• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.26-37
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• 2018

Purpose: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. Methods: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. Results: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. Conclusion: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

• Journal of Oral Medicine and Pain
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• v.24 no.2
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• pp.207-217
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• 1999

This study was performed to investigate the effects of clutch adaptation on the mandibular rotational torque movement in normal people. 69 dental students were selected for the study. Their mean age were 23.6 years and they did not present any signs and symptoms of temporomandibular disorders. $BioEGN^{(R)}$ with $Rotate^{(R)}$ program was used to observe and record the amount of mandibular rotational torque on protrusion, on right excursion, on left excursion, and on comfortable wide opening movement. The natural tooth contact movement and the movement with clutch were performed in the above four each mandibular movement. Clutch was made by the method used in $Pantronic^{(R)}$ clutch fabrication. Distance of slant frontal which was translatory trajectory in frontal plane and degree of rotational torque in horizontal and in frontal plane were recorded. The data obtained were processed with SPSSWIN program and the results were as follows : 1. Distance of slant frontal in each mandibular movement generally increased with clutch. 2. Degree of rotational torque in horizontal and in frontal plane on protrusion and on lateral excursions did not increase with clutch, but the degree on wide opening increased with clutch. 3. Degree of rotational torque in horizontal plane on protrusion and on lateral excursions did not show any difference between right and left side, but the degree in frontal plane on protrusion and on lateral excursions showed significant difference between right and left side. 4. Total amount of rotational torque from right and left sides on protrusion and lateral excursions were not increased with clutch, but the degree on wide opening movement was increased with clutch. And in this case, degree in horizontal plane was larger than that in frontal plane. 5. Correlation between total amount of rotational torque in horizontal plane and that in frontal plane were highly significant on protrusion and on lateral excursions with or without clutch, but the significant correlation on wide opening without clutch became not significant with clutch.

• Journal of Oral Medicine and Pain
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• v.19 no.2
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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 Oral Medicine and Pain
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• v.22 no.1
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• pp.167-181
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• 1997

The aim of this study was to investigate the relationship between velocity and factors which could affect the velocity of mandibular movement. For this study, 30 dental students without any masticatory signs and symptoms and 90 patients with temporomandibular disorders(TMD) were selected as the control group and the patients group, respectively. After determining Angle's classification and lateral guidance pattern of occlusion, clinical examination for TMD was perfomed. Velocity and distance of mandibular movements were recorded with BioEGN, reproducibility index of lateral excursions was evaluated by Pantronic(PRI) and BioEGN (BERI) activity in masticatory and cervical muscles were measured with BioEMG, and occlusal contact time and cross-arch unbalance(Total left-right statistics, TLR) on clenching were recorded with T-scan, respectively. The results of this study were as follows : 1. Velocity in the patients was faster than that in the controls in most mandibular movements, but on wide opening and closing movement, result was reverse. 2. Velocity on closing movements were faster than that on opening movements in the control group and a similar tendency was also shown in the patients group. 3. Patients with muscle disorders showed a tendency to have the highest value of velocity of all diagnostic subgroups, while patients with degenerative joint diseases showed a tendency to have the lowest value. 4. Patients with canine guidance showed a tendency to have the highest value of velocity in three subgroups by lateral guidance pattern, while patients with group function showed a tendency to have the lowest value. 5. BERI had a positive correlation with opening velocity on lateral excursion, while TLR had a negative correlation with opening velocity on swallowing. 6. EMG activity on clenching in masticatory muscles had negative correlation with opening velocity on border movements, and on swollowing, while the activity in rest correlated positively with opening velocity on border movements. 7. There were positive correlation between the velocity and the distance in long components of mandibular trajectory.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.455-466
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• 1999

The purpose of this study was to investigate the magnitude of mandibular rotational torque movements in subjects with TMJ sounds, and to analyse correlation between quantitative characteristics of TMJ sounds and mandibular rotational torque movement. Twenty dental college students with TMJ clicking and twenty students without any TMD signs and symptoms were examined by mean of SonoPak and Rotate program of BioPAK system(Bioresearch Inc. MilWaukee, wisconsin, USA) in this study. Mandibular rotational torque movements were recorded and analysed during maximum mouth opening, protrusion, and lateral excursion in frontal and horizontal planes. The obtained results were as follows: 1. On maximum mouth opening, mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.05). 2. During maximum mouth opening closing, maximum mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.01). 3. On protrusion, mandibular rotational angle and distance of clickin group were significantly greater than those of control group in horizontal plane. (P<0.05). 4. On lateral excursion, there was no significant difference in mandibular rotational angle and distance between clicking group and control group in frontal and horizontal planes. 5. There were significant correlations between peak amplitude of TMJ sounds and maximum mandibular rotational distance during maximum mouth opening (r=-.481) and mandibular rotational distance on maximum mouth opening (r=-.455) in horizontal plane. 6. There were significant correlations between Above 300/(0-300)Hz ratio of TMJ sounds and mandibular rotational angle (r=-.499) and distance (r=-.457) on maximum mouth opening in frontal plane.

• The Journal of Korean Academy of Prosthodontics
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• v.23 no.1
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• pp.137-144
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• 1985

This study was designed to investigate the side shift of orbiting condylar movement by direct measurements from tracings of Denar pantograph. It is well known that side shift has much influence on the articulating surface of teeth. In this study, after locating the ture hinge axis point with Denar hinge axis locatior, the recordings of Mandibular movement were obtained from Denar pantographic recording assembly, and immediate side shift and progressive side shift were measured. For this study, 20 dental studnts who have no missing teeth and no difficulties of mandibular movement and 4 patients who were, treated by occlusal therapy were selected. The results obtained were as follows, 1. The prevalence of immediate side shift was 42%, and the immediate side shift of greater than 0.5mm was only 17%. 2. The mean of immediate side shift (20 of 48) was 0.38mm, that of right lateral excursion (7 of 24) was 0.27mm, and that of left lateral excursion (13 of 24) was 0.44mm. 3. The mean of progressive side shift was $7.21^{\circ}$ that of right lateral excursion was $6.46^{\circ}$, and that of left lateral excursion was $7.96^{\circ}$.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.245-257
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• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• The Journal of Korean Academy of Prosthodontics
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• v.16 no.1
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• pp.13-16
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• 1978

The author conducted an experiment of recording side shift of the lateral mandibular movement and analyzing the timing of the side shift on the twenty-two non-functioning side condyles. As a result, clinically useful informations were obtained. The findings were as follows: 1. On all the non-functioning side condyle path, during the first four millimeters of forward movement, the change in the rate of the mandibular side shift was observed. 2. Band E types of the mandibular side shift ,which have shown a distinct rate of immediate side shift were fifteen condyles, and C type of the mandibular side shift which has shown the greatest rate of the side shift occurs early in the first four millimeters of forward movement was seven condyles. 3. A and D types which have shown generally progressive and distributed nature were not observed.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.2
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• pp.237-248
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• 1993

Although pantograph has been used to investigate whether the determinents of the mandibular movement were possible contributing factors of TMJ click, there was the problems to understand the role of tooth morphology upon the occurrence of click because of using appliance without tooth contacts. There Were advantages to evaluate the effects of tooth morphology upon the mandibular movements, because intraoral tracing device(Functiograph$^{(R)}$) had been obtained maintaining occlusal contact between the upper and lower natural teeth during mandibular movement. The purpose of this study was to record the mandibular eccentric movement quantitatively performed in 20 adult control subjects and 20 adult subjects with TMJ click and to investigate the effects of occlusion upon the occurrence of TMJ click. The obtained results were as follows : 1. The average ICP-P distance was $3.07{\pm}0.73mm$ in subjects with TMJ click, $2.14{\pm}0.85mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 2. The average ICP-P distance was $3.07{\pm}1.14mm$ in subjects with TMJ click, $2.61{\pm}0.96mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05). 3. The average distance of right and left lateral movement was not statistically significant between subjects with TMJ click and control subjects. 4. The average lateral displacement from midline during RCP was $0.75{\pm}0.54mm$ subjects with TMJ click, $0.16{\pm}0.17mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 5. The average lateral displacement from midline during protrusive movement was $0.88{\pm}0.54mm$ in subjects with TMJ click, $0.20{\pm}0.23mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 6. The average angle of right and left lateral movement was $144.2{\pm}20.20^{\circ}$ in subjects with TMJ click, $138.15{\pm}20.09^{\circ}$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.3
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• pp.396-410
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• 1994

Ten subjects who were going to wear conventional complete dentures were selected for this study. Theree subjects were women and seven were men. The average age was 63.1 years(range : 44 to 76 years). With the Height tracer (extraoral tracing device) in place the subject was instructed to go through the entire range of mandibular movements. The extreme lateral pathway of the incisor point, the so-called Gothic arch, was thereby inscribed by the stylus on the tracing plate. The mandibular movements in this study were peformed voluntarily by the subject(self guided technique) and guided by the dentist(chin-point technique and bimanual technique). The Gothic arch tracings were analysed and the Gothic arch angles and eccentric movement distances were measured. The results were as follows : 1. The apex position of the Gothic arch tracings of mandibular movements in edentulous patients varied both anterioposteriorly and mediolaterally. 2. The Gothic arch tracing had some lateral deviation during protrusion. 3. The average Gothic arch tracing angle was $136.7{\pm}12.0^{\circ}$ by subjects self guided technique, $135.7{\pm}5.9^{\circ}$ by chin-point technique, $136.6{\pm}6.5^{\circ}$ by bimanual technique. But there were no statistical differences in the reliability among the three techniques. 4. The average mandibular eccentric movements were irregular and the mandibular eccentric movement distances varied with a wide range.