• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.392-396
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• 2003

Purpose : The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). Patients and Methods : Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. Results: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.157-162
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• 2023

Elongated styloid syndrome (ESS) can present with myriad symptoms that mimic common features of orofacial pain, such as temporomandibular joint disorders (TMJDs), often causing a challenge and delay in diagnosis. We report the case of a 52-year-old male with a three-year history of non-painful clicking during jaw movement initially diagnosed as TMJD-related internal derangement. The patient presented with a history of annoying jaw sounds for three years, described as a popping sound without bilateral clicking or crepitation. Tinnitus and progressive hearing loss were observed in the right ear, and a hearing aid was recommended by an otolaryngologist. The patient was initially diagnosed with TMJD and managed accordingly; nevertheless, his symptoms persisted. Imaging revealed prominent bilateral styloid process elongation that exceeded the recognized cut-off level of >30 mm for elongation. The patient was informed of his diagnosis and its treatment but opted only for further swallowing and auditory assessments of his ear and nose symptoms. Clinicians should consider including ESS as a differential diagnosis in patients presenting with non-specific chronic orofacial symptoms for timely diagnosis and favorable clinical outcomes.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.1
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• pp.29-37
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• 1992

The temporomandibular joint was evaluated using magnetic resonance imaging using a urface coil in 11 patients having reciprocal clicking or locking and compared with the normal joint in five subjects. Serial multisection 3㎜-thick parasagittal, paracoronal, and axial image on both closing and opening mouth were obtained with a 1.5 Tesla MR system and surface coil using CSMEMP, GRASS, MPGR, powerful extensions of fast imaging that is currently under clinical evaluation. MR images obtained were analized correlating with the theory of internal derangement. The obtained results were as follows: 1. The serial findings of structures in joint were determined on the serially sectioned images of joint with reciprocal clicking or locking by CSMEMP and MPGR on closing mouth. 2. The delta shaped white images of synovial fluid in the glenoid fossa and on the posterior surface of condyle were revealed on the parasagittal images by MPGR on opening mouth as in the normal joints. 3. The white image of joint fluid surrounding meniscus was recognized on the paracoronal image by GRASS on opening mouth as in the normal joints. 4. In joints having temporomandibular dysfunction the smooth image of displaced meniscus was recognized, but otherwise in the normal joints the image of muscle was noted on the paracoronal image sectioned at the anterior portion of condyle by GRASS. 5. The more thickened fascial plane between superior and inferior belly of lateral pterygoid muscle was not recognizable in joints having temporomandibular dysfunction than in the normal joints.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.134-137
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• 2017

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.3
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• pp.155-158
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• 2022

Objectives: The aim of this study was to observe the relationship between impacted mandibular third molars and development of temporomandibular joint (TMJ) disorders. Knowledge of the factors that have an adverse effect on the TMJ is necessary for proper diagnosis, treatment, and prognosis of TMJ disorders. Materials and Methods: The study was performed on 80 patients aged between 20 and 60 years with impacted mandibular third molars, over a period of two months. The patients were examined clinically and radiologically to determine the type of impaction and detect the associated TMJ symptoms or disorders. Results: In the 80 patients, 63.8% (51/80) of TMJ disorders were found in the horizontal group, 46.3% (37/80) in the mesioangular group, 42.5% (34/80) in the distoangular group, and 30.0% (24/80) in the vertical group of impacted mandibular third molars. Conclusion: The study concluded that type of impacted mandibular third molar is factor in the development of temporomandibular disorders.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.181-187
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• 2019

Objective: This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population. Methods: This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ${\geq}19$ years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD. Results: Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189-2.190), 1.573 (1.162-2.129) and 1.612 (1.182-2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289-2.454), 1.742 (1.265-2.400) and 1.770 (1.280-2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment. Conclusions: Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

• Imaging Science in Dentistry
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• v.35 no.2
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• pp.69-75
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• 2005

Purpose : To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. Materials and Methods : The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the preauricular area and masticatory muscles and TMJ sounds. Results : There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Conclusion : Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.14.1-14.11
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• 2015

The aim of this article is to review temporomandibular joint symptoms as well as the effects of orthognathic surgery(OGS) on temporomandibular joint(TMJ). The causes of temporomandibular joint disease(TMD) are multifactorial, and the symptoms of TMD manifest as a limited range of motion of mandible, pain in masticatory muscles and TMJ, Joint noise (clicking, popping, or crepitus), myofascial pain, and other functional limitations. Treatment must be started based on the proper diagnosis, and almost symptoms could be subsided by reversible options. Minimally invasive options and open arthroplasty are also available following reversible treatment when indicated. TMD manifesting in a variety of symptoms, also can apply abnormal stress to mandibular condyles and affect its growth pattern of mandible. Thus, adaptive developmental changes on mandibular condyles and post-developmental degenerative changes of mandibular condyles can create alteration on facial skeleton and occlusion. The changes of facial skeleton in DFD patients following OGS have an impact on TMJ, masticatory musculature, and surrounding soft tissues, and the changes of TMJ symptoms. Maxillofacial surgeons must remind that any surgical procedures involving mandibular osteotomy can directly affect TMJ symptoms, thus pre-existing TMJ symptoms and diagnoses should be considered prior to treatment planning and OGS.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.18 no.1
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• pp.167-176
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• 1988

This study was designed to evaluate the morphology of the temporomandibular joint components and dentofacial characteristics of patients with clicking and painful temporomadibular joint. The materials consisted of 80 conventional pantomographs in normal an symptomatic individuals aged 18-23 and divided into 2 groups by symptom of temporomandibular joint. The results were as follows; 1. In morphologic analysis of condylar head, type Ⅰ (anterior, posterior smooth curve) was most dominant in both group(58.75%, 55.0%) and asymmetrical condylar shape was predominant in symptomatic group (18 cases, 45%). 2. In symptomatic group, the condylar width were slightly lesser and the ratio of condylar height to height of condyle-ramus were larger than those of normal group. 3. Vertical overlap of central incisor of symptomatic group was slightly larger than that of normal group. There was significant differences between each group in mandibular midline deviation. 4. The symptomatic group tended to steep mandibular plane angle and the degree of condylar path and condylar axis of normal group were larger than those of symptomatic group. 5. The condylar width was inversely correlated with inclination of condylar path and inclination of condylar path was correlated with condylar axis in both groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.2
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• pp.81-91
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• 1993

Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.