• Title/Summary/Keyword: temporomandibular disorders (TMDs)

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A Study on the Relation between Occlusal Wear Area and Occlusal Contact Patterns (교모면적과 교합접촉양태 간의 관계에 대한 연구)

  • Se-Sook Kang;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.153-168
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    • 1994
  • The aim of the present study was to investigate a relation between occlusal wear area and occlusal contact patterns. For the purpose, occlusal wear area were measured in 58 dental students and in 129 patients with temporomandibular disorders(TMDs) from dental casts. Teeth used in this study were from canine to second molar on both sides in upper arch, totally ten. Occlusal wear area on casts was marked by pencil and photocopies, and then, the area was measured with planimeter. Occlusal relation was clinically examined with regard to Angle's classification, chewing side preference, lateral guidance pattern and bruxing and/or clenching habit. T-Scan, electronic occlusal contact analyzer, was used to record occlusal contact number, contact force, contact time and occlusal balance that is TLR(total left-right statistics) during tooth contact. All measurement were repeated 3 times and the average value was used for data processing. The obtained results were as follows : 1. Mean value of occlusal wear area did not differ significantly between dental students and patients. 2. There ws not significant difference in wear area between chewing side and non-chewing side in both groups. 3. Occlusal wear area was significantly increased with age in both groups. 4. Three subgroups divided by Angle's classification did not show any difference in occlusal wear area among them, but three subgroups divided by lateral guidance pattern showed slightly significant difference between canine guide subgroup and group function subgroup in patients. Occlusal wear ares\a in group function subgroup wear larger than canine guide subgroup. 5. Mean value of wear area in patients with bruxing and/or clenching habit did not differ from those in patients without such habit. 6. Correlationship among items related to occlusal contact pattern were highly consistent and significant in dental students and only one item significantly correlated with occlusal wear area was tooth contact time.

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Changes of the Electromyographic Activity by Head Posture and Cervical Spine Shape (두부자세와 경추형태에 따른 근활성의 변화에 관한 연구)

  • Ho-Chun Hwang;Kyung-Soo Han;Chan Jung
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.393-405
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    • 1996
  • This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.

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Prognosis of Recurred TMD Patients According to Conservative Therapy (측두하악장애 재발환자의 보존적 처치에 따른 예후)

  • Ko, Myung-Yun;Kim, Ik-Hwan;Ok, Seung-Joon;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.241-250
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    • 2007
  • We examined 104 patients(primary group, controlled group) who had visited PNUH from 1994 to 2002, having been diagnosed as temporomandibular disorders(TMDs) and treated in conservative ways such as Behavior modification, medications, physical therapies and splint therapies. We also examined 54 patients(recurred group, experimental group) who had visited PNUH from 1991 to 2001, having been diagnosed as TMDs and experienced recurrence after conservatively treated. To find out the symptoms of Recurred TMD patients and their results of conservative treatments, we compared these two groups mentioned above. The obtained results were as follows: 1. Both primary and recurred groups have showed great improvements with conservative treatments. 2. Both primary and recurred groups have showed no differences in pain, LOM, MCO in their first visits but the noise were louder in primary group. 3. Both primary and recurred groups have showed no differences in pain, LOM, MCO when the treatments were over but the noise were louder in recurred group. 4. Treatments modalities, diagnosis, sex, kind of disease had not affected the results of treatment in either of groups. 5. It has come out that much better results were achieved when the patients in primary group had treated for over 6 months and for more than 10 times.

A Research on the Basis of Questionnaires about the Dental Patients' Awareness and Understanding of TMDs (측두하악장애에 대한 치과 내원환자의 인지도와 이해도에 관한 설문조사 연구)

  • Kim, Kyung Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.275-289
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    • 2013
  • This study was conducted to investigate and analyze the dental patients' awareness and understanding about TMDs. Among the total number of 243 patients who had visited the department of dentistry of Busan Paik Hospital, Inje University or Hanvit dental hospital in Ulsan metropolitan city and participated in the survey, 195 patients who filled in all parts of the questionnaire were selected as the subjects. The results were as follows. 1. The subjects who were aware of the term, "TMDs" were 17.4%. The group with total education period of 12 years and over was significantly more aware of "TMD"(82.4%, p<0.01) than the other group. The subjects who were aware of the term, "jaw joint disease" were 81.0%. 30 to 49 age group(45.6%, p<0.05) and the group with total education period of 12 years and over(60.1%, p<0.01) were significantly more aware of "jaw joint disease" than other groups. 2. More than half of the subjects chose "overuse of the jaws" as the concept of jaw joint disease(50.6%). 3. TV, radio(41.4%) was the most frequent source of awareness about jaw joint disease followed by family and friends(20.2%), hospitals and health professionals(18.2%), internet(15.7%) and newspapers, magazines(4.5%). Among the respondents who were aware of jaw joint disease through TV, radio, 30 to 49 age group showed significantly higher percentage(52.4%, p<0.05) than other age groups. Among the respondents who were aware of jaw joint disease through internet, 18 to 29 age group showed significantly higher percentage(61.3%, p<0.01) than other age groups. Among the respondents who were aware of jaw joint disease from hospitals and health professionals, the group with total education period of 12 years and over showed significantly higher percentage(75.0%, p<0.05) than the other group. 4. Noise during mouth opening and closing(26.9%), mouth opening difficulty(25.1%) and jaw pain(13.7%) were the most frequently responded sign and symptoms of jaw joint disease. For the causes of jaw joint disease, enjoying hard food chewing(19.5%), occlusal discrepancy(19.0%) and chewing with one side only(18.5%) were responded in sequence. TMJ surgery(28%) was the most frequently responded treatment method for jaw joint disease, followed by occlusal appliance therapy(23.9%) and physical therapy(14.6%). For preventive method of jaw joint disease, avoid eating hard food(21.1%), avoid opening mouth wide(17.0%) and simultaneous using of molar of both side when chewing food(15.4%) were chosen frequently.

A Comparison Study on Animal Models for Osteoarthritis in Temporomandibular Joint (측두하악관절에서의 골관절염 유도 동물모델 비교연구)

  • Yu, Sun-Nyoung;Yi, Young-Chul;Park, Hae-Ryoun;Ryu, Mi-Heon;Jeon, Hye-Mi;Kim, Kwang-Youn;Kim, Sang-Hun;Ok, Soo-Min;Ko, Myung-Yun;Ahn, Yong-Woo;Ahn, Soon-Cheol;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.261-271
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    • 2011
  • Osteoarthritis in patients with temporomandibular disorders(TMDs) induces pain, limitation of mouth opening, occlusal problems, and most commonly affects their life quality. Control method and progressive process of osteoarthritis are being extensively researched. The researchers focus on histologic changes, synovial changes, muscular and ligamental changes and observed reaction to pain. Therefore most of them developed the animal model for osteoarthritis in TMD patients. In this study, we applied several methods which induces osteoarthritis of temporomandibular joint(TMJ) in rats or mice. For locally induce osteoarthritis in TMJ, Monosodium iodoacetate(MIA) or interleukin-$1{\alpha}$(IL-$1{\alpha}$) were injected into TMJ joint space for 5 or 3 weeks. Other groups are chosen for osteoarthritis under systemic control including hormonal changes and aging. To observe cellular change, increased collagen, degenerative bony destruction and distribution of proteoglycans (PGs), safranin-O staining and Masson's trichrome staining were used.

RELATIONSHIP BETWEEN MANDIBULAR MOVEMENTS AT INCISAL AREA AND CONDYLAR MOVEMENTS (전치부 하악운동양태와 과두운동 간의 관계)

  • Kang, Seok-Ku;Han, Kyung-Soo;Jin, Tai-Ho;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.1
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    • pp.15-29
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    • 1997
  • The author performed this study to investige the relationship between condylar movements recorded with Pantronic and mandibular movements at incisal area recorded with BioEGN. For this study 24 patients with Temporomandibular disorders(TMDs) and 30 dental students without any masticatory symptoms were selected as patients group and control group, respectively. The items recorded with Pantronic(Denar Corp., USA) were immediate side-shift, orbiting path, protrusive path, and PRI. BioEGN(Bioelectric-gnathography, Bioresearch Inc., USA) were sued to measure the amount of mandibular torque movement in frontal and horizontal plane and also the distance of mandibular translation at incisal area. Amount of mandibular rotational torque movement was analyzed by angle and difference between both condyles in frontal and horizontal plane. The collected data were processed with SAS program and conclusion were as follows : 1. Mean value of items recorded with Pantronic were not significantly differed between patients group and control group except the item of pantographic reproducibility index(PRI). The value of PRI was 39.5 in patients group, and 29.5 in control group. 2. The amount of mandibular torque movement was not differed tin early protrusive and early left excursion between patients group and control group, but in early right excursion, patients group showed more value than control group did. 3. The distance on sagittal plane in early eccentric movements were longer in patients group than those in control group, but the distance of maximal eccentric movements were not significantly differed between patients group and control group. 4. Items which showed significant correlation with PRI were progressive side-shift, and horizontal torque movement in early protrusion and right excursion. 5. The angle of protrusive path of affected side was greater than of non-affected side in unilaterally affected patients, but the protrusive angle of preferred chewing side was not differed from that of contralateral side in control group. 6. The amount of torque movement in early protrusion and right excursion were greater in patients with coincidence of affected side and preferred chewing side than in patients without coincidence.

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Effects of Occlusal Appliance on the Mandibular Position and the Mandibular Rotational Torque Movement during Speech (교합장치가 발음시 하악위 및 하악의 비틀림 회전운동에 미치는 영향)

  • Kim, Moon-Gyu;Han, Kyung-Soo;Kim, Jong-Young;Yang, Keun-Young
    • Journal of Oral Medicine and Pain
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    • v.26 no.1
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    • pp.59-73
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    • 2001
  • This study was performed to investigate the effects of occlusal appliance on the mandibular position and the mandibular rotational torque movement during speech. For this study, 20 patients with temporomandibular disorders(TMDs) and 20 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) and a sentence of 'Sue is missing her house' were used for recording and for observing of speech pattern. There were five mandibular positions observed in this study, that is, mandibular rest position, 'ssi', 'her', 'ha', and 's' speech position. In each position, slant and A-P distance in sagittal plane, vertical distance and lateral distance in frontal plane were measured. Amount of the mandibular rotational torque movement were measured at 'her', 'ha' speech position and for all through speech movement. Centric relation splint(CRS) was placed in both groups, but anterior or posterior bite plane were placed in normal subjects only. Data collected were processed and analysed by SPSS windows program. The results of this study were as follows : 1. Mandibular positions in both groups were not different before adaptation, with CRS, and after removal, but total amount of the mandibular rotational torque movement was greater in patients. 2. Mandible was slightly placed anteriorly with CRS at 'her' and 'ha' speech position in patients, but was placed anteriorly at all the five positions in normal subjects. 3. Difference with type of occlusal appliance in normal subjects were noted only for vertical distance at 'ssi' and 'ha' speech position, and the distance with CRS were more than that with posterior bite plane. 4. Mandibular rotational torque movement at 'her' and 'ha' speech position was greater in patients, but the difference was disappeared after appliance removal. And the torque movement was greater at 'ha' speech position than that at 'her' speech position in frontal plane. It could be concluded that the adaptation of occlusal appliance showed a tendency to locate the mandible anteriorly during speech in both groups, but did not affect total mandibular rotational torque movement which was greater in patients.

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