• Journal of Oral Medicine and Pain
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• 제19권2호
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• pp.193-203
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• 1994

The author performed this study for investigation of the magnitude of mandibular positional change caused by joint sound during mandibular opening and closing movement. There have been many studies stated mandibular border movement or other functional movement, and there also have been many studies reported clicking sound related to mandibular movement speed, trajectory and clinicl course of temporomandibular disorders(TMDs), but there have not been so many studies stated spatial mandibular position accompanied by joint sound. For this study 46 TM joint from the patients with TMDs were used and they were compared by character and occuring phase of the joint sound. Synchronized data which were amplitude and frequency of joint sound and amount of mandibular positional change were collected through sonopak and BioEGN rotate of Biopak system, respectively. Mandibular position was analyzed for translational and rotational movement change between before and after joint sound. The obtained data were processed with SAS program and summary of this paper were as follows : 1. Mean value of the amount of translational movement in whole joints were 6.0mm in vertical direction, 3.3mm in anteroposterior direction and 0.8mm in lateral direction between before and after joint sound. 2. Mean value of the amount of translational movement in clicking joinnts showed slightly increased tendency than in popping joints. 3. The amount of mandibular change in translational movement during closing phase were more than during opening phase. 4. The amount of mandibular rotational change in whole joints were $1.1^{\circ}$, 1.0mm in frontal plane and $0.9^{\circ}$, and 0.8mm in horizontal plane. 5. The amount of rotational movement were more in clicking joints than in popping joints and were more during closing phase than during opening phase, but statistically significance were showed only in frontal plane.

• Journal of Korean Dental Science
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• 제4권2호
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• pp.85-91
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• 2011

Some treatment methods have been proposed for patients with chronic closed lock of temporomandibular joint. We report a conservative treatment for patients who had chronic closed lock of temporomandibular joint and who did not want surgical treatment. Two patients who had been treated in the Template clinic, Soonchunhyang University Bucheon Hospital, are the subjects of this report. The subjects had chronic closed lock symptom for over 3 months after an onset of locking; conventional therapies had no effect. The subjects were treated by making them wear a Template appliance while sleeping and exercise for 10 hours a day. After periodic follow-up, significant improvement was observed for Template treatment in terms of the maximal mouth opening range. When conventional therapy is expected to be ineffective, The Template appliance can be used as conservative treatment for temporomandibular disorders patients with chronic closed lock of temporomandibular joint.

• 한국지반공학회논문집
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• 제15권5호
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• pp.217-228
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• 1999

본 논문에서는 절리암반에서 발생하는 지하수 유동과 굴착된 지하공동으로의 지하수 유입량을 해석하는 대표체적법, 비대표체적법 및 절리망 해석법을 소개하고 절리의 수와 공동의 직경을 변화시키면서 각 해석법의 특징과 결과를 비교하였다. 선처리 과정으로서 다수의 절리가 서로 교차하는 절리암반의 등가 수리전도계수를 산정하는 이론과 계산 과정(일명, 순차적 해석)이 소개되었다. 유한요소망과 절리도 및 순차적 해석을 이용하여 445개 요소 각각의 등가 수리전도계수를 계산하였으며 절리암반의 비균질 수리전도성과 대표물성 결정에 관해 논의하였다. 대표체적법에서는 대표물성을 통해 절리암반의 균질화가 이루어졌으며 따라서 절리밀도, 공동의 직경 및 수리전도대비의 증가에 따른 지하수 유입량의 증가도 규칙적이며 일관성 있는 경향을 보였다. 비대표체적법에서는 암반의 비균질성이 요소 단위로 해석에 반영됨으로써 유입량의 변화 양상은 불규칙하였으나 특성 치수가 증가함에 따라 대표체적법의 결과에 접근하는 경향을 보였다. 절리망 해석은 절리밀도, 공동크기 및 절리망과 공동의 교차 여부 등에 가장 민감하게 반응하였으나 해석결과의 신뢰도가 개별 절리에 관한 자료에 너무 의존하게 되는 단점이 있다. 제한된 범위에서 수집될 수밖에 없는 현장 절리자료의 불확실성을 감안할 때 대표체적법과 비대표체적법이 실질적으로 더 합리적인 해석방법으로 인식되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권3호
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• pp.125-132
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• 2015

Objectives: The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion: We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.

• 치과방사선
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• 제22권1호
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• pp.29-37
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• 1992

The temporomandibular joint was evaluated using magnetic resonance imaging using a urface coil in 11 patients having reciprocal clicking or locking and compared with the normal joint in five subjects. Serial multisection 3㎜-thick parasagittal, paracoronal, and axial image on both closing and opening mouth were obtained with a 1.5 Tesla MR system and surface coil using CSMEMP, GRASS, MPGR, powerful extensions of fast imaging that is currently under clinical evaluation. MR images obtained were analized correlating with the theory of internal derangement. The obtained results were as follows: 1. The serial findings of structures in joint were determined on the serially sectioned images of joint with reciprocal clicking or locking by CSMEMP and MPGR on closing mouth. 2. The delta shaped white images of synovial fluid in the glenoid fossa and on the posterior surface of condyle were revealed on the parasagittal images by MPGR on opening mouth as in the normal joints. 3. The white image of joint fluid surrounding meniscus was recognized on the paracoronal image by GRASS on opening mouth as in the normal joints. 4. In joints having temporomandibular dysfunction the smooth image of displaced meniscus was recognized, but otherwise in the normal joints the image of muscle was noted on the paracoronal image sectioned at the anterior portion of condyle by GRASS. 5. The more thickened fascial plane between superior and inferior belly of lateral pterygoid muscle was not recognizable in joints having temporomandibular dysfunction than in the normal joints.

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 2009년도 춘계 학술발표회
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• pp.58-63
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• 2009

Biaxial compression test was conducted on a transversely isotropic synthetic jointed rock model for the understanding of the fracture behaviors of a sedimentary or metamorphic rocks with well developed bedding or foliation in uni-direction. The joint angles employed for the model are 30, 45, and 60 degrees to the horizontal, and the synthetic rock mass was made of early strength cement. From the biaxial compression test, initiation propagation of tensile cracks at norm to the joint angle was found. The propagated tensile cracks eventually developed rock blocks, which was dislodged from the rock mass. Furthermore, the propagation process of the tensile cracks varies with joint angle: lower joint angle model shows more stable and progressive tensile crack propagation. The experiment results were validated from the simulation by using discrete element method PFC 2D. From the simulation, as has been observed from the test, a rock mass with lower joint angle produces wider damage region and rock block by tensile cracks. In addition, a rock model with lower joint angle shows a progressive tensile cracks generation around the opening from the investigation of the interacted tensile cracks.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.9-14
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• 2019

Objectives: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. Materials and Methods: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (${\leq}25\;years$, >25 and ${\leq}40\;years$, >40 and ${\leq}60\;years$), VAS pain level (${\leq}5$, >5 and ${\leq}7$, >7 and ${\leq}10$), and ROM (<25 and ${\geq}25mm$). Odds ratios (ORs) were used to describe the proportional benefit of each variable the on successful outcome of arthrocentesis. For the OR to be clinically relevant or even clinically noticeable, we assumed that the OR would need to be larger than 2. Results: Mean preoperative pain score was $6.49{\pm}1.560$ and at 6 months postoperative was $0.46{\pm}1.147$ with an average decrease of pain score 6 (P<0.001). The mean preoperactive maximum mouth opening was $26.14{\pm}4.969mm$ and mean maximum mouth opening at 6-month inerval was $38.92{\pm}3.392mm$. The mean increase in the mouth opening was a mean difference of 12.78 mm (P<0.001). Logistic regression showed that the maximum benefit occurred in patients aged <25 years (OR, 12.01; P=0.012), a VAS pain level of >7 (OR, 11.25; P=0.039), and a maximum vertical opening of <25 mm (OR, 7.70; P=0.038). Conclusion: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify "at-benefit" patients early and initiate specific treatment.

• 대한통합의학회지
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• 제7권4호
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• pp.1-11
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• 2019

Purpose : This study was aimed at investgating the effect of McKenzie exercise on temporomandibular joint disorder (TMJD) and body balance. Methods : Thirty subjects with TMJD were selected. They were randomly assigned to one of two groups (15 in each group) : namely the conservative treatment group and McKenzie exercise group. The conservative treatment group were treated physical therapy for 6 weeks (3 times a week). The McKenzie exercise group performed McKenzie exercise for 6 weeks (3 times a week). We measured mouth opening, pain, muscle activation and body balance before and after exercise by using the maximum mouth opening MMO), visual analog scale (VAS), electromyography and Biodex Balance System, respectively. Results : We found statistically significant differences in pain and mouth opening in the conservative treatment group and McKenzie exercise group before and after (p<.05). Conclusion : We confirmed the effect of McKenzie exercise on TMJD. Thus we thought these results could be used as basic data and reference for TMJD. But we need more study effect of McKenzie exercise on TMJD and body balance.

• 치과방사선
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• 제14권1호
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• pp.61-69
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• 1984

For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosed as rheumatoid arthritis through the clinical, radiographic examination and laboratory findings. Temporomandibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.301-307
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• 2014

Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.