• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.1
• /
• pp.52-56
• /
• 2015

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.6
• /
• pp.337-356
• /
• 2020

This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

• Korean Journal of Radiology
• /
• v.23 no.2
• /
• pp.218-225
• /
• 2022

Objective: This study aimed to explore the feasibility of functional evaluation of the lateral pterygoid muscle (LPM) using diffusion tensor imaging (DTI) in patients with temporomandibular joint disorders (TMDs). Materials and Methods: A total of 119 patients with TMD (23 male and 96 female; mean age ± standard deviation, 41 ± 15 years; 58 bilateral and 61 unilateral involvements for a total of 177 joints) and 20 healthy volunteers (9 male and 11 female; 40 ± 13 years; 40 joints) were included in this prospective study. Based on DTI of the jaw in the resting state, the diffusion parameters, apparent diffusion coefficient (ADC), fractional anisotropy (FA), λ1, λ2, and λ3 of the superior and inferior heads of the LPM (SHLPM and IHLPM) were measured. Patients with TMD with normal disc position (ND), anterior disc displacement with reduction (ADWR), and anterior disc displacement without reduction (ADWOR) were compared. Results: Patients with TMD overall, and ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 in both the SHLPM and IHLPM than those in volunteers (p < 0.05 for all), whereas the ND subgroup only had significantly higher ADC and λ1 (p < 0.001). Meanwhile, significant differences in FA in the SHLPM and IHLPM were found between volunteers and ADWOR (p = 0.014 and p = 0.037, respectively). Among the three TMD subgroups, except for λ3 and FA in the ADWR subgroup, ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 and lower FA than those in the ND group (p < 0.050). There was no significant difference in diffusion variables between ADWR and ADWOR. In ADWOR, the osteoarthritis group had significantly higher λ3 and lower FA values in the IHLPM than those in the non-osteoarthritis group. Conclusion: DTI successfully detected functional changes in the LPM in patients with TMD. The unsynchronized diffusivity changes in the LPM in different subgroups of TMD signified the possibility of using diffusion parameters as indicators to identify the severity of LPM hyperfunction at various stages of TMD.

• Journal of Periodontal and Implant Science
• /
• v.47 no.4
• /
• pp.211-218
• /
• 2017

Purpose: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.

• Journal of Acupuncture Research
• /
• v.22 no.5
• /
• pp.133-140
• /
• 2005

Objectives : This study was to evaluate the effect of Chuna on Temporomandibular Disorder Patients with idiopathic Scoliosis, utilizing Cobb's angle to determine the degree of curvature progression in the thoracic and lumbar regions. Methods: From October 1st 2004 to June 31st 2005, the clinical comparison study was carried out 40 cases of Temporomandibular Disorder Patients with idiopathic Scoliosis treated by both Chuna and General oriental method(Experimental Group) & only General oriental method(Control Group), who had been treated at Dept. of Acupuncture and Moxibustion Daejon Oriental Medical Hospital. Results : The results obtained as follows; 1. The facial pain of Experimental Group and Control Group was improved significantly. but the difference of two groups is not significant.(p<0.05) 2. The function of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly.(p<0.05) 3. The limitation of activity of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly. (p<0.05) Conclusion : This result sugests that the Chuna be effective treatment modality on Temporomandibular Disorder Patients with idiopathic Scoliosis. So further research is needed continuously.

• The korean journal of orthodontics
• /
• v.54 no.2
• /
• pp.89-107
• /
• 2024

Objective: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. Methods: The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). Results: Forty-nine articles met the inclusion criteria. The metaanalysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. Conclusions: Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

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

• The Journal of the Korean dental association
• /
• v.57 no.4
• /
• pp.222-232
• /
• 2019

Injection therapy can be used to treat the refractory and chronic pain situations that are not well responded to conventional therapy in TMD-patients. The target of injection is the intra-articular- and peri-articular tissue of joint and adjacent tissue like muscle. For the success of injectional therapy, selection of injection solution and technique is essential, so discussion will be done about that and one of the promising techniques of intra-articular injection, US-guided TMJ Intrar-articular injection, is also discussed.

• Journal of dental hygiene science
• /
• v.9 no.1
• /
• pp.9-15
• /
• 2009

Aimed at office workers at their height of Temporomandibular joint disorder(TMD), organized self-filling questionnaires were distributed from January 7 to 26, 2008 to 216 workers in the fields of service, office work, and production in D metropolitan city, to get a proper recognition about prevention and treatment of TMD by observing how strongly occupational stress influence on them. The findings of the study were as follows: 1. For subjective symptoms of joint noise as TMD, occasional was 45.8% and often 12.0%, while for joint dislocation often was 12.0%. 41.2% said they feel pains while chewing, while 24.1% said they occasionally feel pains while not chewing. 2.8% said they often experience mouth-opening disorder. 2. For joint noise, answers were significantly different according to their ages, while 30's are at their height (P < 0.05). For joint dislocation, the shorter they worked the more they have it, so less than a year worker was 37.9%, while less than 3 years 31.0%, and less than 5 years 20.7%. For work type, daytime workers have more dislocation, 58.6%, than shift-workers 34.5% (P < 0.05, P < 0.01). For pains while chewing, the shorter they worked, the more they experienced, which is the same as mouth-opening disorder (P < 0.01). 3. Workers with mouth-opening disorder have much stress on occupational autonomy (P < 0.05) and workers with dislocation and pains while chewing have much stress on relation trouble (P < 0.05, P < 0.01). Workers with highly occupational insecurity has much trouble on dislocation and pains while chewing, while workers with dislocation have significantly much stress on unproper compensation (P < 0.05). 4. For who have joint dislocation, they have much stress on relation-trouble, occupational disorder, and un-proper compensation (P < 0.01, P < 0.05). Workers with pains while not chewing showed significant difference about occupational insecurity and relation troubles (P < 0.05, P < 0.01). Who have mouth-opening disorder showed significant difference about occupational autonomy (P < 0.05).

• Journal of Oral Medicine and Pain
• /
• v.39 no.4
• /
• pp.140-145
• /
• 2014

Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.