• Title/Summary/Keyword: temporomandibular joint

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The Evaluation of Composite Dose using Deformable Image Registration in Adaptive Radiotherapy for Head and Neck Cancer (두경부 종양의 적응방사선치료시 변형영상정합을 이용한 합성선량 평가)

  • Hwang, Chul-Hwan;Ko, Seong-Jin;Kim, Chang-Soo;Kim, Jung-Hoon;Kim, Dong-Hyun;Choi, Seok-Yoon;Ye, Soo-Young;Kang, Se-Sik
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.227-235
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    • 2013
  • In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), oral cavity($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), parotid gland($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy) and temporomandibular joint($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.

Analysis of Patients with Mandibular Nerve Damage after Root Canal Therapy (근관치료 후 발생한 하악신경 손상 환자에 대한 분석)

  • Lee, Ji-Soo;Song, Ji-Hee;Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.327-336
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    • 2011
  • Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

ULTRASTRUCTUAL ANALYSIS OF THE FIBROUS LAYER OF CONDYLE IN THE RAT TEMPOROMANDIBULAR JOINT WITH AGEING (가령에 따른 흰쥐 하악과두 섬유층의 미세구조 및 교원원섬유의 변화)

  • Byeon, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.305-315
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    • 1998
  • The fibrous layer of mandibular condyle of the neonatal, 1-, 7-, 14-, 27-, 55-days and 1 year old rats were examined in the electron microscope with particular attention to the ultrastructure and diameter of collagen fibrils. In the 1-day rats, most of the cells of the fibrous layer were undifferentiated mesenchymal cells and fibroblasts with rough a little developed rough endoplasmic reticulum(RER) and golgi apparatus(GA). In 7-, 17 and 27-days old rats, most of the fibroblast showed well developed GA and RER with widely distended cisternae containing granular materials. In many of these cells contained intracytoplasmic filaments among the cytoplamic organelle. In 55-day and 1-year old rats, three types of cells were observed, ie, cells containing well developed cytoplasmic organelle presumed to be involved in the collagen fibril synthesis, cells showing well developed lysosomes, golgi apparatus, mitochondria and short cytoplasmic process presumed to be involved in the active resorption of the injured collagen fibrils or cellular debris, cells containing many intracytoplasmic filaments and a little organelle presumed to be cells of inactive state. The average diameters of collagen fibrils were similar in 1- and 7-day old rats as $38.48{\pm}3.81nm$, $38.06{\pm}3.86nm$. That was thickest in 14 days old rats as $50.21{\pm}3.93nm$ among experimental groups. They were gradually thinner in 27-, 55-day rats as $40.05{\pm}2.52nm$, $43.63{\pm}1.20nm$ and thinnest in 1-year old rats as $37.38{\pm}2.17nm$. The distribution pattern of diameters of collagen fibrils were unimordal with peak of 30-60nm in rats from 1-day to 17-day old. With aging from 27-day to 1 year old rats, collagen fibril diameters showed wide distribution pattern and percentage of thin collagen fibrils increased. These results may show the functional adaptation of fibrous layer of mandibular condyle to the increased mechanical forces with aging.

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THE EFFECTS OF DIETARY CONSISTENCY ON THE TRABECULAR BONE ARCHITECTURE IN GROWING MOUSE MANDIBULAR CONDYLE : A STUDY USING MICRO-CONFUTED TOMOGRAPHY (성장 중인 쥐에서 음식물의 경도가 하악 과두의 해면골에 미치는 영향 : 미세전산화 단층촬영을 이용한 연구)

  • Youn, Seok-Hee;Lee, Sang-Dae;Kim, Jung-Wook;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.228-235
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    • 2004
  • The development and proliferation of the mandibular condyle can be altered by changes in the biomechanical environment of the temporomandibular joint. The biomechanical loads were varied by feeding diets of different consistencies. The purpose of the present study was to determine whether changes of masticatory forces by feeding a soft diet can alter the trabecular bone morphology of the growing mouse mandibular condyle, by means of micro-computed tomography. Thirty-six female, 21 days old, C57BL/6 mice were randomly divided into two groups. Mice in the hard-diet control group were fed standard hard rodent pellets for 8 weeks. The soft-diet group mice were given soft ground diets for 8 weeks and their lower incisors were shortened by cutting with a wire cutter twice a week to reduce incision. After 8 weeks all animals were killed after they were weighed. Following sacrifice, the right mandibular condyle was removed. High spatial resolution tomography was done with a Skyscan Micro-CT 1072. Cross-sections were scanned and three-dimensional images were reconstructed from 2D sections. Morphometric and nonmetric parameters such as bone volume(BV), bone surface(BS), total volume(TV), bone volume fraction(BV/TV), surface to volume ratio(BS/BV), trabecular thickness(Tb. Th.), structure model index(SMI) and degree of anisotropy(DA) were directly determined by means of the software package at the micro-CT system. From directly determined indices the trabecular number(Tb. N.) and trabecular separation(Tb. Sp.) were calculated according to parallel plate model of Parfitt et al.. After micro-tomographic imaging, the samples were decalcified, dehydrated, embedded and sectioned for histological observation. The results were as follow: 1. The bone volume fraction, trabecular thickness(Tb. Th.) and trabecular number(Tb. N.) were significantly decreased in the soft-diet group compared with that of the control group (p<0.05). 2. The trabecular separation(Tb. Sp.) was significantly increased in the soft-diet group(p<0.05). 3. There was no significant differences in the surface to volume ratio(BS/BV), structure model index(SMI) and degree of anisotropy(DA) between the soft-diet group and hard-diet control group (p>0.05). 4. Histological sections showed that the thickness of the proliferative layer and total cartilage thickness were significantly reduced in the soft-diet group.

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Effect of Obesity and Psychological Stress on Oral Health (비만과 스트레스가 구강건강에 미치는 영향)

  • Kim, Soo-Hwa;Lee, Sun-Mi
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.119-128
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    • 2015
  • The purpose of this study is to understand the effects of obesity and stress on oral disease in Korean adults by using the data of the Fifth Korea National Health and Nutrition Examination Survey. The subjects of this study are 4,627 adults at the age of 19 to 64, and the data were analyzed by using SPSS Windows ver.18.0. The results are as follows: Obesity was higher in men and the age of 40 to 64 than the other. And the group with lower education or lower income level tended to show significantly higher obesity (p<0.05). As for stress, women, the age of 19 to 39 and the subjects with higher academic career tended to indicate significantly higher stress (p<0.05). As for the effects of obesity on oral disease, there were no significant difference between body mass index (BMI) or waist-hip ratio (WHR) and oral disease but there was statistically significant difference between stress and temporomandibular joint disorder (TMD) (p<0.05). Even when the subjects with stress were obese or abdominally obese, there was no significant difference in oral disease (p>0.05). As to correlation among variables, there were correlations between BMI and WHR, stress and TMD, masticatory problems and periodontal disease or TMD (p<0.05). About the effects of general characteristics, obesity, and stress on oral disease, age was the variable influencing TMD, and age and abdominal obesity were the variables influencing masticatory problems (p<0.05). In this society, the environment surrounding individuals is fairly complex, and the concept of health including quality of life has more complex meaning than in the past. Various factors are influencing obesity and stress, and they are also influencing oral health and behaviors. Accordingly, it will be needed not only to make efforts to reduce obesity and stress but also to employ approaches from different perspectives to improve oral health.

The Content Analysis of the Textbooks of Dental Clinical Course (치과임상교과목 교재에 대한 내용분석)

  • Lee, Sun-Mi;Yoo, Jung-Sook;Ahn, Se-Youn;Lim, Mi-Hee;Han, Ji-Youn;Jun, Mi-Kyoung;Lee, Hyun-Ok;Won, Young-Soon
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.272-279
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    • 2015
  • This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.

Full mouth rehabilitation for a patient with vertical dimension loss using digital diagnostic analysis: A clinical report (수직고경이 감소된 환자의 디지털 진단 분석을 이용한 완전 구강 회복 증례)

  • Choi, Yeawon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.487-496
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    • 2021
  • Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

Development of a prototype simulator for dental education (치의학 교육을 위한 프로토타입 시뮬레이터의 개발)

  • Mi-El Kim;Jaehoon Sim;Aein Mon;Myung-Joo Kim;Young-Seok Park;Ho-Beom Kwon;Jaeheung Park
    • 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.