• Journal of Oral Medicine and Pain
• /
• 제20권1호
• /
• pp.141-158
• /
• 1995

This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.

• The Korean Journal of Pain
• /
• 제8권1호
• /
• pp.86-92
• /
• 1995

Temporomandibular disorders typically present findings of limited or asymmetric patterns of jaw opening and joint sounds usually described as clicking, popping, grating, or crepitus. Recently, patients with temporomandibular disorders have received an increasingly aggressive treatment with a greater emphasis on surgical and dental reconstruction. Scientific studies have not clearly identified the specific causes of the temporomandibular disorders and therefore some of the treatments are empiric, without a firm scientific foundation. We carried out a study on the patients of pain clinic OPD and concluded that the causes of the temporomandibular joint(TMJ) pain are the prolonged contraction of the muscles of mastication, especially the masseter muscle. Therefore, the spasmolytic treatment of masseter muscle would be a better treatment for TMJ syndrome rather than the surgical and dental reconstruction.

• Journal of Oral Medicine and Pain
• /
• 제42권2호
• /
• pp.35-43
• /
• 2017

Purpose: This study aims to evaluate the correlation between joint sounds and radiographic bone change patterns along with clinical symptoms of temporomandibular joint osteoarthritis (TMJ OA) patients. Methods: The patients for this study were over 19 years of age, diagnosed tentatively with TMJ OA. The patients were examined with temporomandibular disorders analysis test and all three radiographs, including panoramic radiography, transcranial radiography, and cone beam computed tomography (CBCT). Information of the patients' age, pain status, joint sound and mouth opening range were collected. And bone change pattern was examined by reviewing panoramic radiography, transcranial radiography and CBCT images. Results: The patients with crepitus had a higher average active mouth opening (AMO) range than patients without crepitus, and the group with bilateral crepitus had a higher average AMO range than the group with unilateral crepitus (p<0.001). And the patient with pain during mastication was increased in the group with clicking than the group without clicking, and the group with bilateral clicking showed a statistically significant increase in the patient with pain during mastication than the group with unilateral clicking (p<0.05). The analytical results of the relevance of crepitus showed a high correlation with bone change observed from each of the three radiographs. And the agreement in bone change findings from 3 groups of paired radiographs showed high agreement (p<0.001). Meanwhile, 77.2% of CBCT findings showed bone change of condyle without crepitus (p<0.001). Conclusions: This study presented significant results in the evaluation of the correlation with crepitus and bone change of TMJ OA patients from panoramic radiography or transcranial projection. However, the accurate assessment is required through CBCT for the patient with complains of persistent pain, limitation of mouth opening, and occlusal change even if the crepitus does not exist.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권2호
• /
• pp.134-137
• /
• 2017

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

• 대한치과의사협회지
• /
• 제46권4호
• /
• pp.232-242
• /
• 2008

관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral>300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절 잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰 되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.

• Journal of Oral Medicine and Pain
• /
• 제41권2호
• /
• pp.35-40
• /
• 2016

Purpose: This study aimed to investigate the characteristics of the symptoms of temporomandibular disorders (TMD) in Korean children and adolescents using representative samples and questionnaires. Methods: A survey involving the interview of 10-, 12-, and 15-year-old children and adolescents regarding the symptoms of TMD was conducted as a part of the 2010 National Oral Health Surveys. The study population included 18,112 subjects (male, 9,734; female, 8,378). The interview involved three questions related to the symptoms of TMD. The prevalence of symptoms of TMD, correlation of the symptoms with sex and age, and the difference in the number of symptoms according to sex and age were analyzed. Results: Among the symptoms of TMD in children and adolescents, the prevalence of temporomandibular joint (TMJ) sounds during mouth opening was 13.0%, while those of TMJ pain and limitation were 3.1% and 4.3%, respectively. While the prevalence of TMJ sounds during mouth opening did not show any statistically significant difference between the sexes, the rates of prevalence of TMJ pain and limitation of mouth opening in were higher in the female subjects than the male (p<0.05). It was also observed that the older the subjects, the higher the prevalence of TMJ sounds, TMJ pain, and limitation of mouth opening (p<0.05). The number of symptoms of TMD was found to be increased among female subjects as well as the older ones (p<0.05). Conclusions: There are variations in the prevalence of symptoms of TMD among Korean children and adolescents according to sex and age, which is consistent with the results of previous studies. It is necessary to conduct a national cohort study to evaluate the risk factors for TMD in children and adolescents.

• Imaging Science in Dentistry
• /
• 제35권2호
• /
• pp.69-75
• /
• 2005

Purpose : To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. Materials and Methods : The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the preauricular area and masticatory muscles and TMJ sounds. Results : There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Conclusion : Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

• 한방안이비인후피부과학회지
• /
• 제17권2호
• /
• pp.99-105
• /
• 2004

Temporomandibular joint disorder is quite common dental problem. Research has shown that 5 to 15$\%$ of the population have a TMJ disorder requiring some type of treatment. TMJ disorder's symptoms are pains in the jaw and muscles of your face, limitation of opening or closing jaw and noises in jaw joint such as clicking or popping sounds. Two patients with TMJ symptoms visited our clinic. They complained pain, limitation of jaw opening and clicking sound. We treated them by stimulating trigger points on the TMJ muscle with acupuncture and had a good effects. The symptoms is reduced or disappeared.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제40권6호
• /
• pp.301-307
• /
• 2014

Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권3호
• /
• pp.157-162
• /
• 2023

Elongated styloid syndrome (ESS) can present with myriad symptoms that mimic common features of orofacial pain, such as temporomandibular joint disorders (TMJDs), often causing a challenge and delay in diagnosis. We report the case of a 52-year-old male with a three-year history of non-painful clicking during jaw movement initially diagnosed as TMJD-related internal derangement. The patient presented with a history of annoying jaw sounds for three years, described as a popping sound without bilateral clicking or crepitation. Tinnitus and progressive hearing loss were observed in the right ear, and a hearing aid was recommended by an otolaryngologist. The patient was initially diagnosed with TMJD and managed accordingly; nevertheless, his symptoms persisted. Imaging revealed prominent bilateral styloid process elongation that exceeded the recognized cut-off level of >30 mm for elongation. The patient was informed of his diagnosis and its treatment but opted only for further swallowing and auditory assessments of his ear and nose symptoms. Clinicians should consider including ESS as a differential diagnosis in patients presenting with non-specific chronic orofacial symptoms for timely diagnosis and favorable clinical outcomes.