorder. The fact that physical therapy is non-invasive and does not appear to be fraught with irreversible changes, makes it a very applicable vehicle in the area of clinical TMJ disorder management.

• 한국임상수의학회지
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• 제22권3호
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• pp.190-193
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• 2005

본 연구에서는 십자인대 손상견의 무릎관절액의 TRAP의 농도와 비교 할 수 있는 정상 관절액의 TRAP 농도의 지표를 제시 하기 위하여, 정상 무릎 관절액의 TRAP의 농도를 측정하였다. 십자인대 손상이 없는 23두 건강한 잡종견(14두 노령견과 9두 성견)을 실험견으로 선택하고 성별, 나이, 몸무게로 구별하였다. 무릎 관절액을 채취 한뒤, Lang method로 관절액의 TRAP을 측정하였다. 측정된 TRAP의 농도를 성별, 나이, 몸무게 등으로 구별하여 $Mean{\pm}SD$로 표시 하였으며, 유의성 차이를 T-test로 구별하였다. 노령견(14두, 2년이상) TRAP의 농도는 $0.083{\pm}0.039\;IU/ml(mean{\pm}SD$, 성견(9두, 2년 이하) $0.064{\pm}0.023\;IU/ml$, 대형견(15두, >22 kg) $0.075{\pm}0.028\;IU/ml$, 소형견(8두, <22 kg) $0.076{\pm}0.046\;IU/ml$, 중성화견(15두) $0.085{\pm}0.036\;IU/ml$, 중성화 되지 않은견(8두) $0.056{\pm}0.022\;IU/ml\;(Mean{\pm}SD)$로 나타났으며, 중성화 견과 중성화 되지 않은 견에서만 유의성 있는 차이 (P<0.05)가 보였다. 본 연구의 정상견에서 TRAP 농도는 십자인대의 손상견과 비교할수 있는 지표로 활용할 수 있을 것으로 사료된다.