• 제목/요약/키워드: occlusal therapy

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The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

  • Lim, Hyun-Dae;Lee, You-Mee;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • 제39권4호
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    • pp.152-155
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    • 2014
  • Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

이모장치의 적응증에 관한 후향적 고촬 (THE RETROSPECTIVE STUDY ON THE INDICATION OF THE CHIN CAP THERAPY)

  • 양원식;김병호
    • 대한치과교정학회지
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    • 제25권1호
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    • pp.1-12
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    • 1995
  • 본 연구는 초진시의 골격형태로부터 이모장치에 대한 반응성을 예측하는 지표를 구하여 III급부정교합환자의 조기 치료를 결정할 때 고려할 수 있는 기준를 마련하기 위해 시행하였다. 성장기의 골격성 III급 부정교합아동 40명을 연구대상으로 하였으며, 이들을 영구치열완성 이후의 교합의 안정성과 최대성장기 이후의 안모의 개선도를 기준으로하여 양호반응군 25명과 불량반응군 15명으로 나누었다. 초진시 두 군 사이에 현저한 차이를 보이는 주요 골격계측항목을 선택하고, 판별분석을 시행하여 다음의 결과를 얻었다. 1. 치료전 $Bj\ddot{o}rk$ sum, 전후안면고경비율, genial angle, lower genial angle, occlusal plane to SN, occlusal plane to AB plane angle 등의 항목에서 두 군 사이의 유의성이 인정되어 양호반응군이 불량반응군에 비해 치료전에 보다 수평적인 안모형태를 지니고 있었음을 알 수 이었다. 2. $Bj\ddot{o}rk$ sum등 두군사이에 유의한 차이를 보인 각 항목들의 임계값과 판별력을 구하였다. 3. 판별에 기여도가 높은 세 항목 즉, $Bj\ddot{o}rk$ sum, genial angle 그리고 occlusal plane to An plane angle을 이용한 판별식을 구하였으며, 이를 이용할 때 본 연구에 사용된 표본의 $85\%$를 올바르게 판별할 수 있었다.

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다수의 구치 상실과 편측성 가위교합을 갖는 환자의 보철 교정 협진 치료 (Orthodontic-prosthodontic interdisciplinary treatment for a patient with multiple missing posterior teeth and unilateral scissors bite)

  • 안기용
    • 대한치과의사협회지
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    • 제53권11호
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    • pp.844-854
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    • 2015
  • This clinical report describes an orthodontic-prosthodontic interdisciplinary treatment for a patient with multiple missing teeth and unilateral scissors bite. A 47-year-old female presented with multiple missing posterior teeth, anterior large overjet, deep bite, and posterior scissors bite on the right premolar area. Periodontal therapy was performed and followed by orthodontic treatment. The maxillary anterior teeth were initially aligned, then two implants were placed for the left mandibular molars to increase occlusal vertical dimension. The scissors bite between the right maxillary and mandibular premolars were corrected using the miniscrews as an anchorage. Other implants were placed for the right maxillary and mandibular molars after the occlusal planes and occlusal relationship were harmonized. The patient adapted well to altered vertical dimension without any specific problems including peri-implant marginal bone loss. Interdisciplinary approach resolve the complex orthodontic-prosthodontic problems and concluded in successful results.

Acute Malocclusion Related to Posterior Disc Displacement According to Complete Disc Tearing: Two Case Reports

  • Jo-Eun Park
    • Journal of Oral Medicine and Pain
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    • 제49권2호
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    • pp.29-34
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    • 2024
  • Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

교합안정장치의 장착이 저작근 활성도에 끼치는 영향에 관한 연구 (A Study on the Effects of Occlusal Stabilization Splint on Electromyographic Activity)

  • Min Shin;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • 제14권1호
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    • pp.67-80
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    • 1989
  • The author studied the changes of muscle activity with Bioelectric processor Model EM2(Myotronics Corp., USA) before and after occlusal stabilization splint therapy. For this study, 15 temporomandibular disorders patients and 15 students without any temporomandibular disorders symptoms were selected, for experimental group and control group, respectively. Experimental group were treated with occlusal stabilization splint and checked about electromyographic activity before and after therapy. Electromyographic levels were measured in both groups at the following mandibular position, i.e., physiologic rest, tapping, light biting, hard open without pain, open with pain, right excursion and ipsilateral biting, left excursion and ipsilateral biting, protrusion, protrusive biting, edge biting and physiologic rest after movement. The obtained results were as follows : 1. In experimental group, post-treatment mean values of muscle activity were lower than pretreatment values. 2. In general, the pre-treatment mean values of muscle activity in experimental group were higher than those of control group. 3. In experimental group, no statistically significant difference appeared between affected and unaffected side. 4. The mean value of muscle activity in physiologic rest position after each movement check was lower than that before each movement check.

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Effect of simultaneous therapy of arthrocentesis and occlusal splints on temporomandibular disorders: anterior disc displacement without reduction

  • Lee, Hye-Sung;Baek, Hyun-Su;Song, Dong-Suk;Kim, Hee-Chul;Kim, Hyo-Geun;Kim, Bok-Joo;Kim, Myung-Soo;Shin, Sang-Hoon;Jung, Sung-Hee;Kim, Chul-Hoon
    • 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.

Intentional passive eruption combined with scaling and root planing of teeth with moderate chronic periodontitis and traumatic occlusion

  • Joo, Ji-Young;Kwon, Eun-Young;Lee, Ju-Youn
    • Journal of Periodontal and Implant Science
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    • 제44권1호
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    • pp.20-24
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    • 2014
  • Purpose: The aim of this clinical trial was to explore the impact of intentional passive eruption (IPE) using occlusal reduction on the periodontal parameters of teeth with moderate chronic periodontitis and traumatic occlusion. Methods: This study was performed on 40 teeth from 16 subjects. At baseline, 4 weeks after initial periodontal treatment, and 6 months after IPE, clinical and radiographic examinations were performed. The 20 teeth in the test group underwent IPE using occlusal reduction, whereas the 20 control teeth did not undergone occlusal reduction. Results: All the periodontal parameters were improved by the initial periodontal treatment. The teeth in the test group showed a significantly greater decrease in pocket depth, tooth mobility, and marginal bone loss than did the control group (P<0.05), but there were no significant changes in the attachment level. Significantly greater improvements in all the parameters were observed in the test group after 6 months of IPE compared to 4 weeks after the initial periodontal treatment (P<0.05). Conclusions: Within the limits of this study, performing initial periodontal therapy combined with IPE using occlusal reduction was shown to be very simple and effective. Moreover, IPE would be helpful in improving periodontal parameters.

두개하악장애환자의 교합안정장치에 의한 치료후 Sonopak을 이용한 악관절음 변화 (A Comparative Study on the Temporomandibular Joint Sounds before and after Occlusal Splint Therapy Using Electrovibratography)

  • Hye-Sook Park;Jong-Hoon Choi;Chang-Seo Park
    • Journal of Oral Medicine and Pain
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    • 제21권1호
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    • pp.67-78
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    • 1996
  • This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

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보철학적 교합 재구성을 위한 교합진단과 치료계획 (The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation)

  • 이승규;이성복;최대균
    • 구강회복응용과학지
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    • 제16권2호
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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