• Journal of Korean Dental Science
• /
• 제8권1호
• /
• pp.1-9
• /
• 2015

Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

• 한국전문물리치료학회지
• /
• 제26권3호
• /
• pp.99-105
• /
• 2019

Background: Although magnetic resonance imaging is accurate, it is expensive to measure the movement of temporomandibular joint. The three-dimensional (3D) motion analysis system is an inexpensive measurement tool. Objects: This study examined the reliability of quantifying the mouth opening and lateral mandibular shift and differences between individuals with and without temporomandibular disorder (TMD) using the hygienic method of surface markers on the skin with 3D ultrasound-based motion analysis. Methods: This study included 24 subjects (12 with and 12 without TMD). Temporomandibular joint motion during mouth opening was recorded using two surface markers with 3D ultrasound-based motion analysis. An intraclass correlation coefficient [ICC (3,k)] was used to confirm the intrarater reliability of quantifying kinematic temporomandibular joint motion, and an independent t-test was used to evaluate differences in maximal mouth opening and lateral mandibular shift between the two groups. Results: Assessment of mouth opening and lateral mandibular shift showed excellent test-retest reliability with low standard error of measurement. The lateral mandibular shift and opening-lateral mandibular shift ratio were significantly increased in the TMD group during maximum mouth opening (p<.05). However, no significant difference in maximal mouth opening was observed between the groups with and without TMD (p>.05). Conclusion: This hygienic and simple surface marker method can be used to quantify the mouth opening and lateral mandibular shift at the end-range of mouth opening. The TMD group showed an increased lateral mandibular shift movement at the end-range of mouth opening. The lateral mandibular shift movement can be regarded as a symptom in the diagnosis and treatment of TMD.

• 치과방사선
• /
• 제28권2호
• /
• pp.321-327
• /
• 1998

The author examined bone changes from 1274 poly tomographic images of 182 temporomandibular joints which showed symptoms of temporomandibular disorder and the following results were obtained; 1. The number of temporomandibular joints which showed bone changes were 64 (35.2％) among 182 joints. 2. The age and sex distribution of 64 joints which had bone changes showed the prevalence of female (90.6％) and third decade (25.0％) followed by fourth (21.2％) and second decade (17.2％). 3. The 252 images which showed bone changes consisted of 56 images from lateral side (22.2％). 118 images from center (46.8％) and 78 images from medial side (30.9％). 4. The most frequently observed bone changes were flattening (22.7％) followed by sclerosis (19.3％) and cortical unsharpness (19.3％)

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제28권2호
• /
• pp.136-142
• /
• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• 척추신경추나의학회지
• /
• 제12권1호
• /
• pp.13-27
• /
• 2017

Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

• 척추신경추나의학회지
• /
• 제4권1호
• /
• pp.65-73
• /
• 2009

Objectives : The propose of this study is to analyze characteristics with sex, age, motivation, symptom, Impression, treatment effect about temporomandibular disorder patients. Method : We performed a retrospective study of 52 patients who visited the Jaseng Hospital of Oriental Medicine, from August 2008 to October 2008. Result : Women occupied the most part. And 27 persons in the 20th are the most distribution of age. The majority of patients occured the symptom for no reason. In the distribution of symptoms, TMD pain(88.46%), Click sound(82.69%), neck pain(52.92%), headache(38.46%), lumbago(21.15%) happened. In the impression through radiological diagnoses, The majority of patients diagnosed Straightening of cervical lordotic curvature. Oriental medical treatment showed a very valuable effect on improvement of TMD symptom. Conclusion : The results showed a valuable treatment effect of temporotandibular disorders on Oriental medical treatment. Therefore this work have the necessity of continuous study and observation and will help us to understand the features of patients who visiting the TMD clinic of Jaseng Hospital of Oriental medicine.

• 한국엔터테인먼트산업학회논문지
• /
• 제13권7호
• /
• pp.461-468
• /
• 2019

본 연구의 목적은 상부 목 안정화 운동이 턱 관절 기능장애과 압통 역치에 미치는 효과를 알아보기 위하여 연구를 진행 하였다. 36명의 대상자를 상무목 안정화 운동 그룹과 대조군 두 그룹으로 설정하여 상부 목 안정화 운동은 압력센서를 활용하였으며, 연구를 총 4주간 주 3회 20분씩 진행하였다. 연구결과 개구범위에 있어서 상부 목 안정화군이 대조군보다 유의한 효과를 보였으며(p<.01, 95% CI: 8.074, 16.899), 우측 치우침에서 상부 목 안정화 운동군이 대조군보다 유의한 효과를 보였다(p<.01, 95% CI: .826, 3.243). 압통 역치의 변화에서는 관자근(p<.01, 95% CI: .251, 1.382)과 깨물근(p<.01, 95% CI: .462, 1.826) 모두 상부 목 안정화군이 유의한 향상을 보였다. 본 연구결과 턱 관절 기능장애 환자에게 상부 목안정화 운동이 턱 관절 장애에 효과적이었다. 턱 관절 장애를 경험하고 있는 환자들에게 더욱더 효과적인 중재방법을 제공할 수 있을 것이며, 나아가 턱 관절 장애로 인한 고통받고 있는 환자들에게 새로운 접근방법을 제시할 수 있을 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권5호
• /
• pp.497-506
• /
• 2000

This study is comprised of data obtained from the files of 346 patients with temporomandibular disorders. All patients were diagnosed, treated and followed in the Department of Dentistry at the Inha university hospital, Incheon, Korea. The patients had treated with medications, physical therapy, occlusal splint and arthrocentesis. The study data were obtained from the medical records and telephone interviews that were conducted by research assistants. The results were as follows 1. The patient's main complaint was pain(77%), and mouth opening limitation was 17%. 2. An analysis of the medical records of the 346 patients disclosed that 82% were improved and 17% had no improvement when they were dismissed. 1% of the patients had become worse during therapy. 3. A success rate of 82% was achieved when medication assisted physical therapy was included. In the current status at the telephone interview, 270 patients(89%) reported that they were doing well with 56% describing themselves as asymtomatic and 32% experiencing only minor residual or recurrent symptoms. 11% regarded themselves as unimproved and worse. 4. In the current status of the unsuccessfully treated patients by medications and physical therapy, 64% of patients were doing well(3% as asymptomatic and 56% as only minor residual or recurrent symptom). But 36% of patients was reported as unimproved and worse. 5. TMJ has a remarkable adaptive potential and TMJ disorder has a natural history of spontaneous fluctuations and favorable prognosis during the subsequent natural course. 6. In the treatment of the temporomandibular disorders, there is a treatment ladder, starting with the simplest and least expensive treatment, that is ascended until resolution of the patient's symptoms occur. These findings suggest that conservative reversible therapies are both sufficient and appropriate for management of temporomandibular disorder in most patients. Major alterations of mandibular position or dentoalveolar relationships do not appear to be necessary for obtaining either short term or long term success and therefore they can be generally regards as inappropriate treatment for this disorder. The fact that physical therapy is non-invasive and does not appear to be fraught with irreversible changes, makes it a very applicable vehicle in the area of clinical TMJ disorder management.

• 대한치과교정학회지
• /
• 제25권5호
• /
• pp.635-639
• /
• 1995

• Journal of Oral Medicine and Pain
• /
• 제42권2호
• /
• pp.29-34
• /
• 2017

Purpose: To evaluate aggravating factors of intermittent locking among temporomandibular joint using magnetic resonance imaging (MRI) and diagnostic criteria for temporomandibular disorder (DC/TMD) diagnosis. Methods: A retrospective analysis was conducted of 35 patients with intermittent locking history but normal intra-articular findings between September 2012 and June 2015 in Kyung Hee University Dental Hospital. A standardized DC/TMD assessment was performed on subjects with MRI findings. Clinical findings were assessed on the basis of maximum mouth opening (active & passive), self-reported habits, patients' age, gender, systemic diseases at the initial visit. First, chi square test was used to examine differences with variables and then risk factors for intermittent locking were assessed using multivariate logistic regression. Results: Self-reported bruxism was strongly associated with intermittent locking history. Conclusions: The new DC/TMD protocol is intended for use within any clinical setting and supports the full range of diagnostic activities from screening to definitive evaluation and diagnosis. Self-reported sleep bruxism has been associated with a higher likelihood of intermittent locking. Comorbidity is therefore a factor that must be assessed. It is necessary to consider the amount of contact of the teeth and the duration.