• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.126-132
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• 2016

Purpose: The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy. Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-$1{\beta}$, IL-6, IL-10, and tumor necrosis factor (TNF)-${\alpha}$ levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ${\leq}5$) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels. Results: Plasma TNF-${\alpha}$, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-${\alpha}$ levels. Percentage time of $SpO_2$ <90 and lowest $SpO_2$ were significantly correlated with plasma TNF-${\alpha}$ level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of $SpO_2$ <90, lowest $SpO_2$, and mean $SpO_2$ were significantly improved after the MAD therapy. Plasma TNF-${\alpha}$ level was significantly decreased after MAD therapy. Conclusions: We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.

• The Journal of the Korean dental association
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• v.43 no.11 s.438
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• pp.713-719
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• 2005

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.3
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• pp.211-216
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• 1993

This is to report functional treatment, as mechano-therapy, of condylar fracture in cases of growing patients. Benoist's appliance was used in 3 cases condylar fractures, provides extraoral elastic forces to external pterygoid muscle. The appliance providing guided exercise of masticatory muscles induces transformative growth of trauma-tic condyles. The results were as follow; 1. Early exercise preventes ankylosis of fractured condyle. 2. Optimal physical exercise therapy induces the normal growth pattern by muscular training and bony remodeling of fractured condyle in children.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.270-274
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• 2010

Introduction: Limited mouth opening is a representative clinical symptom of temporomandibular disorders (TMD) with anterior disc displacement without reduction (ADDWOR). Various treatment methods have been proposed for patients with ADDWOR. This study examined the clinical effectiveness of template therapy for patients with mouth opening difficulty due to the ADDWOR. Material and Methods: A total of 14 patients (female 12, male 2, average age: $29.1{\pm}14.4$), who had been treated in the template clinic, Sooncheonhyang University Bucheon Hospital, from January of 2006 to December of 2008, were enrolled in this study. The subjects were selected according to the following criteria: more than 2 weeks after the onset of locking, mouth opening range <35 mm, and confirmed ADDWOR without a synovial pathology by magnetic resonance imaging (MRI). All patients were treated with the template appliance, instructed to wear it while sleeping and exercise for at least 10 hours per day. The maximum mouth opening (MMO) range and pain recognition scores before and after template therapy were recorded and compared. A paired t-test and Wilcoxon's signed rank test were used for statistical analysis. Results: After the periodical follow up, significant improvement in the opening range was observed in the template treatment group. The average MMO range before treatment was $30.2{\pm}3.5mm$ and the average MMO after treatment and follow up was $47.1{\pm}4.7mm$. The mean amount of mouth opening increment was $16.9{\pm}5.4mm$ (P<0.01) and the pain recognition scores before and after treatment was also improved.(P=0.001) Conclusion: The template appliance proved to be efficient for the treatment of TMD with a closed lock and painful joint due to ADDWOR.

• Journal of Oral Medicine and Pain
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• v.43 no.3
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• pp.61-69
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• 2018

Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.44.1-44.7
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• 2019

Background: We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results: We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion: The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

• The korean journal of orthodontics
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• v.24 no.3 s.46
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• pp.659-672
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• 1994

Dental caries is one of the most prevalent dental diseases in Korea and its prevention is very important in orthodontic therapy. For the cleansing action of saliva itself and/or tooth-brushing is lowered in patient with fixed orthodontic appliance, oral hygiene of the patient becomes worse, which provides more favorable environment for micro-organisms. Chlorhexidine, one of the series of bisguanide, has been reported to be strong antimicrobial agent and very effective on Streptococcus mutans. The purpose of this study is to evaluate the possibility of chlorhexidine as a anticariogenic agent in fixed orthodontic therapy. We used the varnish containing chlorhexidine as a main ingredient for the chemical control of salivary S.mutans in patients with fixed appliance therapy We applied the varnish containing chlorhexidine on the labial and interproximal surface of the teeth before bonding and banding teeth of our patients(N=20) and compared to control group patients(N=20). Before the application of chlorhexidine varnish and four times periodically after the completion of fixed appliance set-up, we sampled saliva of both group patients and incuvate S.mutans for 24 hours. In the culture study of sampled saliva, counting the number of S.mutans colonies, we founded as follows : 1. In patients with fixed appliance therapy, the risk of dental caries increase when it compared to that of preorthodontic treatment ; The number of salivary S.mutans increase in Patient's oral cavity. 2. The experimental agent that contain chlorhexidine is effective to reduce the number of salivary S.mutans. 3. For the effect of this agent is not ever-lasting, periodical application is needed, and additional study for economical interval and number of application is needed.

• Journal of Oral Medicine and Pain
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• v.15 no.1
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• pp.61-68
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• 1991

The author studied the changes of subjective, objective symptoms and muscle activities with EM2 (myo-tronics Co., Seattle, USA) before and after MRA therapy. The 11 patients were treated with MRA and active range of motion, pain and mouth opening limitation were checked at each visit for 6-8 weeks. Electromyographic activities were measured in both anterior lobe of temporalis and middle fibers of masseter at the position in rest, clenching and mastication. The obtained results were as follows : 1. There were significant decrease in pain and mouth opening limitation and significant increase in active range of motion after MRA therapy. 2. The muscle activities tended to decrease in general, especially in the temporal and masseter muscles on clenching and in the masseter on mastication after MRA therapy. 3. There were no significant differences in muscle activities between affected and unaffected side, but there was significant differences in temporal muscle on clenching side after therapy. 4. There were no significant differences in active range of motion, pain and mouth opening limitation between acute and chronic groups. 5. There was more significant decrease in muscle activities of the affected side in acute group than those in chronic group.

• Journal of Korean Dental Science
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• v.4 no.2
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• pp.85-91
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• 2011

Some treatment methods have been proposed for patients with chronic closed lock of temporomandibular joint. We report a conservative treatment for patients who had chronic closed lock of temporomandibular joint and who did not want surgical treatment. Two patients who had been treated in the Template clinic, Soonchunhyang University Bucheon Hospital, are the subjects of this report. The subjects had chronic closed lock symptom for over 3 months after an onset of locking; conventional therapies had no effect. The subjects were treated by making them wear a Template appliance while sleeping and exercise for 10 hours a day. After periodic follow-up, significant improvement was observed for Template treatment in terms of the maximal mouth opening range. When conventional therapy is expected to be ineffective, The Template appliance can be used as conservative treatment for temporomandibular disorders patients with chronic closed lock of temporomandibular joint.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.453-458
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• 2004

Mandibular fracture is less common in children than in adults. However, children are more susceptible to ankylosis and developmental disorders, and don't respond as well to intermaxillary fixation compared to adults. On the other hand, bone fracture is healed more quickly in children and complications are scarce. Mandibular fracture in children is usually treated successfully with acrylic splint therapy with or without the use of eyelet wires and intermaxillary fixation. Severe complications that include ankylosis and developmental disorders may occur. The frequency and severity of such complications can be mitigated with a shorter duration of intermaxillary fixation and good post-operative care. Encouraging mandibular physical therapy by increasing patient motivation may be necessary in such cases where the patient's response is poor and the duration of intermaxillary fixation increases; when the patient is unable to undergo physical therapy, or when intermaxillary fixation is not necessary with the patient showing only minor symptoms such as trismus. In this case report, a 6 year-old girl with bilateral condylar fracture was treated with elastic in both the upper and lower jaws to allow mandibular physical therapy using a Benoist's appliance, which allows opening, lateral, and protrusive retrusive movements of the mandible. A 7-month follow-up showed beneficial therapeutic effects such as increased mandibular movement and prevention of condylar ankylosis.