• Title/Summary/Keyword: mouth opening condition

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CLINICAL STUDY ON THE ETIOLOGY, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF TRISMUS (개구장애 환자의 병인, 감별진단 및 치료방식에 대한 임상연구)

  • Kang, Hee-Jea;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Kim, Jong-Ryoul;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.544-558
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    • 2006
  • Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture, and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.

Severe trismus due to bilateral coronoid process hyperplasia in growth hormone therapy patient: a case report

  • Lee, Sung-Tak;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.249-254
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    • 2012
  • Bilateral coronoid process hyperplasia is a rare condition characterized by an enlarged mandibular coronoid process. The painless progressive reduction of a mouth opening is caused by coronoid process impingement on the posterior aspect of the zygomatic bone. Hyperplasia of the bilateral coronoid process leads to the restriction of a mandibular opening consequent to the impingement of the enlarged coronoid process on the temporal surface of the zygomatic bone or with the medial surface of the zygomatic arch. The process has been diagnosed as developmental hyperplasia. Otherwise, the development of the coronoid process may be associated with growth hormone. This paper describes a case of trismus caused by coronoid hyperplasia in an idiopathic short-stature patient who received growth hormone therapy by somatropin injections.

Customized spacers in provisional treatment of temporomandibular joint ankylosis: a case report

  • Caio Augusto Munuera Ueti;Felipe Burigo Daniel Dos Santos;Murillo Chiarelli;Luiza Brum Porto;Matheus Brum Marques Bianchi Savi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.166-169
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    • 2024
  • Ankylosis of the temporomandibular joint (TMJ) is a condition in which the mandibular condyle fuses with the mandibular fossa through fibrous or bone tissue. It is a debilitating pathology that interferes with chewing, speaking, and oral hygiene. Currently, alloplastic reconstruction is considered the gold standard for treating severely compromised TMJs, such as in ankylosis. The article describes a patient with a history of facial trauma, with bilateral ankylosis of the TMJs, inability to open his mouth, and poor dental condition. Due to a long period of immobilization of approximately 40 years, the initial treatment plan was to remove the ankylosis bilaterally and install customized PMMA (polymethylmethacrylate) spacers. The patient gained mouth opening and improved chewing quality with one year of customized spacer use prior to definitive alloplastic replacement with stock-type TMJ prostheses. Customized joint spacers are a provisional treatment option when definitive alloplastic reconstruction is not indicated. Spacers provide the patient with progressive jaw function and mobility gains.

Occlusal Analysis in the Policemen with Temporomandibular Disorders Using T-scan II System (경찰 종사자의 측두하악장애환자에서 T-scan II System을 이용한 교합분석)

  • Lim, Hyun-Dae;Jung, Seung-Ah;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.365-373
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    • 2006
  • This study suggested correction of excessive mouth opening or maximum occlusal contact to analyse occlusal contact time, occlusal contact number and force through evaluation of occlusal pattern in policemen with temporomandibular disorders. The community of policemen influence on temporomandibular disorder's development and progress due to other condition of mouth opening and maximal occlusal contact. Repeated training or changes of usual life style may cause imbalance of stomatognathic system including the masticatory muscle, then develop or aggravate pain of temporomandibular joints and associated structures. This study uses T-scan II system(Tekscan Co., USA) for evaluation on occlusal pattern may influence temporomandibular disorders, and then the subjects take a sensor at 20 mm opening for maximal occlusal contact force. The policemen with temporomandibualr disorders get more long time on maximum contact timing, more short on end contact timing, and more force on end contact force than general society's. So they get closure of mouth with more short time and more force, then transfer remaining load to temporomandibular joint. There are no statistically significances between affected side and occlusal pattern of occlusal contact time and force. There are Left -right dental arch imbalances seems on Rt. dental arch if affected side is right and Lt. dental arch if affected side is left. In above results, It's worth due consideration that policemen with temporomandibular disorders get more smooth mandibualr movement and less force on maximal occlusal contact position.

A Novel Treatment of Recurrent Temporomandibular Joint Dislocation with Intermaxillary Fixation Using Microimplant: A Case Report

  • Kee, In-Kyung;Byun, Jin-Seok;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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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.

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

  • Chung, Hoon;Oh, Byung-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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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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MULTIDISCIPLINARY CARE OF FREEMAN SHELDON SYNDROME (Freeman-Sheldon Syndrome의 치료에 대한 고찰)

  • Kim, Ji-Hun;Lee, Jeong-Sub;Chang, Cherry
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.545-550
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    • 2010
  • Freeman-Sheldon Syndrome (FSS, also known as "Whistling Face Syndrome") is a rare genetic condition which characteristically includes a small "whistling" mouth, a flat mask-like face, club feet, joint contractures usually involving the fingers and hands, and under-development of the cartilage of the nose. Intelligence is usually normal. Most of the features of this syndrome are due to muscle weakness. The patient, 11 years old boy was consulted from pediatrics to pediatric dentistry due to dental management. After clinical & radiographic examinations, severe multiple problems were found. Dental problems were microsomia(whistling mouth) & micrognathia, perioral muscle contracture, restricted mouth opening, poor oral hygiene & care, generalized dental caries, high palatal vault, severe malocclusion & crowding. And Orthopedic problems, ophthalmic & respiratory, anesthetic problems were found. Then He also had psychiatric problem, hospital(dental) phobia due to previous medical history(frequent hospitalization). And he had genital problem, cryptochidism, too. Due to these intricate problems, he suffered with feeding, swallowing difficulties and showed growth retardation. For enhancing patient's oral health, pediatric dentist, orthodontist, oral surgeon, pediatrician, psychiatrist, orthopedist, they all agree with early, cautious intervention and treatment. So, he has been treated by multidisciplinary care, now he is recovering general health maintenance.

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

  • Lee, Bu-Kyu;Hong, Jun Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.14.1-14.11
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    • 2020
  • Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

A study of subjective oral health actual condition in elementary school teachers, Daegu area (대구광역시 일부 초등학교 교사들의 주관적인 구강보건실태)

  • Choi, Sung-Suk;Kim, Jae-Do;Ryu, Hae-Gyum
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.3
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    • pp.248-261
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    • 2009
  • Objective : This study was performed in order to figure out Oral Health Actual Condition in Elementary School Teachers in Deagu area. This study was conducted from March through May 2008. Method : A total of three hundred and ten Elementary School Teachers were surveyed. The collected data were analyzed by Oral Health Actual Condition and cognition, Diet habit or living and one's own intellect health state, Oral disease sign symptoms of percent and 2-test and One-way ANOVA test by using SPSS12.0 Program. Results : 1. The most of result Frequencies of tooth brushing per one day were 3 over 91.0% and Oral Examination, Oral Health Education need. 2. The result of oral disease sign and symptom were hypersensitivity due to cold food(39.0%), halitosis(21.6%), gingival bleeding tendency(21.3), clicking sound on TMJ(18.7%), hypersensitivity due to tooth burshing(17.1%), easy crown fracture and to be fine(10.0%), pain on TMJ or limitation of mouth opening(7.1%). 3. The most of result age a group oral hygiene assistance article age 20 for interdental tooth brushing(46.4%), age 50 over not used interdental tooth brushing 38.5%. 4. The result of sign and symptom and snack following was statistically significant(P<0.05), health of own cognition and Oral health of own cognition was statistically significant(P<0.001). Conclusion : The study of understanded the Subjective Elementary School Teachers Oral Health Actual Condition and Promotion of Oral Health follow up Oral examination and Oral Health Education have to system groping.

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Development for Fishing Gear and Method of the Non-Float Midwater Pair Trawl Net(I) - Opening Efficiency of Model Net according to the Length of Lower Warp - (무부자 쌍끌이 중층망 어구어법의 개발(I) - 아래끌줄의 길이에 따른 모형어구의 전개성능 -)

  • 이주희;유제범;이춘우;권병국;김정문
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.39 no.1
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    • pp.33-43
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    • 2003
  • The midwater pair trawl which is being used at present in Korea have several problems. Firstly, it is difficult to control the net height on high towing speed. Secondly, net breaking often occurs owing to floats and thirdly, the volume of net on the net drum is so large. This study is aiming for examining the possibility of application for the Korean midwater pair trawl through the model experiment of non-float midwater pair trawl. The model of non-float midwater pair trawl was manufactured as 1/100 of the full scale net which is being used in bottom pair trawl for 850ps class considering the Tauti's Similarity law. The model experiment was carried out to analyze the opening efficiency according to the variation of lower warp length and the opening efficiency was investigated between th proto type and non-float type. The results obtained can be summarized as follows ; 1. The hydrodynamic resistance of non-float type was about 10~20% smaller than that of the proto type and it increased about 1ton according to the increase of dL at the condition of the same flow speed. The resistance acting on the lower warp decreased about 5% but that of the upper warp increased according to the increase of lower warp length (dL) at the condition of the same flow speed. 2. The net height of the non-float type decreased almost linearly according as the increased of flow speed and it increased in a logarithmic functional form with the increase of the lower warp length at the condition of the same flow speed. On the decreasing rate of the net height, the non-float type was lower than the proto type and the difference of the decreasing rate was about 12% at 3.0 knot, 25% at 4.0 knot, 25% at 4.0 knot respectively when dL was 30m. 3. The net width of non-float type was not varied so much as only 2m range and was larger than that of proto type. 4. The mouth area of non-float type decreased in a exponential functional form. On the decreasing rate of the mouth area, the non-float type was lower than the proto type. The filtering volume increased in a logarithmic functional form with increasing flow speed and the filtering volume of proto type decreased steeply over 3.0knot, but that of non-float type increased until 4.0knot. 5. The optimal length of lower warp was when the value of dL was about 30m and the optimal position of front weight was at the connection point of four net pendants.