• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.101-111
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• 2006

Temporomandibular disorders (TMD) is a collective term embrassing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both. The prevalence of signs and symptoms associated with TMD can be best appreciated by examining epidemiologic studies. But domestic epidemiologic studies about sex, history, chief complaint, diagnosis were not sufficient comparing with foreign countries. The results obtained as follow. 1. The number of visiting patients were 6500 and mean age was 34.06 year (Male's mean age was 33.15, Female's 34.62). In the age of patients, there was no significant difference between sex. 2. There are most patients who were referred by dentist (80.07%). Most diagnostic group was arthrogenous TMD group and followed by myogenous TMD, soft tissue disease. 3. There was strong interaction between diagnostic groups and chief complaint. 4. There was little pain difference between right and left sides. Male mainly had pain onset under 6 month, but female had pain onset more than 6 month. 5. The number of patients who had joint sound history were 3445 (53.15%). There was no significant difference of pain onset between sex. Clicking sound was most among joint sounds which happened to patients. 6. In analyzing the parafunctional habit, male mainly had bruxism, but female had clenching habit.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.20 no.2
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• pp.235-250
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• 1990

Thirty-nine patients (forty-four joints) who had been diagnosed as having meniscus perforation of the temporomandibular joint by inferior joint space arthrography and had been treated by surgical procedures were evaluated retrospectively. Information of clinical findings, arthrotomographic findings and surgical findings was collected on a standardized form and evaluated. The results were as follows: 1. On the 34 patients of 38 joints which were surgically confirmed perforation of meniscus or its attachments of the temporomandibular joint, there were 29 females and 5 males (5.8:1). The average age was 36 years (range 17 to 70). 2. The common clinical findings of group that had meniscus displacement without reduction and with perforation were pain on the affected joint and limitation of mouth opening. In the group showing meniscus displacement with reduction and with perforation the common clinical findings were pain and clicking on the affected joint. 3. 32 joints (84.2%) were arthrotomographically anterior meniscus displacement without reduction and with perforation, 6 joints (15.8%) showed anterior meniscus displacement with reduction and with perforation. 4. Joints categorized arthrotomographically as having meniscus displacement without reduction and with perforation were less likely to have full translation of the condyle in comparison with the normal or meniscus displacement with reduction and with perforation groups. (p<0.05) 5.The arthrographic findings of 44 joints having meniscus perforation were compared with surgical findings, there were 6 false positive findings of meniscus perforation, the reliability of arthrographic findings of meniscus perforation was a 86.4% correlation with surgical findings. 6. On the site of perforations of 38 joints which were surgically confirmed perforation of meniscus or its attachments, twenty-three of perforations (60.5%) were in location at the junction of the meniscus and posterior attachment, forteen (36.9%) were located at the posterior attachment and one (2.6%) was at the meniscus itself.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.455-466
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• 1999

The purpose of this study was to investigate the magnitude of mandibular rotational torque movements in subjects with TMJ sounds, and to analyse correlation between quantitative characteristics of TMJ sounds and mandibular rotational torque movement. Twenty dental college students with TMJ clicking and twenty students without any TMD signs and symptoms were examined by mean of SonoPak and Rotate program of BioPAK system(Bioresearch Inc. MilWaukee, wisconsin, USA) in this study. Mandibular rotational torque movements were recorded and analysed during maximum mouth opening, protrusion, and lateral excursion in frontal and horizontal planes. The obtained results were as follows: 1. On maximum mouth opening, mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.05). 2. During maximum mouth opening closing, maximum mandibular rotational angle and distance of clicking group were significantly greater than those of control group in frontal plane. (P<0.01). 3. On protrusion, mandibular rotational angle and distance of clickin group were significantly greater than those of control group in horizontal plane. (P<0.05). 4. On lateral excursion, there was no significant difference in mandibular rotational angle and distance between clicking group and control group in frontal and horizontal planes. 5. There were significant correlations between peak amplitude of TMJ sounds and maximum mandibular rotational distance during maximum mouth opening (r=-.481) and mandibular rotational distance on maximum mouth opening (r=-.455) in horizontal plane. 6. There were significant correlations between Above 300/(0-300)Hz ratio of TMJ sounds and mandibular rotational angle (r=-.499) and distance (r=-.457) on maximum mouth opening in frontal plane.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.388-394
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• 1997

Temporomandibular (TM) joint Pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• Journal of Oral Medicine and Pain
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• v.11 no.1
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• pp.19-27
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• 1986

Registration of the mandibular movement in patients with temporomandibular joint noise (clicking and/or crepitus) was performed using one of mandibular tracking devices(SAPHON VISI-TRAINER CII,Tokyo Shizai-sha Inc.,Japan). The obtained results were follows : 1. In many cases, the movement pattern of light emitting diode(LED) attached on the mandibular midline showed lateral deviation from a vertical reference line which was pronounced in association with TMJ noise during opening and closing. 2. In patients with unilateral TMJ noise the mandibular midline usually towards the side demonstrating TMJ noise during opening. 3. A distinct V-shaped discontinuity in the trace of velocity of mandibular movement was found at the point of the TMJ noise. 4. In patients with TMJ noise the velocity of mandibular movement at the point of the TMJ noise was decreased rapidly. 5. In several cases, TMJ noise could be eliminated by traning of Rocabado`s control of TMJ rotations.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.38-46
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• 2016

Purpose: study for discriminating method of origin side vibration from non-symptomatic clicking group. Materials and Methods: 60 joints vibrations of 30 subjects in non-symptomatic clicking group was recorded via subject's awareness, examiner's palpation and JVA analysis. Origin side vibration was discriminated with consideration for frequency spectrum, time delay and phase shift of waveforms, analysis of numeric values. Results: There were all unilateral vibrations with JVA analysis and number of origin vibrations were 42. 11 pairs of vibrations showed time delay and phase shift and transferred side vibrations showed smaller values of total integral and bigger values of > 300 / < 300 ratio than origin side vibrations except one pair of vibrations. Also as the ipsi-lateral joint vibrations with smaller values of total integral showed bigger values of > 300 / < 300 ratio than the contra-lateral joint vibrations and there all ipsi-lateral vibrations were showed small values of total integral below 10 and hard to detect time delay and phase shift. So the features were used in discrimination of origin side vibrations. Conclusion: There should be all-around considerations for discrimination of origin side vibrations that is frequency spectrum, phase shift and time delay and analysis of numeric values.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.7-18
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• 1989

The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.13-20
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• 1985

The author obtained the oblique lateral trans cranial radiograms from 376 patients (114 of male, and 262 of female) with temporomandibular joint arthrosis. After tracing each film, the author analyzed the dimensional changes of the condylar heads with pain, clicking, mouth opening limitation, and masticatory difficulty respectively, which were the chief complaints of the TMJ arthrosis and compared these data with control group. The results were as follows; 1. There was a great predilection for occurrence of the TMJ arthrosis in female (262 cases) over male (114 cases). But there was no significant difference in ratio between the sexes on each symptom. In male, 60 patients (52.6%) had pain, 28 patients (24.6%) had clicking, 21 patients (18.4%) had mouth opening limitation, and 5 patients (4.4%) had masticatory difficulty. In female, 148 parients (56.5%) had pain, 57 patients (21.8%) had clicking, 47 patients (17.9%) had mouth opening limitation, and 10 patients (3.8%) had masticatory difficulty. 2. Examined controlled group, the author analyzed the dimension of W-W', 0-H, 0-A, 0-B on the right side first, and left side second. In male, the dimension of W-W' was 14.52㎜, 14.13㎜; 0-H was 13.92㎜, 13. 71㎜' 0-A was 8.91㎜, 9.0㎜ and 0-B was 8.67㎜, 8.78㎜. In female, W-W' was 13.77㎜, 13.51㎜; 0-H was 13.42㎜, 13.35㎜; 0-A was 8.92㎜, 9.01㎜; and 0-B was 8.59㎜, 8.80㎜. 3. W-W' and 0-H of the experimental group were distinctly lesser than the controlled group. Male with mouth opening limitation show the least (12.70㎜, 13.00㎜) on W-W', but both sexes with pain show the least on 0-H. There was no significant difference between experimental group with Clicking and controlled group on 0-H, 0-A, and 0-B. And also there was no difference on 0-B in patients with every symptom except masticatory difficulty. The dimensional changes of the condylar heads with those symptoms were as follows; a) In male patients, complaing of pain, W-W' of the right and left was 13.80㎜, 12.80㎜; 0-H was 13.10㎜, 12.90㎜; 0-A was 8.69㎜, 8.18㎜; 0-B was 8.33㎜, 8.42㎜. In female, W-W' was 13.01㎜, 12.90㎜; 0-H was 12.48㎜, 12.80㎜; 0-A was 8.60㎜, 8.49㎜; 0-B was 8.48㎜, 8.50㎜. b) In male patients with clicking, W-W' was 13.70㎜, 13.10㎜; 0-H was 13.90㎜, 13.10㎜; 0-A was 8.81㎜, 8.16㎜ 0-B was 8.34㎜, 8.25㎜. In female, W-W' was 13.10㎜, 13.50㎜; 0-H was 13.30㎜, 12.91㎜; 0-A was 8.95㎜, 8.49㎜; 0-B was 8.23㎜, 8.70㎜. c) In male patients with mouth opening limitation, W-W' was 12.70㎜, 13.00㎜; 0-H was 13.40㎜, 13.40㎜; 0-A was 8.37㎜, 8.48㎜; 0-B was 8.33㎜, 8.62㎜. In female, W-W' was 13.00㎜, 12.50㎜ 0-H was 12.90㎜, 13.10㎜; 0-A was 8.49㎜, 8.09㎜; 0-B was 8.77㎜, 8.01㎜. d) In male patients with masticatory difficulty, W-W' was 13.30㎜, 13.20㎜; 0-H was 13.40㎜, 12.60㎜; 0-A was 8.26㎜, 8.32㎜; 0-B was 7.80㎜, 8.20㎜. In female, W-W' was 12.30㎜, 12.00㎜; 0-H was 13.10㎜, 13.20㎜; 0-A was 8.68㎜, 7.95㎜; 0-B was 7.46㎜, 7.87㎜.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.121-134
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• 1984

The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms, duration of the diseases were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases, 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%). sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The condylar positional changes and bone changes according to the region were as follows: a) In the condylar head the most frequent bone change was erosion (30.45%) and the most frequent condylar positional change was downward position (37.40%) in closed state, restricted movement of condyle (33.2%) in open state. b) In the articular eminence the most frequent bone change was eburnation (39.91%) and the most frequent condylar positional change was downward position (39.79%) in closed state, restricted movement of condyle (27.22%) in open state. c) In the articular fossa the most frequent bone change was eburnation (53.94%) and the most frequent condylar positional change was downward position (42.57%) in closed state, restricted movement of condyle (30.32%) in open state.