• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.1
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• pp.18-24
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• 2013

Objectives: The goal of this study is to establish data baseline to ameliorate oral health policies for patient. The research was conducted in dental clinic at Seoul Metropolitan Children's Hospital - the major municipal hospital for the disabled. The outpatients' visiting patterns to the dental clinic were analyzed, compared to other medical departments. For further research related to TMD, the questionnaires were given to the subjects. Material and methods: Data for visiting patterns/frequencies was collected from patient records of 1419 outpatients who visited the dental clinic at Seoul Municipal Children's Hospital in 2011. Then TMD-related questionnaires were given to 127 outpatients who were over 13 years old. Results: 1. 219 out of 1419 patients (15.4%) who visited the dental clinic at Seoul Municipal Children's Hospital in 2011 were the disabled. 2. Compared to normal patients, disabled patients visited the dental clinic and rehabilitation medicine department more frequently.(p<0.05) However, there was no apparent difference in visiting frequencies between the disabled and the normal patients in the psychiatric department.(p=0.3237) 3. 44% of the TMD-related questionnaire subjects responded that they often consumed relatively hard or tough food, 53% answered they had unilateral chewing habit, 3% had bruxism, and 12% had clenching habit. Conclusion: In the dental clinic at Seoul Municipal Children's Hospital, 19% of outpatients over 13 years old had TMD such as clicking and pain. Also, the disabled patients' visits to the dental clinic were considerably more frequent, compared to the normal patients and to other medical departments. Accordingly, the result may suggest that the proper systematic supports from the government are essential to the dental clinic at municipal hospital for the disabled.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.273-279
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• 2016

Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.5.1-5.5
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• 2016

Background: This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Methods: A total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis. Results: The results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment. Conclusions: Within the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.

• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.96-106
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• 2016

Purpose: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.407-420
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• 1995

This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.155-159
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• 2014

Objectives: The purpose of this article is to evaluate factors influencing prognosis of arthrocentesis in patients with temporomandibular joint (TMJ) disorder. Materials and Methods: The subjects included 145 patients treated with arthrocentesis at the Dental Center of Ajou University Hospital from 2011 to 2013 for the purpose of recovering mouth opening limitation (MOL) and pain relief. Prognosis of arthrocentesis was evaluated 1 month after the operation. Improvement on MOL was defined as an increase from below 30 mm (MOL ${\leq}30mm$) to above 40 mm (MOL ${\geq}40mm$), and pain relief was defined as when a group with TMJ pain with a visual analog scale (VAS) score of 4 or more (VAS ${\geq}4$) decreased to a score of 3 or more. The success of arthrocentesis was determined when either mouth opening improved or pain relief was fulfilled. To determine the factors influencing the success of arthrocentesis, the patients were classified by age, gender, diagnosis group (the anterior disc displacement without reduction group, the anterior disc displacement with reduction group, or other TMJ disorders group), time of onset and oral habits (clenching, bruxism) to investigate the correlations between these factors and prognosis. Results: One hundred twenty out of 145 patients who underwent arthrocentesis (83.4%) were found to be successful. Among the influencing factors mentioned above, age, diagnosis and time of onset had no statistically significant correlation with the success of arthrocentesis. However, a group of patients in their fifties showed a lower success rate (ANOVA P=0.053) and the success rate of the group with oral habits was 71% (Pearson's chi-square test P=0.035). Conclusion: From this study, we find that factors influencing the success of arthrocentesis include age and oral habits. We also conclude that arthrocentesis is effective in treating mouth opening symptoms and for pain relief.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.1
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• pp.19-22
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• 2010

Cerebral palsy is an umbrella term encompassing a group of non-progressive non-contagious motor conditions that cause physical disability in human development. Motor disorder of cerebral palsy is often accompanied by disturbances of sensation, perception, cognition, communication, behavior and seizure disorder. Disharmony of motor function leads to frequent falling down. Moreover patients have high prevalence of class II malocclusion. Compared to normal patients, the patients with cerebral palsy tends to have high prevalence of recurrent trauma and bruxism which make restoration of the anterior tooth more difficult. This case report is consisted of three cases of cerebral palsy patients who have challenging problems with restoration of anterior teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.2
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• pp.171-178
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• 2007

Botulinum toxin type A (BTX-A) has a local effect at the neuromuscular junction by blocking acetylcholine release and thus causing paralysis and atrophy of the affected muscles. In dentistry, Botulinum toxin type A(BTX-A) is used for the treatment of masseteric hypertrophy, temporomandibular disorder, and severe bruxism related neurologic disorder. We hypothesized that the muscle atrophy after BTX-A injection into masseter muscle in growing rats, could affect the jaw growth. The purpose of this study was to determine the effects of the BTX-A injected into the masseter muscle on the jaw growth in rats. Rats were divided into four groups(group 1; control group, group 2; saline injection group, group 3; BTX-A injection group, group 4; baseline control group). Group 4 was sacrificed at the beginning of the experiment to provide baseline values of jaw measurements. The weight, length and width of jaw in those groups were measured every weeks. This study reported that the mandibular body length, condylar length, coronoid process length, anterior region height, coronoid process height and condylar height of the jaw in BTX-A injection group were shorter than those of the control and saline injection groups(P<0.05). In conclusion, BTX-A injected into the masseter muscle may affect the undergrowth of the jaw in rats.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.261-266
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• 2013

Myofascial pain is a condition associated with regional pain and muscle tenderness characterized by the presence of myofascial trigger points. In this case report, a subject complaining of nighttime bruxism was clinically assessed, and a latent trigger point of the anterior temporalis muscle was identified with manual palpation. A surface electromyographic (SEMG) exam of the anterior temporalis muscle harboring the latent trigger point demonstrated several SEMG features, including post-contraction irritability, delayed relaxation following contraction and accelerated muscle fatigue. It was concluded that a SEMG exam may detect abnormal masticatory muscle function and, therefore, assist in the evaluation of myogenous temporomandibular disorders.