• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.330-336
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• 1999

Study of dentofacial structure relationships relative to TMJ internal derangement is required to increase the predictability of TMJ internal derangement. But few studies have been reported. The purpose of this study is to reveal any correlation of dentofacial characteristics with TMJ internal derangement by lateral cephalometric analysis. Patients were devided into two groups. (1) Symptomatic patients with TMJ internal derangement (2) Asymptomatic volunteers with no TMJ internal derangement. Twenty symptomatic patients with TMJ internal derangement(7male, 13female) were selected from our clinic and had undergone a standarized clinical examination, panorama, transcranical view, TMJ tomography. Twenty asymptomatic volunteers(9male, 11female) were selected from our clinic with no pain, no limitation of motion. All subjects had undergone lateral cephalometric analysis. The results were obtained as follows. 1. No significant difference between ID and normal group is detected in cranial base. 2. Maxilla position of ID group is located more posterioly than normal group. 3. Mandible position of ID group is located more posteriorly than normal group and facial profile is hyperdivergent. 4. Posterior facial height of ID group is less than normal group thus facial profile is hyperdivergent. The patients, as mentioned, have a high prevalance of ID thus it should be careful in TMJ ID diagnosis and treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.78-86
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• 1996

This is a retrospective study of 31 patients, who were diagnosed as bilateral TMJ internal derangement in consequence of magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) at Department of Dentistry, Ajou University Hospital, and who were compared clinical findings with radiological findings. The results obtained were as follows. 1. The average of the patients of bilateral TMJ internal derangement was 27.3 years with a range from 12 to 74 years, and 93.6% of the patients were yonger than 40 years of age. The male-female ratio was 1 : 6.8, and the females of $20{\sim}29$ years were most common in 35.5%. 2. In the patients of bilateral TMJ internal derangement, the patients who complained clinical symptoms bilaterally were 38.7% and the patients who complained clinical symptoms untilaterally were 61.3%. 3. The most common disc position of bilateral TMJ internal derangement was anterior disc displacement without reduction on both sides in 38.7%. The most common disc configuration of bilateral TMJ internal derangement was biconcave on both sides and amorphous on both sides in closed mouth, and was amorphous on both sides in open mouth. 4. In the patients of bilateral TMJ internal derangement, the joints which really showed clinical symptoms were most common in anterior displacement without reduction of 48.9%.

• Journal of Oral Medicine and Pain
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• v.13 no.1
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• pp.71-84
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• 1988

The author examined 206 temporomandibular disorders patients, who visited department of Oral Diagnosis and Oral Medicine in Seoul National University Hospital during the period from May 1st 1987 to April 30th 1988, clinically and radiologically and with prepared questionnaire. By clinical and radiological examination, the patients were divided into 2 groups(the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome: the patient with temporomandibular joint internal derangement only). The symptom severity index and contributing factors were examined with the questionnaire, and differences in 2 groups were studied. The conclusions are followings : 1. The symptom severity index presenting the severity of symptom was higher and the scope of symptom was wider in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction compared to the patients with temporomandibular joint internal derangement only. 2. Emotions, behaviors, cognitions, and social factors were more undesirable in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome than the patients with temporomandibular joint internal derangement only.

• Imaging Science in Dentistry
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• v.33 no.2
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• pp.63-70
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• 2003

Purpose: To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. Materials and Methods: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. Tl-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. Results: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment(TPA) were correlated neither with clinical, nor with other MRI findings. Conclusion: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

• The Journal of the Korean dental association
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• v.58 no.6
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• pp.364-376
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• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

• Journal of Oral Medicine and Pain
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• v.11 no.1
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• pp.37-43
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• 1986

The purpose of this study was to investigate the effects of the posterior slope of articular eminence on internal derangement of temporomandibular joint. The author had taken transcranial oblique lateral projections of both TMJs in 30 normal subjects and 40 internal derangement patients who had 54 affected sides and 26 unaffected sides, and then analyzed the films. The results were as follows : In normal subjects, there was no significant difference between in the males and females, and between in the right and left sides. The posterior slope of articular eminence of affected sides in patients was stiffer than that of unaffected sides in patients and also stiffer than that of normal subjects. Therefore, the author concluded that stiffer posterior slope of articular eminence was, the more susceptibility to internal derangement would be.

• Imaging Science in Dentistry
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• v.32 no.4
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• pp.221-225
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• 2002

Purpose: To evaluate the relationship between internal derangement and osteoarthrosis in the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). Materials and Methods: One hundred and six MR images of TMJs in 53 patients were evaluated. Disc displacements and osseous changes of the TMJs were assessed. Lateral and rotational disc displacements were also evaluated on coronal images. Results: No significant differences in the frequency of osseous changes of the TMJs between disc displacement with reduction and disc displacement without reduction groups were found. The erosion of the condylar head and the sclerosis of the articular eminence were more frequent in the internal derangement group than in the no disc displacement group. The flattening was the most frequently observed osseous change of both the condylar head and articular eminence. Conclusion : The relationship between internal derangement and osteoarthrosis is obscure, but it is thought that both disorders adversely affect each other.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.219-226
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• 2017

Purpose: This study investigated the relationship between pain and internal derangement in temporomandibular disorder(TMD) patients using magnetic resonance imaging (MRI). Materials and Methods: This study analyzed 356 TMD patients (712 temporomandibular joints [TMJs]). The inclusion criteria were the presence of spontaneous or provoked pain on one or both TMJs and having undergone MRI. The patients with provoked pain were divided into 3 groups: pain on palpation, pain on mouth opening, and pain on mastication. MRI was performed using a 1.5-T scanner. T1- and T2-weighted parasagittal and paracoronal images were obtained. According to the findings on the T1-weighted images, another 3 groups were created based on internal derangement: normal, disc displacement with reduction, and disc displacement without reduction. The MRI findings were independently interpreted by 2 experienced oral and maxillofacial radiologists at 2 different times. Statistical analysis was performed by the chi-square test using SPSS (version 12.0; SPSS Inc., Chicago, IL, USA). Results: Provoked pain on mouth opening was found to be correlated with internal derangement in TMD patients (P<.05). However, spontaneous pain and provoked pain on palpation or mastication were not associated with internal derangement(P>.05). Conclusion: These results suggest that internal derangement was a significant predictor of provoked pain on mouth opening.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.48-53
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• 1999

Purpose: The aim of this study was to investigate the improvement of referred symptoms of TMJ internal derangement after open surgery of TMJ. Materials and Methods: The present study focused referred symptoms such as headache, neck pain, shoulder pain and evaluated the incidences and changes in their improvement at 1, 3, 6, 12 months after surgery in 118 patients who had TMJ internal derangement and received meniscoplasty(or meniscorrhaphy) and eminectomy at TMJ clinic of Yonsei University, Yongdong Severance Hospital, between 1992 and 1997. Results: One hundred eighteen patients(102 females, 16 males) with mean age of 29.6 years(range, 14 to 74) were included in this study and the mean follow-up period was 19.5 months(range, 12 to 60). The incidences of headache, neck pain, shoulder pain among the surgically treated TMJ internal derangement patients were 66.9%, 28.8%, 28.0% before surgery. Thirty-two preoperative severe(+++) headache patients were all improved their headache at 1, 3, 6 months after surgery, but slight relapse(9.4%) was found at 12 months after surgery. The clearance rate of preoperative neck and shoulder pain were 91.2% and 90.9% at 1 month after surgery and all of these groups had no pain at 12 months after surgery. Conclusions: Referred symptoms of TMJ internal derangement such as headache, neck pain, shoulder pain were dramatically improved after surgical treatment of TMJ.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.127-141
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• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.