• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.223-232
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• 1987

The author obtained the transcranial-oblique lateral radiograms from 78 patients(26 male, 52 female) with temporomandibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54㎝ mouth opening with clicking, TMJ pain and mouth opening limitation repectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follows: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p<0.01) 2. In 2.54㎝ mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p<0.01) 3. Examined experimental group, the degree of condylar horizontal movement of affected ide was lesser than that of the normal side in 2.54㎝ mouth opening.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.2
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• pp.249-270
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• 1993

For understanding of anatomy, physiology, and diseases of human TMJ, it is required to evaluate quantitatively the movement of the disc and condyle head of mandible. The histologic section of cadaver TMJ were examined, and the magnification of the MR image and its details of anatomy were evaluated. And then a quantitative analytic method, by comparing the Sectograph and the MR image of vital human TMJ, was proposed. For this study, 15 subjects(Male, 24~35years) were selected from a prosthodontic examination randomly, and each subject’s five interocclusal rubber registration records were made on the ICP, and 5, 10, 15, and 20mmjaw opening positions. All subjects were radiographed with a Denar Quint Sectograph Image System(Denar Corp., USA), and imaged with a MRP-20EX MR Image System(0.2T, Permanent Magnet Type, Hitachi Medical Corp., Japan) using an 100mm diameter bilateral type surface coil. These images were traced on the acetate tracing paper, and analyzed In this study, the findings led to the following conclusions. 1. In comparison of the histologic section of autopsy specimen with the MR image at the same section, the size(dimension) of MR image was 70% of the real one. It was possible to recognize the shape of articular disc, anterior and posterior attachments, and adjacent soft tissues, because of the excellent reproducibility of anatomical structure. 2. When we compared the amount of joint space on MR image with that of joint space on sectograph, the amount of joint space on sectograph was significantly greater than that of joint space on MR image, except at the top of condylar head. 3. The position of minimum joint space on sectograph at intercuspal position didn't coincide with the middle position of articular disc on MR image, and was approximately in the anterior third of posterior band of articular disc. 4. The amount of condylar movement on MR image at opening movement was greater than that of articular disc movement. From Intercuspal position to 5mm jaw-opening movement, the condylar movement showed hinge one, and over the range 5mm jaw-opening it suggested hinge & translatory one. 5. In terms of area variation of articular disc measured on MR image in sagittal plane, the area of posterior band increased with increasing the amount of Jaw opening, but the area of anterior band decreased conversely.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.20 no.2
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• pp.299-313
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• 1990

The author analysed tomographic and cephalometric radiographs of 82 temporomandibular joints from 41 symptomatic patients and 40 temporomandibular joints from 20 asymptomatic young adults. The results were as follows; 1. The mean condylar angulation in control group and patient group was 21.72±6.48° 20.13±9.14° respectively and there was no significant difference between two groups. 2. The mean depth of cut was 6.63±0.38㎝ in control group and 6.57±0.46㎝ in patient group. 3. Mean height and width of condylar head were 6.66±1.83㎜, 12.42±0.49㎜ in control group and 6.22±1.36㎜, 11.93±l.92㎜ in patient group. 4. The mean height of articular fossa was 10.20±2.04㎜ in control group and 9.89±1.98㎜ in patient group. The mean width of articular fossa was 21.08±2.08㎜ in control group and 21.24±3.03㎜ in patient group. 5. In centric occlusion the superior joint space was largest (4.15±0.93㎜), followed by the posterior joint space (2.99±0.97㎜) and the anterior joint space (2.70±0.73㎜) in control group. The superior joint space (3.47±1.31㎜) and posterior joint space (3.47±7.07㎜) were same in patient group. There was significant difference in left superior joint spaces between two groups (p<0.05). 6. The condylar position in articular fossa was displaced anteroinferiorly (0.99±3.65㎜ anteriorly, 1.75±1.01㎜ inferiorly) in control group and posteroinferiorly (3.20±4.69㎜ posteriorly, 1.25±1.87㎜ inferiorly) in patient group with 1 inch opening. In maximum opening, it was displaced anteroinferiorly (6.09±3.55㎜ anteriorly, 1.38±2.47㎜ inferiorly) in control group and anteroinferiorly (1.70±5.96㎜ anteriorly, 1.37±1.85㎜ inferiorly) in patient group. There was significant difference in anteroposterior position of both condyles with 1 inch opening and maximum opening between two groups (p<0.01). 7. The mean inclination of upper central incisor and the posterior inclination of articular eminence in control group was 65.60±6.04° 58.88±9.18° in control group, and 67.14±8.41°, 59.70±9.08° in patient group respectively. There was no significant correlation between two groups.

• The Journal of Korean Academy of Prosthodontics
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• v.26 no.1
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• pp.63-84
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• 1988

Recently the instantaneous centre concept has been used to understand the biomechanics by which a tissue derangement causes a mechanical derangement in temporomandibular joint. In this study, four male subjects without temporomandibular joint disorder and malocclusion were selected for the determination of the instantaneous centre of rotation (I.C.R) in the mandibular movement. The habitual opening and closing paths were recorded on the sagittal plate by two spring pencils attached on the lower anterior teeth which was designed for this study, and the I.C.R. was calculated by the computer program of Rouleaux's method. Also the computer graphic opening and closing movements of mandible were obtained according to the determined I.C.R. The results obtained from this study were as follows. 1. The instantaneous centres of rotation were not positioned within the condyle in the mandibular opening and closing movement. 2. There was some similarity between the anatomical curvature of the articular emience and the movement pattern of condyle. 3. The opening path and the closing path of the most superior pl)int of the condyle stowed a slight difference. 4. At the early stage of the habitual opening movement, the condyle was moved downward. 5. The opening and closing mandibular movements were simulated by the instantaneous centre of rotation which was determined by the computer program of Rouleaux's method.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.1
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• pp.133-136
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• 2012

This case report describes the effectiveness of cervical chuna manipulation in the management of traumatic temporomandibular joint disorder. A 14-year-old male developed trismus after being stuck. He received cervical chuna manipulation and acupuncture. The mouth opening range was assessed to measure disability, and the visual analogue scale to measure discomfort. This was carried out at the beginning, during and at the end of treatment. After treatment, the patient's mouth opening range was improved from 10 mm to 45 mm. Also, the visual analogue scale was decreased. This case study suggests that cervical chuna manipulation can be effective for the management of traumatic temporomandibular joint disorder.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.289-294
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• 2019

Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.291-306
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• 1995

Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

• Tunnel and Underground Space
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• v.4 no.1
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• pp.1-16
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• 1994

The study on the flow characteristics and analysis of groundwater in discontinuous rock mass is very important, since the water inflow into the underground opening during excavation induces serious stability and environmental problems. To investigate the flow through single rock joint, the effect of various aperture distribution on the groundwater flow has been analyzed. Observed through the analysis is the "channel flow", the phenomenon that the flow is dominant along the path of large aperture for given joint. The equivalent hydraulic conductivity is estimated and verified through the application of the joint network analysis for 100 joint maps generated statistically. Both the analytic aproach based on isotropic continuum premise and the joint network analysis are tested and compared analyzing the gorundwater inflow for underground openings of different sizes and varying joint density. The joint network analysis is considered better to reflect the geometric properties of joint distribution in analyzing the groundwater flow.ater flow.

• 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.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.105-121
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• 1989

The author analysed tomograms and submento-vertex radiograms of 90 temporomandibular joints from 45 asymptomatic young adults. 15 had Angle class Ⅰ malocclusion, 15 classⅡ and 15 class Ⅲ. Corrected lateral tomograms were obtained in three condylar positions; centric occlusion, centric relation and 1 inch mouth opening. The condylar angulation, depth of cut, joint spaces were analysed in each radiogram. The obtained results were as follows; 1. The mean condylar angulation in Angle class Ⅰ, Ⅱ, Ⅲ group was 17.55±5.51° 13.33±8.85° 16.25±6.60° respectively, and there was no significant difference in each group. The mean condylar angulation of right side (16.62±7.23°) was larger than left side (14.80±7.33°). 2. The mean depth of cut in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.13±1.61㎝, 3.05±3.80㎝, 7.75±2.19㎝, respectively. Angle class Ⅰ and class Ⅱ group revealed significant difference in measurement (p<0.0l). 3. The mean height of articular fossa in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.67±3.06㎜, 9.61±2.57㎜, 8.93±2.83㎜, respectively. And the mean width of articular fossa was 19.90±2.80㎜, 19.48±3.83㎜, 20.36±4.82㎜, respectively. 4. The mean height and width of condylar head was 5.11±1.16㎜, 11.20±2.26㎜, respectively. 5. In centric occlusion, the superior joint space was the largest (3.42±1.42㎜), followed by anterior joint space (2.94±1.95㎜) and the posterior joint space (2.64±1.19㎜. In centric relation, the anterior joint space was the largest (3.86±2.17㎜), followed by the superior joint space (3.64±3.68㎜) and the posterior joint space (1.18±0.77㎜). 6. The displaced measurement from centric relation to centric occlusion was 1.10±1.04㎜ anteriorly and 0.24±0.97㎜ inferiorly. In 1 inch mouth opening state, the condylar head displaced posteroinferiorly (2.49±2.49㎜ posteriorly, 1.17±1.34㎜ inferiorly) from the apex of articular eminence. And Angle class Ⅰ and Ⅱ group, Angle class Ⅱ and Ⅲ group revealed significant difference in posterior measurement, respectively (p<0.01).