• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.214-237
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• 2023

This study aimed to evaluate the clinical efficacy and safety of acupuncture and electroacupuncture for temporomandibular joint disorder (TMD). We searched 11 databases to find randomized-controlled trials (RCTs) published between January 2018 and January 2023 that used acupuncture and electroacupuncture to treat patients with TMD. We performed a meta-analysis of 18 RCTs involving 1,109 patients. Nine studies reported that the treatment and control groups showed improvement in the evaluation index post-treatment. The results of the meta-analysis showed that the treatment groups receiving acupuncture combined with manual therapy had significantly improved visual analog scale score and dysfunction index than the control groups receiving manual therapy. Moreover, the treatment groups receiving acupuncture combined with Western medicine had statistically improved maximum mouth opening than the control groups using Western medicine. In conclusion, acupuncture and electroacupuncture have clinical effects on TMD patients. Given that 11 studies were obtained from the Chinese database, a regional bias would be considered. Furthermore, the included studies had high a risk of bias in terms of randomization, concealment, and blinding. Further studies are required to correct these limitations.

• Journal of Oral Medicine and Pain
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• 제9권1호
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• pp.77-92
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• 1984

The purpose of this study was to investigate the relationship between the mandibular positions and the habitual mandibular opening and closing movements in normal subject using the newly developed electric mandibular movement analyzing device(Saphon Visi-Trainer C-II.Tokyo Shizaisha Inc. Tokyo, Japan) One of the cause of the temporomandibular joint dysfunction has been considered abnormal mandibular positions especially the abnormal deviation between intercuspal position from retruded contact position. The subjects in this study were consisted of 55 young adults in 20 decade who had normal occlusion, no prosthodontic restorations and no history of disturbance or pain on temporomandibular joint and masticatory muscles. The results were as follows : 1. The deviations of intercuspal position from retruded contact position were 0.23mm in frontal view and 1.02mm in sagirral view. 2. The larger the deviation of intercuspal position from the retruded contact position, the higher the proportion of uncoincidence of the habitual nandibular closing and opening trajectories was, and the proportion was higher in sagittal view than frontal view, 10mm opening than 5mm opening. 3. Correlation between the deviation of intercuspal position from retruded contact position and uncoincidence rate of the habitual mandibular closing and opening trajectories was higher in frontal view than sagittal view.

• 치과방사선
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• 제10권1호
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• pp.47-55
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• 1980

The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological ylar head, articular eminence, and articular fossa were analized and discussed view point. The positional changes of condylar head and articular fossa relatation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthrotic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 106 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrom and osteoarthrosis of TMJ.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.739-743
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• 2005

Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

• 치과방사선
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• 제9권1호
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• pp.13-18
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• 1979

The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental mary of College of Dentistry, Seoul National University, Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54㎝) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normalrange was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41. 1 %. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71. 5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric occlusion and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.

• 대한치과보철학회지
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• 제30권1호
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• pp.15-24
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• 1992

The purpose of this study was to analyze the mandibular asymmetry of the patients with the temporomandibular dysfunction. In this study, 20 dental students aged between 22 and 27 years, Chosun University, who did not possess any restoration and symptoms like the temporomandybular joint click, pain, and opening limitation of the mandible were selected as the normal group. And 80 patients who were analyzed into the patients with the temporomadibular dysfunction(TMD) were divided into group I as the internal derangement and group II as external derangement. Both the normal group and the TMD Group were faked submento-vertex cephalogram by routine methods after that the unilateral mandibular length(L) and the amount of mandibular asymmetry and deviation were measured and analyzed. The results were as follows : 1, Unilateral mandibular length(L) of the normal group and the TMD group were $112.7{\pm}10.20mm\;and\;102.65{\pm}8.10mm$ respectively (P<0.01). 2. The amount of mandibula asymmetry of the normal group and the TMD group were $5.95{\pm}4.63mm\;and\;5.68{\pm}4.35mm$ respectively (P<0.5). 3. The amount of mandibular deviation of the normal group and the TMD group were $6.00{\pm}4.07\;and\;4.67{\pm}3.40mm$ respectively (P<0.3). 4. In the TMD group, unilateral mandibular length(L) in the affected site and the non-affected site were $102.73{\pm}8.68mm\;and\;102.53{\pm}7.68mm$ respectively (P<0.5).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

• 대한전기학회논문지:시스템및제어부문D
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• 제50권11호
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• pp.541-549
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• 2001

The term 'silent period(SP)' refers to a transitory, relative or absolute decrease electromyography(EMG) activity, evoked in the midst of an otherwise sustained contraction. Masseteric SP is elicited by a tap on the chin during isometric contraction of masseter muscle. In this paper, a new EMG signal generation model including SP in masseter muscle is proposed. This work is based on the anatomical structure of trigeminal nerve system that related on temporomandibular joint(TMJ) dysfunction. And it was verified by comparing the real EMG signals including SP in masseter muscle to the simulated signals by the proposed model. Through this studies, it was shown that SP has relation to variable neurophysiological phenomena. A proposed model is based on the control system theory and DSP(Digital Signal Processing) theory, and was simulated using MATLAB simulink. As a result, the proposed SP model generated EMG signals which are similar to real EMG signal including normal SP and an abnormal extended SP. This model can be applied to the diagnosis of TMJ dysfunction and can effectively explain the origin of extended SP.

• 대한치과보철학회지
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• 제22권1호
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• pp.85-94
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• 1984

The purpose of this study was to investigate treatment effectiveness of TENS and bite plane for bruxism and TMJ dysfunction patients. The electromyograms were made on males aged 23 to 25 with sound stomatognathic system, 5 males bruxism aged 24 to 27, and 1 male and 4 females TMJ dysfunction patients (right TMJ pain) aged 14 to 33. The electromyographic study was limited to the middle of masseter muscle and anterior temporal muscle. The electromyographic study was carried out with 8-channel EM2 (Myotronics Research Inc.) and was taken 5 mandibular positions of clinical rest position, clench intercuspal position, clench protruded, cluch right, clench left. The 2 pairs of surface electrodes were used exactly, with the ear lobe as reference point. The recording were subjected to determine the mean voltage. The results were as follows; 1. In the clinical rest position, the muscle activities of bruxism and TMJ dysfunction patients were higher than those of normal at the before treatment, but that were lower or similar to those of normal at the TENS after and after bite plane wearing. 2. In the clench I.C.P., the muscle activities of TMJ dysfunction patients were decreased as the order of the before treatment, after TENS, after occlusal bite plane wearing, but those of bruxism were irregular. 3. In the clench right and the clench left, the muscle activities of the middle of masseter muscle of the non-working side of bruxism were higher than those of the working side at the before treatment and after TENS, but the muscle activities of after occlusal bite plane wearing were similar to those of the normal. 4. In the clench right and the clench left, the muscle activities of the middle of masseter muscle and anterior temporal muscle of the working side of TMJ dysfunction patients were higher than those of non-working side as like the normal at the before treatment, after TENS, and after occlusal bite plane wearing.