• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.305-318
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• 2007

To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.29-34
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• 2011

Objectives: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. Methods: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients’ data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. Results: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. Conclusion: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.211-218
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• 2007

The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.593-599
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• 2001

Recently, tempormandibular disorder(TMD) shows an tendency to increase every year. TMD is a collective term embracing a number of clinical problems that involve the masticatory musculature, temporomandibular joint(TMJ) and associated structures, or both. TMD, viewed in distribution of age, often occurred from late teens to late twenties. But recently, the age of occurrence tends to be lower. Accordingly, early diagnosis of tempormandibular disorder is very important. In this study, we measured the maximum mouth opening which is simple and easy to carry out as a way of TMD diagnosis. In this study, the maximum mouth opening was examined for 1,775 children from 4 to 12 years of age. We compared the relationship between the maximum mouth opening with the age, height, and weight. The results obtained were summarized as follows; 1. The mean maximum mouth openings of 4, 8, and 12 year of age were respectively 40.16mm, 47.32mm, 50.54mm for male, 39.79mm, 44.85mm, 48.09mm for female. 2. The maximum mouth opening increased with age, and the values were greater in male than in female. 3. The maximum mouth opening increased with height, and the values were eater in male than in female except between 105cm and 115cm 4. The maximum mouth opening increased with weight, and the values were eater in male than in female. 5. The correlation between the maximum mouth opening with the age, height, and weight was all significant, and height showed the highest correlation.

• Korean Journal of Acupuncture
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• v.33 no.4
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• pp.183-193
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• 2016

Objectives : The purpose of this study is to find out the effect of Postural Yinyang Correction of TMJ(Functional Cerebrospinal Therapy; FCST) on Bell's palsy. Methods : We reviewed the medical records of 41 patients who were treated for Bell's palsy at the Dept. of Acupuncture and Moxibustion, Dong-Eui University from January $1^{st}$, 2016 to August $31^{st}$, 2016. The patients were divided into 2 groups: Group A(n=21), and Group B(n=20). Patients in Group A were treated by Korean Medical Treatments with FCST using ABA(Accurate Balancing Appliance), a standard intra-oral appliance. Patients in Group B were treated by Korean Medical Treatments without FCST. To estimate the efficacy in recovering palsy, we analyzed the House-Brackmann Grading Scale and Yanagihara's Unweighted Grading System. Results : In both groups, H-B grades were improved significantly during each period except the period from the first visit to one week later(P01). The improvement of H-B grade during each period in Group A is higher than Group B except the period from one week later to two weeks later, but statistically insignificant. In Group A, Y-score was significantly improved during each period except during P01. In group B, Y-score was significantly improved during each period except during P01 and the period from the first visit to two weeks later. The improvement of Y-score during each period in Group A is higher than Group B, but statistically insignificant. Conclusions : FCST using Standard Intraoral Appliance may be helpful in treating Bell's Palsy, but the further researches are needed.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.317-324
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• 2009

This study aimed to assess stiffness and elasticity of the masticatory muscle in the patients with the masticatory muscle pain using a tactile sensor and to investigate whether the masticatory muscle pain affects the facial expression muscles. From those who visited Department of Oral Medicine in Dankook University Dental Hospital, 27 patients presenting with unilateral muscle pain and tenderness in the masseter muscle (Ms) were selected (mean age: $36.4{\pm}13.8$ years). Exclusion criterion was those who also had temporomandibular joint (TMJ) disorders or any neurological pain. Muscle stiffness and elasticity for the muscles of mastication and facial expression was investigated with the tactile sensor (Venustron, Axiom Co., JAPAN) and the muscles measured were the Ms, anterior temporal muscle (Ta), frontalis (Fr), inferior orbicularis oculi (Ooci), zygomaticus major (Zm), superior and inferior orbicularis oris (Oors, Oori) and mentalis (Mn). t-tests was used to compare side difference in muscle stiffness and elasticity. Side differences were also compared between diagnostic groups (local muscle soreness (LMS) vs myofascial pain syndrome (MPS) and between acute (< 6M) and chronic ($\geq$ 6M) groups. This study showed that Ms and Zm at affected side exhibited significantly increased stiffness and decreased elasticity as compared to the unaffected side.(p<0.05) There was no significant difference between local muscle soreness and myofascial pain syndrome groups and between acute and chronic groups. The results of this study suggests that masticatory muscle pain in Ms can affect muscle stiffness and elasticity not only for Ms but also for Zm, the facial expression muscle.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.441-447
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• 2007

Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.257-267
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• 2023

Purpose. The purpose of the study was to fabricate a prototype robotic simulator for dental education, to test whether it could simulate mandibular movements, and to assess the possibility of the stimulator responding to stimuli during dental practice. Materials and methods. A virtual simulator model was developed based on segmentation of the hard tissues using cone-beam computed tomography (CBCT) data. The simulator frame was 3D printed using polylactic acid (PLA) material, and dentiforms and silicone face skin were also inserted. Servo actuators were used to control the movements of the simulator, and the simulator's response to dental stimuli was created by pressure and water level sensors. A water level test was performed to determine the specific threshold of the water level sensor. The mandibular movements and mandibular range of motion of the simulator were tested through computer simulation and the actual model. Results. The prototype robotic simulator consisted of an operational unit, an upper body with an electric device, a head with a temporomandibular joint (TMJ) and dentiforms. The TMJ of the simulator was capable of driving two degrees of freedom, implementing rotational and translational movements. In the water level test, the specific threshold of the water level sensor was 10.35 ml. The mandibular range of motion of the simulator was 50 mm in both computer simulation and the actual model. Conclusion. Although further advancements are still required to improve its efficiency and stability, the upper-body prototype simulator has the potential to be useful in dental practice education.

• Journal of Oral Medicine and Pain
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• v.37 no.1
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• pp.33-45
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• 2012

This study was designed to assess follow-up study of condylar bone changes using cone beam computed tomography in patients with osteoarthritis. The author performed clinical examination for osteoarthritis patients who visited Orofacial Pain Clinic, Department of Oral Medicine, Pusan National University Hospital. CBCT(Cone beam computed tomography) was taken for 228 joints in 114 subjects. After average 10 months, CBCT was retaken. A Oral medicine and Oral radiologist evaluated CBCT each other. Condyle bone changes were classified by no bone change, flattening, erosion, osteophyte and sclerosis. The obtained results were as follow. 1. The condylar bone changes of osteoarthritis in temporomandibular disorder were as follow: 1) The transitions of each types of condylar bone changes was maintained at the initial state of the majority. 2) The transition of erosion was distributed erosion, flattening, sclreosis, osteohyte in order. 3) The transition of flattening was distributed flattening, osteohyte, normal, sclreosis in order. 4) The transition of osteohyte was distributed osteohyte, erosion, sclreosis, flattening in order. 5) The transition of sclreosis was distributed sclreosis, osteohyte, erosion, normal in order. 2. The signs and symptoms according to transition of each types of condylar bone changes were as follow 1) In the transition of condylar bone changes from erosin to erosion, pain, noise, LOM and MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to flattening, pain, LOM, MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to no bony change, pain, noise, LOM had symptomatic improvement. In the transition of condylar bone changes from erosion to flattening than the maintenance of eosion, MCO had symptomatic improvement. 2) In the transition of condylar bone changes from flattening to flattening, pain, noise and MCO had symptomatic improvement. In the transition of condylar bone changes from flattening to sclerosis, LOM had symptomatic improvement. 3) In the transition of condylar bone changes from osteophyte to osteophyte, pain, LOM and MCO had symptomatic improvement.