• 제목/요약/키워드: joint opening

검색결과 339건 처리시간 0.021초

Chronic dislocation of temporomandibular joint persisting for 6 months: a case report

  • Kim, Chul-Hwan;Kim, Dae-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.305-309
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    • 2012
  • Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

Adaptive Techniques for Joint Optimization of XTC and DFE Loop Gain in High-Speed I/O

  • Oh, Taehyoun;Harjani, Ramesh
    • ETRI Journal
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    • 제37권5호
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    • pp.906-916
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    • 2015
  • High-speed I/O channels require adaptive techniques to optimize the settings for filter tap weights at decision feedback equalization (DFE) read channels to compensate for channel inter-symbol interference (ISI) and crosstalk from multiple adjacent channels. Both ISI and crosstalk tend to vary with channel length, process, and temperature variations. Individually optimizing parameters such as those just mentioned leads to suboptimal solutions. We propose a joint optimization technique for crosstalk cancellation (XTC) at DFE to compensate for both ISI and XTC in high-speed I/O channels. The technique is used to compensate for between 15.7 dB and 19.7 dB of channel loss combined with a variety of crosstalk strengths from $60mV_{p-p}$ to $180mV_{p-p}$ adaptively, where the transmit non-return-to-zero signal amplitude is a constant $500mV_{p-p}$.

협골궁과 근돌기 골절의 미처치로 초래된 악관절증의 외과적 치험례 (A CASE REPORT OF THE ARTHROSIS OF THE TEMPOROMANDIBULAR JOINT RESULTED NONTREATED FRACTURES OF THE ZYGOMATIC ARCH AND CORONOID PROCESS)

  • 정훈;오병섭
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권2호
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    • pp.215-220
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    • 1994
  • In the case of the trauma on the maxillofacial region occurred, we think that one of the most important thing is recovery of the function as well as reconstruction of the anatomical form. Especially, it has been that the structure of the surrounded temporomandibular joint has a great possibility to cause mouth opening limitation when a bit of displacement is caused. Therefore, in the case of the trauma on mid-face we think that we treat it after complete evaluate condition of soft and hard tissue surrounding the articular disc as well as fracture site. We report results of our study, since we obtained good results from our study concerning the refixation of the zygomatic arch, high condylectomy, coronoidectomy and myotomy for the patient being suffered from the arthrosis of the temporomandibular joint caused by insufficient fracture treatment of zygomatic arch and coronoid process.

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Giant cell tumor of temporomandibular joint masquerading as temporomandibular joint pain dysfunction syndrome: a rare case report

  • Sam, Jo Ee;Rachmat, Rullyandrianto Pan Nuriman;Melano, Cri Saiful Jordan;Wahab, Nasser Abdul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권2호
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    • pp.134-137
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    • 2017
  • Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

2-6세 한국 어린이의 최대 개구량 측정 (Measurement of Maximum Mouth Opening in 2 to 6 year-old Korean Children)

  • 최혜진;김추성;이대우;양연미;김재곤
    • 대한소아치과학회지
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    • 제42권3호
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    • pp.242-248
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    • 2015
  • 최대개구량은 측두하악관절과 저작계의 임상 기능 평가에 유용한 진단 도구이다. 이 연구는 한국 유치열기 어린이의 정상 최대개구량을 측정하고 관련 인자들 간의 상관관계를 조사함으로써, 소아 악관절 장애의 진단 및 치과치료시 안전한 개구 범위 정립에 기여할 수 있는 기초 자료를 마련하고자 하였다. 악관절장애가 없는 건강한 어린이(만2-6세) 151명을 대상으로 최대개구량을 측정하고, 성별, 연령, 신장, 체중과 입의 너비를 기록하였다. 평균 최대개구량은 $37.72{\pm}5.10mm$였고 성별에 따른 유의한 차이는 없었으나, 연령, 신장, 체중, 입의 너비 증가에 따라서는 유의하게 증가하였다(p < 0.05). 최대개구량과 관련 요인들 간의 상관관계 분석 결과, 신장에서 가장 높은 상관관계가 관찰되었다. 결론적으로 한국 유치열기 어린이의 정상 최대개구량에 관한 자료를 얻을 수 있었고, 이 연구는 소아 악관절장애의 진단 및 안전 개구 범위에 관한 기초 지식을 제공할 수 있을 것이다.

두개하악장애환자의 임상양태에 관한 연구 (Clinical Features of the Patients with Craniomandibular Disorders)

  • Myung-Yun Ko;Mi-Eun Kim
    • Journal of Oral Medicine and Pain
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    • 제18권2호
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    • pp.29-41
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    • 1993
  • A prevalence study was carried out on 847 CMD patients who had visited the Department of Oral Medicine in Pusan National University from 1990 to 1993. To obtain the same type of information, all subjects were interviewed and examined clinically using a standardized examination form, The ratio of women to men was about 3:1 and all subjects were divided into acute and chronic groups on the basis of 6 months of duration. Diagnostic groups consisted of muscle disorder, joint disorder and muscle-joint disorder. As related to gender, duration and diagnosis subjective and objective symptoms in CMD were studied. The obtained results were as follows : 1. Muscle-joint disorder had the highest percent, followed by muscle disorder and joint disorder. 2. The most common reasons for CMD treatment were pain, joint noise and limited opening, while headache and neckache were relatively often reported as associated symptoms and dizziness, ringing in the ears also reported as secondary CNS excitatory effects. 3. Pain was more ofter seen in women, acute group and muscle-related disorder groups (p<0.05, p<0.01). Noise was significantly frequent in chronic group and joint-related groups (p<0.01). 4. Analysis of contributing factors presented that macrotrauma was found frequently in men (p<0.05), and that muscle-related groups were more related to stress than joint disorder grop (p<0.05). 5. Hard end feel was seen significantly often in joint-related disorder group (p<0.05). On the other hand, soft end feel was frequent in muscle disorder. 6. Reciprocal clicks and crepitation increased with chronicity. Subjects with joint-related disorder groups significantly often reported all kinds of noises (p<0.01). 7. Tender muscles and joints were more often reported in women and chronic group. Whereas muscle-related disorder groups revealed significantly more tender muscles (p<0.01). joint-related disorder groups presented significantly more tender joints (p<0.01).

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측두하악관절 장애에 대한 임상진단의 유효성 연구 (EVALUATION OF CLINICAL METHODS IN THE DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DISORDERS: A COMPARISON STUDY WITH MAGNETIC RESONANCE IMAGING)

  • 김형욱;신성수;김종식;김기영;김윤지;홍순민;천세환;박양호;최원철;박준우
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권4호
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    • pp.367-374
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    • 2007
  • Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

심한 퇴행성 악관절 질환 환자에서 보철성 과두를 이용한 하악과두 재건술의 치험례 (A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE)

  • 전용민;김창현;차정섭;민경기;권종진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권2호
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    • pp.162-167
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    • 2010
  • This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

  • Lim, Seung-Weon;Choi, Jin-Young;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제49권6호
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    • pp.413-426
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    • 2019
  • This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis

  • Malhotra, Vijay Laxmy;Singh, Virendra;Rao, JK Dayashankara;Yadav, Sunil;Gupta, Pranav;Shyam, Radhey;Kirti, Shruti
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권3호
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    • pp.129-134
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    • 2019
  • Objectives: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. Materials and Methods: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (${\geq}35mm$) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. Results: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. Conclusion: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.