• Journal of Oral Medicine and Pain
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• 제19권2호
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• pp.181-192
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• 1994

There have been many different theories on the etiology of temporomandibular disorders(TMDs). The objective of the study was to investigate the effects of occlusal fctors and recent life event changes as prediposing fctor on the development of temporomandibjlar disorders. To evaluate the above predisposing factor, the author used T-scan system(Tekscan Co. U.S.A.) for quantitative occlusal analysis, clinical examination for occlusal state and Social Readjustment Rating Scale(SRRS) for recent life event change units (LCU). 63 patients with TMDs and 57 patients with malocclusion presented at Wonkwang University Dental Hospital participated in this study. The subjects were grouped by Angle's classification and presence of absence of TMDs and parafunctional oral habits. Data gained with regard to contact number, contact force, contact time, occlusal state(number of total teeth and occluding teeth, overjet, overbite) and occlusal interferences (protrusive posterior contact, nonworking side interference, and RCP-ICP slide) and recent life event changes. The data were processed and analysed by SAS statistical package program, The results of this study were as follows : 1. There were no significant differences on both quantitative occlusal contact analysis and occlusal state between TMDs group and Angle's malocclusion group. Also, there were no differences among the Angle's classifications. But amount of overjet in TMDs group were more greater than that of malocclusion group. 2. There was no difference on protrusive posterior contact, and balancing contact between TMDs group and Angle's malocclusion group. Premature contact was more frequent in malocclusion group, but RCP-ICP slide was more frequent in TMDs group. And RCP-ICP slide was more freqent in Angle's class II malocclusion than Angle's I or III malocclusion. 3. Life changes units in TMDs group were higher than those in malocclusion group. And recent life change units in group with parafunctional oral habit were higher than those in group without parafunctional oral habits. Clenching was the most common habit among parafunctional oral habits.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.361-368
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• 1998

In order to evaluate the clinical features of the rcurred patients with temporomandibular disorders, 52 patients were subjected at the Dept. of Oral Medicine, PNUH from 1985 through 1996. As related to gender, duraton and diagnosis, Ll the relate factors-multiple diagnosis, emotinal problem, history of treatment, parafunctional habit, life distrubance, and trauma were analyzed. The obtained results were as follows : 1. The patients with multiple diagnosis were 83 percent and more often seen in women, chronic group and muscle-joint disorder group. 2. Duration of retreatment in chronic group and muscle-joint disorder was longer. 3. The patients with oral parafunctional habits were 89 percent and more often seen in women, chronic gorup, muscle-joint disorder group. 4. the Recurred patients showed 46 percent in history treatment, 42 percent in life distrubances, 39 percent in macrotrauma and 12 percent in emotional problem.

• Journal of Korean Dental Science
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• 제13권2호
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• pp.59-66
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• 2020

Purpose: The purpose of this study was to investigate the masseter muscle thickness before and after treatment using ultrasound sonography in patients with parafunctional habits. Materials and Methods: From September 2019 to March 2020, a total of 27 patients who visited the Department of Oral and Maxillofacial Surgery at Ewha Womans University Seoul Hospital were collected. The thickness of both masseter muscles was measured using a tablet ultrasound scanner. Statistical analysis was performed by using the IBM SPSS version 26.0 statistical package (IBM Corp) with significance level at 0.05. Result: According to the statistical results, the thickness of the masseter muscle was thicker on the right side than on the left, with no correlation with sex or age. The severity and duration of pain did not have a significant correlation with the thickness of the masseter muscle. Botulinum A toxin injection in the masseter muscle was the most effective way to reduce pain and reduce the thickness of the masseter muscle. Splint treatment also showed some effects in reducing the thickness of the masseter muscle. Conclusion: Based on the findings, it can be claimed that ultrasonography is simple, inexpensive and easily repeatable method to get real-time diagnosis and treatment results for masseter muscles.

• 치위생과학회지
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• 제15권6호
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• pp.721-727
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• 2015

본 연구는 전라북도에 소재한 5개 대학교에 재학 중인 1~4학년 남녀 대학생 396명을 대상으로 스트레스가 측두하악장애에 영향을 미치는 구강악습관과의 연관성을 파악하고자 실시하였으며 그 결과는 다음과 같다. 구강 내 악습관 정도에 '수면 시 한쪽으로 누워 잔다'가 가장 빈도 높은 구강 악습관으로 나타났으며 그 외에 '카페인 음료를 즐겨 마신다', '손이나 물건으로 턱을 괸다', '음식을 한쪽으로만 씹는다' 등이 높은 순으로 나타났다. 일반적 특성에 따른 스트레스를 살펴본 결과 성별에 따라서는 학교생활 문제, 자신 문제, 경제적 문제에서 유의한 차이가 있는 것으로 나타났다. 학년에 따라서는 스트레스 중 자신 문제만이 통계적으로 유의한 차이가 있었다. 요인 간 상관관계를 알아보기 위하여 실시한 결과 지각된 스트레스 중 학교생활 문제, 자신 문제는 구강 악습관 점수와 유의한 정적 상관이 있는 것으로 나타났다. 일반적 특성 및 지각된 스트레스가 구강 악습관 점수에 미치는 영향에 대해 알아보기 위하여 다중선형회귀분석을 실시한 결과 성별, 학년, 주관적 구강건강 상태, 학교생활 문제로 인한 스트레스, 자신 문제로 인한 스트레스가 유의한 변수로 나타났다. 본 연구결과 대학생의 구강 악습관과 스트레스는 유기적으로 관련을 맺고 있으며, 측두하악장애에 영향을 미치는 구강 악습관이 해결하기 어려운 구강문제임을 인식하고 구강 악습관에 대한 적절한 구강보건교육과 예방이 필요하다. 또한 스트레스 완화를 위한 노력으로 규칙적인 운동 및 식생활을 하며 개인의 특성에 맞는 스트레스 해소 방법이 필요할 것으로 생각된다.

• 대한치과의사협회지
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• 제48권5호
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• pp.379-390
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• 2010

The aim of this study was to investigate clinical and cephalometric characteristics of patients with anterior open bite and mandibular condylar resorption. Total of 45 subjects were recruited from the patients who visited the Department of Oral Medicine, Kyungpook National University Hospital in 2006 for treatment of temporomandibular dysfunction. After taking patient's history concerning temporomandibular joint dysfunction, clinical examination was performed and panoramic, transcranial, and lateral cephalometric radiographs were obtained. The cephalometric data were compared to those of normal Korean population. The results were as follow: 1. Clinical characteristics 1) Female was 4.6 time more prevalent than male, and 82.2% of the subjects were in second and third decade. 2) Angle's Class I occlusal type was 51%, Class II was 29%, and Class III was 20%. 3) The mean value of the overjet and overbite were 3.2mm and -1.1mm, respectively. 4) Most of the patients had parafunctional oral habits. 2. Cephalometric characteristics 1) SNA showed no significant difference between condyle resorption and normal group. However, in female resorption group, SNB was lesser and ANB was greater than those in normal group. 2) SN-GoMe and FMA increased in resorption group. 3) Palatal plane angle did not show significant difference between resorption and normal group. 4) Total posterior facial height was significantly smaller and total anterior facial height showed no significant increase as compared with those of the normal group. 5) Mandibular body length did not show any significant difference between resorption and normal group.

• 대한장애인치과학회지
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• 제10권2호
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• pp.89-92
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• 2014

상악 전치부 완전탈구를 주소로 내원한 지적 장애를 동반한 뇌병변 장애를 가진 25세 환자에서 재식 후 구치부 bite block을 추가한 vacuum-formed splint을 이용한 교합 안정술을 통하여, 외상 치아의 동요도 감소 및 교합안정을 이루는데 도움이 될 것으로 사료 된다.

• 대한치과의사협회지
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• 제54권3호
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• pp.198-205
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• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.169-179
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• 2016

Purpose: This study is designed to analyse etiology and bone pattern at the first visit using cone-beam computed tomography (CBCT) and to evaluate the treatment outcome of conservative treatment in temporomandibular disorder (TMD) patients with rheumatoid arthritis (RA). Methods: One hundred condyles in 50 subjects with RA were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Dental Hospital, diagnosed as TMD. Condylar bone changes were classified by normal, erosive bony change, proliferative bony change and combined group (erosive bony change+proliferative bony change). They were treated conservatively with physical therapy, medication, behavioral therapy and/or occlusal stabilizing splint therapy. After 3 months on average, patients were re-evaluated with regards to subjective symptoms and the clinical findings were investigated. Results: TMD patients with RA have behavioral contributing factors such as parafunctional habit. The results that analyse bone pattern at the first visit using CBCT proliferative bony changes group (32.6%) were more common than erosive bony changes group (15.2%). In comparison between unilateral and bilateral bony change in temporomandibular joint, the ratio showed no significant differences. After 3 months of conservative treatments, pain, noise, limitation of motion (LOM) were markedly improved regardless of occlusal splint therapy. However only LOM was significantly improved through occlusal splint therapy during 3 months. Conclusions: TMD patients with RA had similar behavioral contributing factors and characteristics of CBCT images shown in general TMD patients and also similar response to conservative treatment so it is difficult to differentiate. Therefore when TMD patients show symptoms corresponding to clinical diagnostic criteria of RA at the first visit, serological testing should be conducted and through this, early diagnosis and treatment of RA should be initiated.

• Journal of Oral Medicine and Pain
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• 제42권4호
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• pp.89-101
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• 2017

Purpose: The purpose of this study is to investigate the prevalence of temporomandibular disorders (TMDs) in children and adolescents, their characteristic contributing factors, the characteristic features of symptoms and symptoms, and the response to treatment. Methods: We studied the researches, that were the results of the searches for words such as temporomandibular disorder, TMD, children, adolescents, and juvenile through PubMed and DBpia. Results: According to a study conducted in Busan, the ratio of adolescents increased from 18.3% to 21% in 2008 compared to 2000, and the proportion of boys increased from 38.58% to 45.38%. One of the characteristic contributing factors for adolescents is the macrotrauma such as jaw trauma, vehicle accidents, sports, physical abuse, forceful intubation, and third molar extraction. The second is a microtrauma from parafunctional habit such as bruxism, clenching, hyperextension, wind instrument, and fingernail biting that can cause joint overload, cartilage breakdown, synovial fluid alterations, and other changes within the joint. The diagnosis of TMDs in juvenile adolescents is not significantly different from that of adults. Medical history, clinical examination and radiological examinations are required. Conclusions: In the temporomandibular joint history and assessment, all comprehensive dental history examination is required, including head and neck pain, mandibular dysfunction, previous orofacial trauma, history of present illness with an account of current symptoms. For the treatment and management of temporomandibular arthritis in juvenile adolescents, understanding the characteristics of TMDs in juvenile adolescents and thoroughly analyzing appropriate diagnosis and possible contributing factors through comprehensive history taking & examination, conservative treatment, including fast and active cautions education, will be essential.

• Journal of Oral Medicine and Pain
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• 제34권1호
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• pp.91-102
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• 2009

2006년 한 해 동안 경북대학교 구강내과에 측두하악장애를 주소로 내원한 전체 환자 중에 파노라마 방사선 사진 상에서 인정될만한 하악과두흡수가 관찰된 환자를 대상으로 측모두부방사선 사진을 촬영하였으며, 측두하악장애의 임상적 평가와 악안면 골격형태를 분석하여 다음과 같은 결론을 얻었다. 1. 임상적 평가 1) 측두하악장애를 주소로 내원한 총 환자 수는 2419명 이었고 그중 224명 약 9.3%가 과두흡수를 나타내었다. 과두흡수가 있는 환자군 중 여자는 183명(81.7%)이고 남자는 41명(18.3%)으로 여자에서 월등히 많이 유발되었다. 환자의 연령은 12세에서 70세에 걸쳐 분포되었으며 평균 연령은 30.6세였다. 연령분포는 10대가 26.3%(59명), 20대가 34.8%(78명), 30대가 13.8%(31명), 40대가 11.2%(25명), 50대가 7.1%(16명), 60대가 6.3%(14명), 그리고 70대가 0.4%(1명)로 나타났다. 2) 과두흡수 부위의 통증을 호소한 경우는 145명, 통증을 호소하지 않은 경우가 79명이었다. 3) 과두흡수 환자 중 이갈이 습관을 53명, 이깨물기 습관은 80명이 호소하였으며, 다른 기타 습관들을 보고한 경우가 204명이었다. 4) 과두흡수 부위의 통증을 호소한 환자의 치료기간은 1개월 미만이 81명으로 전체적으로 치료기간이 짧게 나타났다. 2. 악안면 골격 형태 평가 전체 과두흡수 환자 224명중 18세 이상의 186명(여자 155명, 남자 31명)만이 한국 성인 정상교합자의 측모두부방사선사진 계측연구 결과와 비교하였다. 1) SNA, SNB는 남녀 모두에서 유의한 작은 값을 나타냈고, ANB항목에서는 남자는 평균 3.57 여자는 5.05으로 여자 환자에서 큰 값을 보여 남자에 비해 하악이 더 후퇴되어 있음을 알 수 있다. 2) 남녀 모두 SN-GoMe, FMA의 각도가 과두흡수 환자에서 유의하게 상당히 커져 있음을 보였다. FMA는 남자는 평균 30.44, 여자는 31.69로 여자에서 수직적 성장이 더 크게 나타났다. 3) 총후안면고경(posterior facial height)이 과두흡수 군에서 모두 작은 것이 특징으로 보였으며, 총전안면고경(Anterior facial height)은 과두흡수 환자군에서 남녀 모두 정상군에 비해 차이가 없었다. 저자의 연구에서 얻어진 결과에 의해 하악과두흡수는 정형외과적으로 퇴행성관절염과는 달리 젊은 여성에서 유병률이 높았으며 이는 남성보다 여성에서 수직적 골격 성장 양상으로 인해 하악과두 전방부의 압축응력을 증가시키는 위험요인을 가진 환자에서 발현이 높은 것으로 생각되며 그리고 노년층보다는 젊은 사람에서 이상기능활동으로 인한 부하의 증가 때문이라 생각한다. 하악과두흡수를 보이는 환자들의 치료기간이 대체적으로 짧으며, 나이가 증가함에 따라 내원하는 환자수가 증가하지 않는다는 것은 이 질환이 자기한정적임을 알 수 있고, 생리적 내성 범위 이상의 부하가 가해져 발생한 하악과두의 재형성 과정으로 생각한다.