• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.239-248
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• 2021

The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.

• Imaging Science in Dentistry
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• 제47권4호
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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.

• Journal of Oral Medicine and Pain
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• 제22권1호
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• pp.95-109
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• 1997

The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.411-419
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• 2000

Purpose: This study was aimed at analysis of the changes in the condyle position in subjects with mandibular setback osteotomies Method: Twenty patients were evaluated retrospectively for their changes in the condyle position who underwent surgical mandibular setback using bilateral sagittal split osteotomies with a manual condyle repositioning technique and rigid fixation. The cephalometric and panoramic analysis was performed preoperatively, 1 week, 6 months, and 1 year postoperatively. And postoperative noise, temporomandibular joint pain, and mouth opening were clinically examined 2 months, 4 months, 6 months, 8 months, 10 months, and 12 months postoperatively. Result: The condyles rotated posteriorly and laterally immediately after surgery, and they returned to the preoperative position during follow-up period but it is not significant. The statistical analysis (Paired t-test) showed no significant effects in postsurgical stability. The changes in the condyle position didn't have a significant harmful influence on temporomandibular joint disorder. Conclusion: A careful surgical mandibular setback using manual condyle repositioning and fixation technique will move condyle minimally and that will decrease the relapse and temporomandibular joint disorder.

• 한국치위생학회지
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• 제14권3호
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• pp.303-310
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• 2014

Objectives : The purpose of the study is to investigate the effects of bite force by gender and physical features. Methods : A self-reported questionnaire was filled out by 212 college students in Chungnam province from October to December, 2013. The questionnaire consisted of oral health condition. The bite force of the first molar teeth was measured. Results : Males showed the greater bite force than females(p<0.001). Those who had temporomandibular joint(TMJ) disorder suffered from mouth opening difficulty and weaker bite force than those who had not(p<0.05). Those who had malocclusion showed weaker bite force (p<0.01). Those who had a habit of chewing gums tended to have greater bite force than those who had not(p<0.05). The bite force was correlated with height(r=0.309), weight(r=0.345), and BMI(r=0.249)(p<0.01). Conclusions : Males showed greater bite force than females. The temporomandibular joint (TMJ) disorder, subjective malocclusion, and eating habit also affected the bite force.

• 한국콘텐츠학회논문지
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• 제18권7호
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• pp.628-634
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• 2018

턱관절 디스크 검사 시 MRI는 유용한 검사법으로 디스크의 정확한 위치변화를 관찰하고자 개구상태에서 오랜 시간 검사가 필요하다. 이에 3D프린팅 기술을 이용하여 개구상태를 유지시켜 줄 고정 장치(TMJ device)를 제작하고 이를 기존 고정 장치와 비교하여 유용성을 평가하고자 하였다. 기존 TMJ device를 사용한 영상에 비해 3D 프린터로 자체 제작한 TMJ device를 사용한 영상에서 SNR이 다소 낮은 결과를 보였지만 임상적으로 사용하는데 큰 결함이 없고 환자 개인별 특화된 맞춤형 제작이 가능하고 더불어 3D 프린팅 기술을 활용하여 유사도구 제작에 기여함으로서 비용대비 편익이 상승될 것이라 사료된다.

• 대한치과교정학회지
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• 제23권3호
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• pp.427-445
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• 1993

The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.156-162
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• 2014

Dislocation of temporomandibular joint (TMJ) is troublesome condition which was most commonly shown far anteriorly displaced mandibular condyle to the articular eminence, thereby make it impossible to close one's mouth. It is often referred to as 'open lock' in clinically. Although anatomical modification of the articular eminence through eminectomy has been considered most satisfactory and efffective treatment for managing the recurrent dislocation, it seldom performs clinically due to its invasiveness and patient's reluctance. We thought a shortterm intermaxillary fixation could be of benefit to the patient suffering from recurrent dislocation. A 21-year-old male patient with recurrent TMJ dislocation which had developed after excessive mouth opening, was successfully treated with intermaxillay fixation using microimplant for 2 months. It is more conservative and less complicated method than eminectomy in treating recurrent TMJ dislocation. Transient intermaxillary fixation using microimplant and elastics could be one of treatment options for recurrent TMJ dislocation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권6호
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• pp.392-396
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• 2003

Purpose : The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). Patients and Methods : Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. 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. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. Results: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. 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.

• Imaging Science in Dentistry
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• 제42권3호
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• pp.169-174
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• 2012

Purpose: To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods: A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were assessed using cone-beam computed tomography (CBCT) images. Results: The overall prevalence of osteoarthritic changes was higher in symptomatic (26.8%) than in asymptomatic adolescents (9.9%) (p<0.05). In the symptomatic group, the frequency was higher in males (33.3%) than in females (23.0%) (p<0.05). Erosion was the most common change for the symptomatic group (15.6%), whereas sclerosis was the most common change for the asymptomatic group (5.4%). Posterior condylar position was more frequently observed in the symptomatic group (p<0.05). Erosion was more common in the samples with TMJ pain or mouth opening limitations as compared to those without them (p<0.05). Conclusion: This study showed that osteoarthritic changes in TMJ were common in children and adolescents, with a much higher prevalence in symptomatic patients.