• 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 Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.87-101
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• 2012

Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.227-239
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• 2007

To evaluate the treatment outcome after conservative treatment in patients with osteoarthritis of the TMJ(OA), the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as osteoarthritis of the TMJ, and treated with conservative methods from 1994 to 2006. 101 patients with diagnosis of osteoarthritis of the TMJ were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorders(MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subject's status at the first and the last visit. The results were as follows : 1. In the OA group, satisfactory treatment outcome was obtained with conservative methods. But, at the last visit, the symptoms of the OA group were not improved enough compared with those of the MMD group. 2. In the OA group, radiographic findings of panorama view and transcranial projection were positive by about 60 percent. But, computed tomography and single photon emission computed tomography were positive by more than 90 percent. 3. At the last visit of the OA group, the joint noise was reduced significantly. 4. In the majority of the OA group, satisfactory treatment outcome was obtained with conservative methods such as medication, physical therapy, and occlusal stabilization appliance. In the majority of the MMD group, satisfactory outcome was obtained with medication and physical therapy. 5. It took the OA group from 6 months to 2 years to be cured well while the MMD group within 6 months.6. The OA group needed more than 10 times' treatment for satisfactory outcome while the MMD group needed less than 10 times' treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 2022

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.113-122
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• 2024

The gradual teeth wear with age is a natural phenomenon, but excessive wear beyond physiological levels can lead to vertical dimension loss, occlusal imbalance, temporomandibular joint disorders, and periodontal disease. In such cases, prosthodontic restoration becomes necessary emphasizing the importance of appropriate vertical dimension increase and stable occlusion in central relation (CR). In this case, a 74-year-old patient with clenching and grinding habit had severe teeth wear and after assessing interocclusal distance, wear degree, pronunciation, and facial profile, it was decided to perform full-mouth fixed prosthesis restoration with a 4 mm vertical dimension increase. And the significantly displaced Maximum Intercuspal Position (MICP) caused by parafunctional movements was re-established as a stable mutually protective occlusal relationship at centric relation and after a successful 4 months adaptation to provisional restorations, the final prosthesis was fabricated. During 4months of observation periods, stable occlusion in central relation and mutual protection occlusal relationships were maintained and the patient was satisfied with function and aesthetics, leading to this report.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.217-225
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• 2009

As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

• 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.