• 턱관절균형의학회지
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• 제13권sup호
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• pp.21-26
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• 2023

본 증례에서는 틱 장애 증상과 오심 구토를 동반한 환자에게 턱관절균형요법을 병행한 한방 치료를 적용하여 증상의 호전을 관찰하였다. 따라서, 이와 같은 경우에 턱관절균형요법을 적용하여 중추신경계와 자율신경계를 안정화시켜 틱장애 증상을 개선시킬 뿐만 아니라 전체적인 척추 정렬을 바로잡음으로써 소화기계와 관련된 흉추의 안정화를 통하여 관련된 증상의 호전에도 효과가 있을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제48권4호
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• pp.137-143
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• 2023

Purpose: To assess Google Trends (GT) search behavior regarding orofacial pain (OFP) and headaches. Methods: GT scores for OFP and headache specialists between February 2013 and December 2022 were analyzed. Statistical tests such as Poisson regression analyses, mean differences, and Cohen's D were used to assess the score change over time. Results: The top three search words for OFP specialists were "temporomandibular joint (TMJ) specialist," "TMJ doctor," and "TMJ dentist," whereas the top three search words for headache specialists were "Headache specialist," "Headache doctor," and "Migraine specialist." Here, TMJ is temporomandibular joint. The GT scores for OFP specialists increased significantly (p<0.05) for all years except 2017, with the highest mean difference in 2020. The scores for headache specialists showed similar trends but gradually. Conclusions: The interest in OFP and headache specialists expressed by Google searches has increased over the years. More awareness is needed regarding the OFP scope of practice, and the use of GT may serve as an indicator.

• 한국전문물리치료학회지
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• 제15권1호
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• pp.61-68
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• 2008

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

• Imaging Science in Dentistry
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• 제31권2호
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• pp.73-84
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• 2001

Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.67-71
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• 2022

Subchondral cysts are frequently encountered in patients with temporomandibular joint osteoarthritis (TMJ OA), particularly in advanced stage. Subchondral cysts within osteoarthritis are typically lying adjacent to the joint surface where initial load bearing occurs during activity and have been associated with greater pain and disease progression. Although the etiology of these cysts remains uncertain, recently studies report that the induction of the subchondral bone mechanical stress caused subchondral cysts. Repeated overloading leads to further deterioration of subchondral bone which render subchondral bone structure more fragile, increase the risk of osteoarthritis progress. The purpose of this study was to assess the effect of conservative treatment and longitudinal osseous changes of a large subchondral cyst in a mandibular condyle in a symptomatic TMJ OA patient.

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

• Imaging Science in Dentistry
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• 제44권4호
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• pp.293-299
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• 2014

Purpose: This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods: The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the $X^2$ test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results: Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Conclusion: Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

• Journal of Oral Medicine and Pain
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• 제44권1호
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• pp.35-39
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• 2019

Calcifying aponeurotic fibroma (CAF) is an uncommon benign soft-tissue fibroblastic tumor with characteristic histological features. It mainly occurs in the distal part of the extremities, such as the hands and feet, in children and adolescents. Males are twice as commonly affected as females. CAF exhibits local invasiveness, and hence, its recurrence rate is also high. Therefore, complete surgical excision is both diagnostic and therapeutic. The occurrence of CAF in the maxillofacial region, especially the temporomandibular joint (TMJ), is very rare, and this necessitates its differentiation from other TMJ neoplasms. The differential diagnosis of CAF requires microscopic examination. Herein, we report a rare case of CAF located at the left mandibular condyle, which was confirmed by histopathological analysis.

• Journal of Oral Medicine and Pain
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• 제44권2호
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• pp.65-68
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• 2019

Temporomandibular disorders (TMD), involving the masticator system of temporomandibular joint (TMJ) and masticator muscle, can be characterized with the cardinal signs and symptoms of jaw pain, noises and limitation of mandibular range of motion. However, TMD requires differential diagnosis due to its heterogeneous characteristics with various causes despite the similar clinical profiles. Oral cancer involving TMJ and the masticator system, although infrequent, can be one of these causes and should be considered one of the most life-threatening disease mimicking TMDs. This report introduces a case of masticator space tumor originally diagnosed as TMD in a 73-year-old Korean female with previous history of brain tumor. The clinical signs and symptoms closely mimic that of TMD which may have disrupted differential diagnosis. We discuss here key points for suspecting TMDs of secondary origin, namely, that of cancer and the implications it has on dental clinicians.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.21-29
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• 1993

The purpose of this study was to evaluation of temporomandibulr joint space according to increasing the occlusal force on working and non-working side during unilateral bite. For the study, 22 normal adults, age ranged from 23 to 25, who had no symptoms on TMJ area and masticatory muscles and had normal or class I molar relationship were selected. Transcranial TMJ radiograph was taken during unilateral biting with sensor of Bite force checker (Nihon Kohden Kygyo Co.Ltd., Japan) on each 1st molar teeth of right and left side which were forced each 0Kg, 10Kg, 20Kg and 30Kg by use of Accurad-200 (Denar Corperation's product). The radiographs were traced on the screen, which was magnified by 5. The size of temporomandibular joint space at anterior, superior and posterior compartment were measured with Dumas's method (reference line of between squamotympanic fissure and the most inferior point of articular eminence). On the basis of this study, the following results were obtained. 1. Size of anterior TMJ space was tend to decrease on the working side and increase on the non-working side according to increasing the occlusal force, but not significant statistically (p>0.05). 2. Size of superior TMJ space was tend to increase on the working side and decrease on the non-working side according to increasing the occlusal force (p<0.05). 3. Size of posterior TMJ space was tend to decrease on both working ad nonworking side, but non significant statistically.