• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.48-53
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• 2016

Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.

• Journal of Oral Medicine and Pain
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• v.44 no.2
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• pp.65-68
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• 2019

Temporomandibular disorders (TMD), involving the masticator system of temporomandibular joint (TMJ) and masticator muscle, can be characterized with the cardinal signs and symptoms of jaw pain, noises and limitation of mandibular range of motion. However, TMD requires differential diagnosis due to its heterogeneous characteristics with various causes despite the similar clinical profiles. Oral cancer involving TMJ and the masticator system, although infrequent, can be one of these causes and should be considered one of the most life-threatening disease mimicking TMDs. This report introduces a case of masticator space tumor originally diagnosed as TMD in a 73-year-old Korean female with previous history of brain tumor. The clinical signs and symptoms closely mimic that of TMD which may have disrupted differential diagnosis. We discuss here key points for suspecting TMDs of secondary origin, namely, that of cancer and the implications it has on dental clinicians.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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• pp.151-160
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• 2007

Objectives : This study was carried out to investigate the effects of Chuna & General Oriental Method on Temporomandibular Joint Disorder Patient(Functional Lateral Mandibular Displacement) with Many Clinical Symptoms. Methods : The therapies were Chuna, acupuncture treatment and herbal medicine. We estimated the effects of treatment by measuring the length from the end of frenulum labii superioris to the frenulum labii inferioris, Visual Analog Scale(VAS) and Patient Global Assessment(PGA) before and after treatment. Results : After treatment, we confirmed these improvements: the length from the end of frenulum labii superioris to the frenulum labii inferioris changed from 10-7mm to 0-2mm, the VAS was changed from 10 to 0-2 and many clinial symptoms improved. Conclusions : These results suggusted that Chuna & General Oriental Method effected for Temporomandibular joint disorders caused many clinical symptoms.

• 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 the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.5
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• pp.231-237
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• 2013

Objectives: This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. Materials and Methods: Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. Results: The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. Conclusion: Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.35-40
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• 2016

Purpose: This study aimed to investigate the characteristics of the symptoms of temporomandibular disorders (TMD) in Korean children and adolescents using representative samples and questionnaires. Methods: A survey involving the interview of 10-, 12-, and 15-year-old children and adolescents regarding the symptoms of TMD was conducted as a part of the 2010 National Oral Health Surveys. The study population included 18,112 subjects (male, 9,734; female, 8,378). The interview involved three questions related to the symptoms of TMD. The prevalence of symptoms of TMD, correlation of the symptoms with sex and age, and the difference in the number of symptoms according to sex and age were analyzed. Results: Among the symptoms of TMD in children and adolescents, the prevalence of temporomandibular joint (TMJ) sounds during mouth opening was 13.0%, while those of TMJ pain and limitation were 3.1% and 4.3%, respectively. While the prevalence of TMJ sounds during mouth opening did not show any statistically significant difference between the sexes, the rates of prevalence of TMJ pain and limitation of mouth opening in were higher in the female subjects than the male (p<0.05). It was also observed that the older the subjects, the higher the prevalence of TMJ sounds, TMJ pain, and limitation of mouth opening (p<0.05). The number of symptoms of TMD was found to be increased among female subjects as well as the older ones (p<0.05). Conclusions: There are variations in the prevalence of symptoms of TMD among Korean children and adolescents according to sex and age, which is consistent with the results of previous studies. It is necessary to conduct a national cohort study to evaluate the risk factors for TMD in children and adolescents.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.136-142
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• 2006

Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.2
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• pp.45-52
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• 2011

Objective : We had good effects on two patients who had problem with temporomandibular joint by using upper cervical manipulation combined with acupuncture therapy. Methods : Two temporomandibular disorder cases were managed by using upper cervical manipulation, combined with acupuncture therapy. We used Toggle-recoil technique for the purpose of upper cervical manipulation. Results :Even though symptoms of two patients were not same, each cases showed clinical changes by using upper cervical manipulation. Two cases had effects on decreasing pain of temporomandibular joint, and at the first case, the range of motion of temporomandibular joint was increased. Conclusion : We could treat temporomandibular disorder patients by using upper cervical manipulation combined with acupuncture therapy.

• The Journal of the Korean dental association
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• v.48 no.7
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• pp.522-530
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• 2010

Temporomandibular disorders(TMD) have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory muscles, and associated structures. Since Dr. James Costen has mentioned about the relationship between TMD and posterior bite collapse, there have been many controversies about the etiology and comorbidities of TMD. The purpose of this study was to investigate the relationship between TMD and hearing acuity in 158 volunteers with or without TMD symptoms. The subjects were examined clinically about TMJ sound, missing teeth, tinnitus, TMJ pain and masticatory muscle pain and the hearing acuity were measured by Audiometer(ITO AE-1000, Japan). The result of this study indicated that there was no significant differences between TMD symptoms and hearing acuity relatively.