• Journal of Oral Medicine and Pain
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• v.11 no.1
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• pp.57-66
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• 1986

A study of occlusal relationship and TMJ dysfunction, parafunctional relationship and TMJ dysfunction using PRI was investigated in 23 dental students without history of being treated, ranging from 19 to 24 years old. The author used Denar Pantronic and D5-A articulator to study above. The obtained results were as follows : 1. Distribution of PRI in experimental subjects was as follows. None 13%, Slight 43%, Moderate 40%, Severe 4% Prevalance of TMJ Dysfunction was 87% 2. PRI scores of occlusal group Aoi (less than 5 in Helkimo occlusion/articulation index) was $11.72\pm2.32$ , those of occlusal group Boi (more than 5 in Helkimo occlusion/articulation index) 23.0 $\pm$ 8.06. There was a significant difference between group Aoi and group Boi(P<0.01) 3. PRI scores of occlusal group Ald (no eccentric interference, less than 0.5mm in lateral shift of slide in centric) was 12.0 $\pm$ 2.49, those of occlusal group Bld(no eccentric interference, less than 0.5mm in lateral shift of slide in centric) 24.5$\pm$5.33 There was a significant difference between group Ald and group Bld(P<0.05) 4. Prevalance of parafunction subjects(%) was 65.2%. 5. PRI scores of parafunction group was 21.6 $\pm$ 9.48, those of nonparafunctional group 18.7 $\pm$ 9.06. There was not significant difference between parafunctional group and nonparafunctional group(P>0.1)

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.79-85
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• 2005

This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. 1. There was no difference in sex(p=0.91) and age(p=0.73) between two groups. 2. In the experimental group, dull pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.69). 3. In the experimental group, severe pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.40). 4. In the experimental group, pain shown bilaterally was presented more frequently than in the control group. But, there was no difference between two groups(p=0.52). 5. In the experimental group, pain was more increased by physical activities than in the control group. But, there was no difference between both groups(p=0.74). The pain of TTH patients with OPF was presented to be non-dull pain frequently and more bilaterally and severely, also increased more by physical activities than the pain of TTH patients without OPF. But, there was no significant difference between two groups. Therefore, it is considered that the pain of TTH is not influenced by OPF.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.4-10
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• 2009

Though implant treatment is considered as a common treatment option for edentulous patients, there have been few studies on the temporomandibular disorder (TMD) related with implant treatment. The purposes of this study were to evaluate the relevance of TMD to the implant patients and to evaluate the risk factors of TMD in relation with implant treatment. For the evaluation of various risk factors of TMD in relation with implant therapy, clinical evaluation focused on patient factors and implant factors. From a group of 694 patients, 25 patients (3.6 %) were included in this study. The majority of the patients were included in the asymptomatic 'adaptive' group. Parafunction was detected in 11 patients, 8 patients were male. Four patients having parafunction showed complications such as implant failure or fracture of the suprastructure. From the results, it is possible that TMJ related symptoms are developed or aggravated after implant therapy, which requires relatively more chair time; so TMJ examination should be included in the pre-operative evaluation for dental implant patients. Also, it is important to treat patients after they sign an informed consent that includes a detailed explanation on the possibility of TMD during treatment.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.110-117
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• 2016

Purpose: The purpose of this study is to determine factors influencing the duration of occlusal appliance (OA) treatment for patients with temporomandibular joint (TMJ) internal derangement. Methods: Ninety patients were included for this study, who satisfied the following including criteria: (i) those who were diagnosed as disc displacement of TMJ by taking magnetic resonance imaging (MRI) and (ii) those who were finished OA treatment. The subjects were classified into three groups according to the period of OA treatment: (i) early response group (<6 months), (ii) moderate response group (6 months-1 year), and (iii) delayed response group (>1 year). Demographic data, data from chief complaints and past history of temporomandibular disorder, data from clinical examination and diagnostic imaging including panoramic view and TMJ MRI were compared among groups. One-way ANOVA and chi-square analysis were used to test statistical significance. Results: There were no significant differences in demographic data, data from chief complaints and TMJ imaging. However, only the prevalence of oral parafunctional habits including bruxism, clenching, and unilateral chewing showed significant differences among groups. Conclusions: Oral parafunctional habits could be factors to influence the duration of OA treatment in the patients with TMJ internal derangement.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.113-120
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• 2007

Although most cases of tension-type headache(TTH) are myogenic headache, in some cases, arthralgia appears, such as the disorder of the temporamandibular joint. This study is designed to compare the clinical patterns of arthralgia to those of myalgia, when both symptoms are co-existing. Among 167 patients who visit our clinic during a certain period, whose chief complaint was TTH, 18 patients were the arthralgia group, 50 patients were the myalgia group, and 99 patients who have both arthralgia and myalgia were the arthromyalgia group. Three groups were asked to answer the questionnaires about their age, gender, and oral parafunction such as bruxism or clenching. Then we gathered statistics on the data from the accomplished questionnaires. 1. There was statistical significance in age among the three groups(p=0.02). 2. There was no statistical significance in sex and oral parafunction among the three groups. 3. There was statistical significance the myalgia group was older than the arthromyalgia group(p<0.03). The results of the study show that as patients become older, TTH with myalgia happens more frequently than TTH with arthralgia and myalgia does.

• Journal of Korean society of Dental Hygiene
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• v.14 no.5
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• pp.739-746
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• 2014

Objectives : The purpose of this study was to examine the relationship of stress symptoms, oral habits and temporomanbibular joint symptom among 20-30 ages adults. And it's also meant to investigate the direct and indirect influence of these factors by using a path model to determine their causal relationship. Methods : The subjects in this study were 287 selected 20-30 ages adults, on whom a survey was conducted from June 15 to July 10, 2014. The data were analyzed using SPSS 18.0(SPSS 18.0 K for window, SPSS Inc USA) and IBM SPSS Amos 18.0(SPSS Inc, Chicago, IL, USA). Results : There were significant differences in oral habits, TMJ symptoms and stress according to gender. There were significant differences in oral habits, TMJ symptoms, physical and psycho-emotional symptoms according to Systemic disease. And stress, physical, psycho-emotional symptoms, oral habits and TMJ symptoms were correlated to one another. Stress exerted a direct influence on physical, psycho-emotional symptoms, and psycho-emotional symptoms had a direct impact on physical symptoms, oral habits and TMJ symptoms. Physical symptoms exercised a direct influence on oral habits and TMJ symptoms, and oral habits affected TMJ symptoms in a direct way. physical, psycho-emotional symptoms and oral habits served as parameters that produced partial mediation effects, and the two factors had an indirect impact on TMJ symptoms. Conclusions : It's found that stress exerted direct and indirect influence on oral parafunction and TMJ symptoms. Like other diseases, oral habits and TMJ symptom that stem from stress is likely to lead to chronic diseases if the two are not noticed at the right time. Therefore individual people should try to get rid of stress in a manner to be appropriate for their own characteristics in order to maintain their oral health.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.85-95
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• 2008

The purpose of this study was to evaluate the effects of oral habits on the muscles of mastication and facial expression by means of two parameters: muscle stiffness and elasticity. 10 healthy, fully-dentate male subjects in their twenties were selected for this study; all had normal Class I occlusal relationships. Muscle stiffness and elasticity were measured with a tactile sensor(Venustron, Axiom Co., JAPAN) while subjects were asked to relax and perform various parafunctional activities such unilateral clenching(biting the bite force recorder with a force of 50kg on each subject's preferred side), jaw thrusting and lip bracing. The following muscles were examined: temporalis anterior(Ta), masseter(Mm), frontalis(Fr), inferior orbicularis oculi(OOci), zygomaticus major(Zm), superior and inferior orbularis oris(OOrs and OOri) and mentalis(Mn). Paired t-test, Correlation Coefficients, ANOVA and Multiple Comparison t-tests were used for statistical analysis. Unilateral clenching was highly correlated with bilateral stiffness and elasticity of all the muscles tested. Mm was affected by all three oral habits; Ta was affected by unilateral clenching(p<0.05); Zm was affected by unilateral clenching and OOrs, OOri and Mn were most affected by lip bracing(p<0.05). This study indicates that not only the masticatory muscles but also the muscles of facial expression, mainly circumoral muscles, can be significantly influenced by parafunctional activities such as unilateral clenching and lip bracing.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.308-323
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• 1996

This study tried to find the prevalence and distribution of temporo-mandibulr disorders(TMD) for workers (employee) in Seoul area to investigate the correlation between TMD and possible etiological factors such as general muscle and joint symptoms, headache, unilateral chewing and parafunction. This study was an epidemiological investigation of answers obtained from 282 persons by questionaire from Aug. 1995 to Nov. 1995. The major findings from the questionaire were as follows. (1) 43.26% of the subjects(282 persons) has TMD. (41.88% of man and 43.26% of women) (2) The more often people have general muscle and joint symptoms and headache, the more susceptible they are to TMD. Their correlation was very significant(p<0.001). (3) The more people have bad oral habits such as bruxism, clenching and biting habit, the more likely they have TMD. The more sensitive people are to stress, the more frequently they have bad oral habits such as bruxism, clenching and biting habit. (4) Unilateral chewing has higher TMD index than bilateral chewing. There is no relationship between ache areas and TMD index.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.431-439
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• 2007

This study was performed to investigate the dental ages of the patients with temporomandibular disorders(TMD), using a method of age estimation by dental attrition, and to compare the differences of dental ages between control and experimental groups. In addition, they were compared according to oral habit. Clinical evaluations for the tooth attrition were to examine the study models of 65 TMD patients (mean age of 26.6 years, aged 18 to 40) had visited to the Department of Oral Medicine and Orofacial Pain Clinic, Dental Hospital, Dankook University as a experimental group and 22 volunteers (mean age of 25.4 years, aged 23 to 36) without TMD as a control group. Age differences were calculated subtracting real age from estimated age. Age differences between experimental and control groups were compared statistically between groups classified according to oral habit. As a results, dental age was increased significantly in TMD patients compared with normal subjects. Oral parafunctions which increased dental age were bruxism, clenching and heavy chewing in order. Conclusively, it should be consider that there can be much discrepancy between real age and age estimated by dental attrition in patients with TMD. In addition, it is suggested that dentists should try to protect the tooth from attrition by various parafunction on treating the patients with TMD.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.3
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• pp.145-154
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• 2001

In the past, many dentist were interested mainly in the mechanical aspects such as tooth preparation and retainer types for making dental restoration. But, these days, the concept of restorative treatment emphasizes the importarce of gnatic system and masticatory muscles in addition to oral cavity. So, the current considerations for the fixed prosthodontic treatment include the stabilization of temporomandibular joint and neuromuscualr system and the relationship of periodontal ligament and occlusion. To achieve the above objectives, occlusal splint has been used as one of the mouth preparations for restorative treatment. The objectives of occlusal splint are as follows; 1. To use as preliminary application for periodontal-occlusal treatment 2. To provide proper vertical dimension 3. To control abnormal habits and parafunction 4. To treat the temporomandibular disease and myofascial pain 5. To establish the new therapeutic position In some cases, the patients had improper vertical dimension and occlusal interferences caused by prostheses reconstucted using centric relation recorded without considering the health of TMJ and manticatory muscle. And these prosthesis act as primary source that cause pathologic phenomenon in periodontal ligament, muscles and TMJ. Physiologically, in order to make the treatment occlusion guided by proper centric relation method, the method should be guided after the use of occlusal splint for some period. The main objective of prosthetic treatment is to maintain the function and health of stomatognathic system. So, one of the most important things that have to be performed by clinicians is a clinical ability to do the correct diagnosis and treatment planning based on the stomatognatic function and occlusion.