• Journal of Oral Medicine and Pain
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• 제13권1호
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• pp.5-12
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• 1988

The purpose of this study was to evaluate the therapeutic effect of occlusal stabilization splint on the clinical symptoms and the condylar movement in patients with Temporomandibular Disorders(TMD). For the study, 15 TMD patients treated with stabilization splint and followed up were selected. The age of them was from 18 to 65 years and the mean period of treatment was 2.9 months. The author examined signs and symptoms of TMD according to Dr. Friction's evaluation from and recorded the condylar paths with Denar pantronic before and after splint therapy. The obtained results were as follows : 1. On the first visit, 11 patients(73.3%) showed muscle tenderness on palpation and the frequency was lateral pterygoid, masseter, medial pterygoid, temporalis, sternocleidomastoideus in the order named. 2. Occlusal stabilization splint was more effective in pain relief(100%) than in other dysfunction improvement(85.7%) 3. The amount of maximum opening increased from 37.1㎜ to 42.2㎜, but those of protrusion and laterotrusion changed little. 4. Pan. PRI scores decreased from 32.9 to 21.8, which meant improved reproducibility of mandibular border movements, and the group with sever dysfunction category showed more decrease in score than the group with moderate or slight dysfunction category.

• 대한치과의사협회지
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• 제25권10호통권221호
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• pp.927-930
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• 1987

하기 내용은 네델란드 Amsterdam치대의 Hansson교수와 스웨덴 Karolinska의 Riise교수의 ‘악관절 기능장애환자의 진단 및 처치’에 관한 course work의 내용중 일부이며 최근에 유럽제국에서는 시술이 간편하여 임상가에게 널리 이용되는 방법중에 하나이다. 현금에는 TMJ를 전공하는 학자들도 그 분야의 광범위성에 비추어 전공을 세분화하는 경향이 있어 Dr. Hansson은 splint therapy에 의한 muscle activity를 Dr. Riise는 occlusal adjustment를 주로 연구하고 있다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권1호
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• pp.14-20
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• 2013

Objectives: This study sought to evaluate the effect of simultaneous application of arthrocentesis and occlusal splint. Materials and Methods: A retrospective study of 43 patients (3 males, 40 females) whose symptoms had improved was conducted at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital between 2008 and 2010. Subjects were divided into three groups: Group A (17 patients with arthrocentesis and occlusal splints simultaneously applied), Group B (13 patients whose symptoms did not improve with occlusal splints, undergoing arthrocentesis after occlusal splint use for 8 weeks), and Group C (13 patients that only used occlusal splints). We compared these groups in maximum comfortable opening (MCO) and the visual analogue scale of pain and noise. Follow-up was performed at 1 week, 1 month, 3 months, and 6 months. Results: The improvement of symptoms was noted in all three groups, but Group A had a quicker improvement than the other groups, in terms of pain reduction and MCO increases. Conclusion: The simultaneous application of arthrocentesis and occlusal splints can reduce patient discomfort more quickly.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.316-324
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• 1998

This study was performed to evaluate the clinical features and treatment results on 55 temporomandibular disorder patients who had treated by conservative treatment using occlusal splint. The results were as follows; 1. The ratio of men to women was about 1:2.2 and most of the patients were second and third decades. 2. Pain was the most frequent symptom, followed by clicking and mouth opening limitation. 3. The number of acute and chronic groups on the basis of 6 months duration of symptoms were similar. 4. Most of patients had Angle's Class 1 molar relationships(78.2%), followed by Class 3 and Class 2. 5. Centric Relation splints were used alone for treatment of 34 patients and 21 patients were treated with Centric Relation splints and Anterior Repositioning splints. The treatment duration of the patients who had complained pain was average 9.8 weeks and 6 patients of them had slight pain continuously during follow-up. 6. Eleven patient's maximum mouth opening who had mouth opening limitation was improved from 30. 7mm to 43.0mm during procedures.

• 구강회복응용과학지
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• 제28권4호
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• pp.441-452
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• 2012

다른 근골격성 질환에서와 같이, 측두하악장애의 징후와 증상은 일시적이거나 자기 한정적(self-limiting)인 경우가 많다. 따라서 복잡한 교합 치료나 수술과 같은 비보존적, 비가역적 치료를 초기치료로 선택하는 것은 가급적 피해야 한다. 또한 자가요법, 행동 수정, 물리치료, 약물요법, 장치치료 등과 같은 보존적, 가역적 치료가 측두하악장애의 초기치료로 추천된다.

• 대한치과교정학회지
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• 제25권6호
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• pp.675-688
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• 1995

The purposes of this study were:1) to determine the normal range of CR-CO discrepancy in normal occlusion group ; 2) to evaluate the changes of condylar position and craniofacial morphology between centric relation and centric occlusion before and after stabilization splint therapy in malocclusion group outside the normal range of CR-CO discrepancy. The normal occlusion group consisted of 80 subjects who had well-balanced faces and good occlusions with acceptable Class I molar relationship. They had not been treated orthodontically and had no signs or symptoms of temporomandibular joint dysfunction. 71 malocclusion patients enrolled for orthodontic treatment at the Department of Orthodontics, College of Dentistry, Chosun University comprised the malocclusion group, little variation of growth factor by the second molar eruption. They had CR-CO discrepancy beyond normal range and were subdivided into anterior-posteriorly -[25 Class I (0$\geq$4), and 24 Class III (ANB$\leq$0)] : vertically - [20 Normodivergentscy (30$\geq$34), and 18 Hypodivergency (SNGoMe$\leq$30)] ; and sexually - [26 Male and 45 Female]. For malocclusion group, stabilization splint with mutually protected type of occlusal scheme was applied for three months. Panadent articulators, Panadent condylar position indicator (CPI), and lateral headfilm were used to investigate the influence of stabilization splint on condylar position and craniofacial morphology. The results of this study were as follows. 1. The amounts of CR-CO discrepancy in normal occlusion were that the antero-Posterior component (${\bigtriangledown}X$) was $0.56\pm0.46mm$ (Male:$0.63\pm0.42mm$, Female:$0.49\pm0.50mm$) ; the supero-inferior component (${\bigtriangledown}Y$) was $-0.75\pm0.48mm$ (Male:$-0.76\pm0.52mm$, Female:-$0.73\pm0.43mm$) : and the transverse component (${\bigtriangledown}Z$) was $-0.33\pm0.28mm$ (Male : $-0.38\pm0.29mm$, Female:$-0.31\pm0.27mm$). 2. The condylar position was in normal range after stabilization splint therapy. 3. The mandible was always rotated infero-posteriorly after stabilization splint therapy. 4. Antero-posteriorly, Class III malocclusion responded very well to the stabilization splint therapy. 5. Vertically, Hyperdivergency responded very well to the stabilization splint therapy 6. Sexually, Male responded very well to the stabilization splint therapy.

• Journal of Oral Medicine and Pain
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• 제30권2호
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• pp.247-255
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• 2005

본 연구의 목적은 교근에 보툴리눔 A형 독소주사량에 따른 교근위축 효과의 차이와, 교합안정장치의 동반치료시 교근위축의 증감의 관련성이 있는지, 부가적으로 주사부위로부터 어느정도 부위까지 근육위축의 효과가 나타날 수 있는지 전산화 단층촬영을 이용하여 평가하는데 있다. 자원자 32명을 8명씩 25 U, 25 U와 교합안정장치 장착, 35 U, 35 U와 교합안정장치 장착 군으로 나누어 보툴리눔 A형 독소주사량 차이와 교합안정장치 동반시의 교근위축효과 차이를 전산화 단층촬영을 이용하여 1, 2, 3 position의 3부위에서 측정, 평가한 결과 다음과 같은 결론을 얻었다. 1. 25 U 군에서 3 position 우측 두께감소, 25 U와 교합안정장치 군에서 3 position 우측 두께감소, 35 U 군에서 3 position 우측 두께감소와 좌측 면적감소를 제외하고 모든 부위에서 근육위축효과가 나타났으며 35 U와 교합안정장치 군에서는 모든 부위에서 근육위축효과가 유의성 있게 나타났다. (P < 0.05) 2. 보툴리눔 독소주사량 차이(25 U와 35 U)에 따른 근육 두께와 면적의 감소효과 차이는 나타나지 않았다. (P > 0.05) 3. 교합안정장치를 장착했을 때 근육두께 감소효과가 증가하는 것으로 나타났다. (P <0.05) 이상의 결과를 종합해 볼 때 교근비대 치료에 있어서, 보툴리눔 독소주사 이용시 교합안정장치의 동반치료가 보다 높은 근육위축 효과를 보이기에 이를 임상적으로 적용할 가치가 높다고 사료된다.

• 구강회복응용과학지
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• 제37권4호
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• pp.225-231
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• 2021

목적: 측두하악장애 환자에게 주로 사용되는 장치 치료의 적응증 및 효과에 대한 연구는 다수 존재하나, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 방법에 대한 연구는 부족하다. 따라서 본 후향적 연구는 측두하악장애 환자를 대상으로, 증상 개선에 따라 장치를 테이퍼링하여 종료하는 과정을 고찰하고자 한다. 연구 재료 및 방법: 턱관절 질환, 근막 통증, 이갈이 및 이악물기 등을 주소로 연세대학교 치과대학병원 구강내과를 내원하여 장치 치료(교합안정장치, 전방위치교합장치)를 시행한 130명의 환자의 차트 리뷰를 통해 장치 치료를 테이퍼링하여 종료하는 과정을 알아보았다. 결과: 평균 장치 장착 기간은 29개월로, 매일 장치를 장착한 기간은 8.4개월, 일주일에 3 - 4일간 장치를 장착한 기간은 9.5개월, 일주일에 1 - 2일간 장치를 장착한 기간은 11.1개월이었다. 결론: 측두하악장애 환자에서 장치 장착 시 처음 6개월 간은 매일 장착, 이후 6개월에서 18개월 동안은 일주일에 3 - 4일간 장착, 18개월 이후부터는 일주일에 1 - 2일간 장착하는 방식으로 테이퍼링하여 장치 치료를 종료할 시 측두하악장애 환자의 증상은 완화시키면서 교합 변화 등의 부작용은 최소화시킬 수 있을 것으로 사료된다.

• 대한소아치과학회지
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• 제29권4호
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• pp.586-591
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• 2002

이갈이(bruxism)는 일반적으로 주간의 이악물기(clenching)와 야간의 이갈이(grinding)를 포함하는데 이악물기는 상하악의 정적인 관계에서 대합하는 치열이 힘있게 다물어지는 것을 의미하고 이갈이는 하악의 편심운동시에 상하악이 동적인 관계에서 힘 있게 다물어지는 것을 의미한다. 이갈이의 원인은 아직까지 정확하게 밝혀진 것은 없지만 가장 큰 요인으로 정서적 스트레스를 들 수 있고, 수면장애나 약물, 중추신경장애 등을 원인으로 볼 수 있다. 이갈이의 치료는 근본적인 치료법은 아직까지 없으나 정서적 스트레스를 감소시키고, 교합조정이나 교합안정장치, 약물요법, 물리치료 등을 통해서 이갈이의 증상 및 징후를 치료하는 것이 치료의 목표가 된다. 본 증례는 이갈이를 주소로 내원한 환자에서 교합안정장치를 통하여 이갈이가 감소하는 결과를 얻었기에 보고하는 바이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권3호
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• pp.183-205
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• 2021

This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.