• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.155-165
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• 2006

The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.180-185
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• 1995

TMJ ankylosis is classified with true and false type. A true ankylosis is defined as any condition that produces fibrous or bony adhesions between the articular surfaces of the temporomandibular joint. The main causes of true ankylosis are trauma or infection. A false ankylosis results from pathologic conditions outside the joint that limit mobility of the mandible such as myogenic disorders, coronoid impingement or rare direct bony fusion between maxilla and mandible. The treatment of choice of TMJ ankylosis is surgical intervention. We experienced the male patient with complete mouth opening limitation since 45 years before. This patient has true TMJ ankylosis and rare bony synostosis between maxilla and mandible in the right posterior region. We performed surgical intervention and had a favorable result.

• Journal of Oral Medicine and Pain
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• v.8 no.1
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• pp.69-76
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• 1983

Background variables in 203 patients with TMJ pain dysfunction showing no bony change, ranging from 11 to 76 of age, were studied by use of the modified form of self-administered questionnaires deviced by Carlsson et al intended to give a review of the patient's history. All the patients were identified in the Dept. of Oral Diagnosis and Oral Diagnosis and Oral Medicine, Seoul National University Hospital, during the period from Feb. 1983 to Nov. 1983. The questions concerning general somatic and psychic health, educational and social condition were dealt with in this article. The obtained results were as follows : 1. The main symptoms reported by 203 patients were difficulties in opening the mouth wide(74.4%), clicking of TMJ(70.9%), chewing difficulties(69.0%), and pain on movement of mandible(57.6%) 2. The most fequently reported medical symptoms or histories were stomach disease (21.2%), insominia(15.3%), ENT disease(13.8%) and skin disease (12.8%) 3. Seventy-eight percent of the patients denied having had a nervous or psychic disorders while 4% were currently under treatment for such disorders. 4. Eleven percent of 203 patients with TMJ dysfunction thought their family situation was distressing(8.4%) or very troublesome(3.4%).

• Journal of Korean society of Dental Hygiene
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• v.14 no.3
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.540-548
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• 2011

Proteus syndrome is a congenital hamartomatous malformation that is characterized by a wide range of deformities, including craniofacial deformities. Proteus syndrome features partial gigantism and asymmetry of the limbs, plantar hyperplasia, hemangiomas, lipomas, lymphangiomas, varicosities, verrucous epidermal nevi, macrocephaly, cranial hyperostosis, and long bone overgrowth. We diagnosed Proteus syndrome in a male patient who visited our hospital with a chief complaint of limited mouth opening and report the case because we obtained a good healing outcome after treating the condition with a corrective osteotomy.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.11 no.2
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• pp.62-66
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• 2015

Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.141-152
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• 1984

The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36.90%(217 case), sclerosis 34.18% (20 cases), errosive chang 25.85% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent(36.90%), of which frequency was signifiantly higher than forward positioning (11.22%) and backward positioning(4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restricted movement of condylar head within articular fossa was most frequent(35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erossive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33.33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of normal positioning, forward positioning and downward positioning of condylar head was 38.38%, 36.96% and 44.64% respectively. 4. Bone changes of condylar head was 47.11%, articular eminence 41.50% and articular fossa 11.39% respectively. This revealed that the frequencies of bone changes. were higher in the projected portion of bony structures of temporomandibular joint than their depressed portions. On the otherhand, in the bone changes of condylar head, deformity was 59.57% which was the most frequent. In the bone changes of articular eminence and articular fossa, however, sclersis was 41.39% and 65.67% respectively, which was the most frequent in those portions.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.365-377
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• 2012

Objectives : This research was conducted to determine the effect of the Visiting Oral Health Care Program by examining the oral health of the elderly women, who are the beneficiaries of this Visiting Oral Care Program. Methods : This research was conducted from November of 2011 to February of 2012, in Chilgok-gun in the Kyeongbuk Province, South Korea. One hundred and twenty five (125) elderly women among the beneficiaries of the Visiting Oral Care Program within the area were randomly selected for the research. The research subjects would regularly visit the area senior citizen center, and they were divided into two groups, with 64 of them belonging to a control group, and the rest (61 people) belonged to a intervention group. The research subjects were examined for their dental health condition, and we investigated the effect of the Visiting Oral Care Program through this research. Results : 1. When they were asked about how many times they wash their dentures, the majority of the control group, 57.4% of them answered that they do it "once" a day. The majority of the intervention group answered "more than 3 times", with 35.2% of group mentioning that they wash their dentures more than 3 times a day(p<.001). 2. When the research subjects were asked to scale their overall quality of life before and after the Visiting Oral Care Program, the control group had rated 49.3 before the Service and 56.8 after the Service (p<.01), and scores for the individual factors to determine the overall quality of life has significantly improved as well (p<.01, p<.01, p<.01, p<.01, p<.01, p<.01, p<.01). 3. The oral hygiene condition after the Visiting Oral Care Program has shown improvement as well. The control group scored 64.2 for the severity of the symptoms of dental plaque before the dental care, and scored 46.8 after the dental care (p<0.1). The control group was diagnosed for the symptoms of coated tongue, and the severity of the symptoms were scaled as 3.7 before the Program and 2.0 after the Program (p<.01). Furthermore, the overall functionality of the oral cavity was improved as well. The control group showed 1.0 time increase in repetitive voluntary swallowing test (p<0.1), increased amount of sublingual saliva from 0.8mm to 1.4mm, and from 1.6mm to 2.0mm in dorsum linguae(p<0.1). Also, the control group showed an improvement in mouth opening as well, increased from 3.9 to 4.0cm after the oral care program (p<.05). When compared the result with the examination after the Visiting Oral Care Program, the two groups showed a significant difference with the control group showing a significant improvement compared to the intervention group(p<.01, p<.01, p<.01, p<.01, p<.05). 4. The correlation between the dental hygiene condition and the functionality of oral was made for the result of examining the beneficiaries for Visiting Oral Care Program. The amount of saliva showed a negative correlation with the severity of dental plaque (p<.05), and a positive correlation with the repetitive voluntary swallowing count (p<0.1). Also, mouth opening showed a positive correlation with repetitive voluntary swallowing count (p<.05). Conclusions : After the Visiting Orall Care Program, the beneficiaries of the program experienced improvement in their quality of life related to oral health, overall oral hygiene and functionality of oral.

• Journal of Oral Medicine and Pain
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• v.36 no.2
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• pp.117-121
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• 2011

Tetanus is fatal neurological disease caused by Clostridium tetani on contaminated wound that is characterised by muscle spasm, muscle pain, and autonomic dysfuction. C. tetani exist on contaminated wound frequently that developed clinical tetanus under low oxygen condition. Tetanus have four symptomatic form: generalized, localized, cephalic, and neonatal. The incubation period is about 7 days and mortality is high. The commonest presenting symptom is trismus and other is stiffness of neck and back(opisthotonos), muscle spasm, dysphagia, facial pain, risus sardonicus. Trismus is primary presenting symptom in 50~75% of the cases and this have high possibility of initial visit to dental office. This case report of a patient who visit in our department with trismus as chief complaint.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.383-386
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• 2008

Osteomyelitis is considered an inflammatory condition of bone that usually begins as an infection of the medullary cavity and quickly extends to periosteum of the area. Early acute osteomyelitis of the mandible is usually characterized by deep, intense pain, high intermittent fever, paresthesia or anesthesia of the lower lip and a clearly identifiable cause. If the disease is not controlled or inadequately treated after onset, acute osteomyelitis progresses to a chronic form. The diagnosis of mandibular osteomyelitis rests on processing for identification of microbiologic isolates and on imaging studies to determine the extent of disease. Mandibular osteomyelitis often is associated with involvement of the masticator space and can exhibit symtoms similar to temporomandibular disorder including orofacial pain and limited mouth opening. Advanced imaging modalities can be helpful in obtaining a proper diagnosis.