• Title, Summary, Keyword: 턱관절장애

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Treatment of hearing loss due to temporomandibular joint disorders: Case Report (턱관절 장애로 인한 청각장애의 치료: 증례보고)

  • Kang, Dong-Woo;Kim, Young-Kyun
    • The journal of the Korean dental association
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    • v.57 no.4
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    • pp.204-212
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    • 2019
  • Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

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A Case Report of Phantogeusia Managed by Postural Yinyang Correction of Temporomandibular Joint with Customized TMJ Balancing Intraoral Appliance (맞춤형 턱관절 균형 구강내 장치를 활용한 턱관절 자세 음양교정술의 환상미각증 치험 1례)

  • Park, Eun Jin;Lim, Jae Eun;Lee, Young Jun;Kim, Cheol Hong
    • Journal of TMJ Balancing Medicine
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    • v.8 no.1
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    • pp.24-29
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    • 2018
  • Objectives: The purpose of this study was to report the effect of Postural Yinyang Correction of the Temporomandibular joint (Functional Cerebrospinal Therapy, FCST) for phantogeusia. Methods: A patient with phantogeusia was treated at the Department of Acupuncture & Moxibustion, Dong-Eui University Korean Medicine Hospital from Oct 10th, 2018 to Dec 4th, 2018. A patient received 24 times of FCST with Customized TMJ Balancing Intraoral Appliance, upper cervical manipulation. To estimate the efficacy, Visual Analogue Scale (VAS), Oral Health Impact Profile-14 (OHIP-14) and questionnaire. Results: The patient showed a certain degree of improvement in phantogeusia and other subject symtoms within 8 weeks. Adverse effects were not reported. Conclusions: These results showed that FCST using an Customized TMJ Balancing Intraoral Appliance, may be useful for reducing the symptoms of phantogeusia.

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Comparison of Asymmetries on Masseter Muscle Thickness and Range of Motion in Subject With and Without Temporomandibular Disorders (턱관절 장애 유무에 따른 깨물근의 두께와 턱관절 가동범위의 비대칭성 비교)

  • Lee, Ji-won;Yang, Yeon-ju;Won, Jong-im
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.28-36
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    • 2019
  • Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

A Systematic Review and Meta-analysis of Manual Therapy for Temporomandibular Disorder (턱관절장애에 대한 수기요법의 체계적 문헌 고찰과 메타분석)

  • Kim, Hong-Guk;Ryoo, Dek-Woo;Jeong, Seong-Mok;Kim, Sung-Jin;Baek, Seung-Won;Lee, Chang-Hee;Yoon, Jin-Young
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
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    • v.12 no.1
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    • pp.13-27
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    • 2017
  • Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

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THE EFFECT OF EARLY REMOVAL OF THE FIXATION PLATES AND ACTIVE MOUTH OPENING EXERCISE ON THE TEMPOROMANDIBULAR DYSFUNCTION AFTER MANDIBULAR SETBACK SURGERY (하악골 전돌증 환자에서 하악지 시상분할골절단술후 금속고정판의 조기제거 및 기능운동이 턱관절장애에 미치는 영향)

  • Jeon, Joon-Hyuk;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Oh, Jung-Hwan;Kwon, Yong-Dae;Yoon, Byung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.545-551
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    • 2005
  • Purpose: The effect of orthognathic surgery on the temporomandibular dysfunction has been controversial. The purpose of this study is to prove statistically that early removal of fixation plate at postoperative 2 weeks with active exercise of mouth opening could relieve preoperative temporomandibular dysfunction and reposition of temporomandibular joint. Patients and Methods: All 28 subject patients underwent mandibular setback with BSSRO in Kyunghee medical center by one surgeon. The fixation plates used for rigid fixation were removed at postoperative 2 weeks and we had the patients excercise active mouth opening with intermaxillary rubber rings for the guiding proper postoperative occlusion. Temporomandibular symptoms were checked and radiographs were taken before surgery, within a month after surgery, six to twelve months after surgery respectively. Results: The temporomandibular dysfunction symptoms were relieved after the surgery and the condyle was displaced inferior-posteriorly immediate after surgery and repositioned toward its original position during follow-up periods. Conculusion: Orthognathic surgery may benefit temporomandibular joint dysfunction by obtaining a postoperative stable occlusion and more physiologic neuromuscular function. The early removal of fixation plates after BSSRO could reposition the temporomandibular joint to physiologic position and relieve the symptoms of temporomandibular dysfunction by permitting movement of proximal segment.

The Relationship between Dental Treatment and Temporomandibular Disorder (치과치료와 턱관절장애의 연관성에 관한 연구)

  • Kim, Yeong-Gyun;Lee, Yong-In
    • The journal of the Korean dental association
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    • v.46 no.5
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    • pp.308-314
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    • 2008
  • The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, symptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were : Implant treatment, 14 cases ; Tooth extraction, 3 cases and others. 2. TMD symptoms were : pain on TMJ, 12cases : Sound on TMJ, 3cases ; Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were : Synovitis and/or capsulitis, 10 cases ; 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were : Improvement, 6cases ; sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD, prior explanation and knowledge TMJ treatment are very important in these cases.

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The Influence of Unloading Taping Method Using Non-elastic Tape on the Pain, Opening Mouth, Functional Level, Quality of Life in Patients With Temporomandibular Joint Disorder (비탄력 테이프를 이용한 무부하 테이핑 기법이 턱관절장애 환자의 통증 수준, 개구범위, 기능적 수준, 삶의 질에 미치는 영향)

  • Hwang, Jea-hoon;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.23 no.3
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    • pp.29-39
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    • 2016
  • Background: In the treatment of temporomandibular joint (TMJ) disorder, the goals of traditional physical therapy are not only to reduce the inflammatory process leading to pain, but also to decrease joint overload and muscle hyperactivity. To achieve those goals, physical therapists generally use a photo-therapy, joint mobilization, and massage. Objects: To examine the impact of an unloading technique using non-elastic taping on the pain, opening mouth, functional level, and quality of life in patients with TMJ disorder. Method: Twenty patients with TMJ disorder were included in this study and randomly divided into the experimental ($n_1$=10), and control ($n_2$=10) groups. Traditional physical therapy including massage and stretching for 30 min was performed in both groups. Non-elastic taping was performed in the experimental group after traditional physical therapy, and they were recommended to keep the tape attached for 12 hours. Outcomes for pain, functional level, and quality of life were measured using a survey. The opening mouth was measured using a general ruler. Result: Significant differences were observed in the pain level, opening mouth, functional level, and quality of life after the intervention and on follow-up in both groups. However, we found that while the levels of all parameters were maintained throughout the follow-up period in the experimental group, the functional status level was not maintained throughout the follow-up period in the control group. Conclusion: Our unloading technique using non-elastic tape results comparable to those achieved by traditional physical therapy in the treatment of TMJ. However, the unloading taping method using non-elastic tape is more effective than traditional physical therapy in maintaining the impact of intervention.

Reliability of the Korean Version of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (한국어판 측두하악장애 연구진단기준 (RDC/TMD) 설문지의 신뢰도에 관한 연구)

  • Sohn, Byung-Jin;Park, Min-Woo;Park, Ji-Woon;Chung, Sung-Chang;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.323-338
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    • 2008
  • Objectives: The aim of this study was to analyze the reliability of the Korean language version of the Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD) axis II questionnaire among TMD patients. Methods: The Korean version of the RDC/TMD questionnaire was distributed to 154 TMD patients(31 men, 123 women) who visited Seoul National University Dental Hospital. The test-retest reliability was also assessed among the same subjects with a one- or two-week time interval. The subjects did not receive any form of therapy until the retest administration was completed. Results: The internal consistency reliability of pain intensity, disability score, jaw disability, and psychosocial status were 0.92, 0.94, 0.68, and 0.94, respectively using the Cronbach's alpha coefficient of the 1st test. Test-retest reliability coefficients of each items of the questionnaire ranged from 0.40 to 0.94 assessed with kappa value, and the intra-class correlation coefficient(ICC) for each subscale ranged from 0.81 to 0.93. Test-retest reliability coefficient of the graded chronic pain(GCP) scale was 0.63. Conclusions: The Korean language version of RDC/TMD axis II questionnaire demonstrated good reliability. It can be used as a valuable instrument for the analyses of the psychosocial aspects of the TMD patients in Korea.

Correlation Among the Cervical Kyphotic Angle, Pain, and Disability Level in Patients With Temporomandibular Disorders (턱관절장애 환자의 목뼈 뒤굽음 각과 통증 및 기능장애 수준 간에 상관성 연구)

  • Lee, In-su;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.2
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    • pp.102-110
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    • 2020
  • Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

Survey of Pain to Palpation of the Occipitofrontalis Muscle in Patients with Temporomandibular Disorders (측두하악장애 환자에서의 뒤통수이마근의 촉진 통증 양태)

  • Im, Yeong-Gwan;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.35 no.3
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    • pp.213-219
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    • 2010
  • Aim: The aims of this study were to survey the frequency of pain to palpation of the occipitofrontalis muscle in a TMD patient group, and to identify patients showing pain to palpation of the occipitofrontalis muscle that is also consistent with patients' headache symptom. Methods: A total of 218 TMD patients ($32.0{\pm}13.1$ years) participated in this study. Patients' symptoms, including headache, were surveyed by questionnaire. Temporomandibular joints, jaw muscles, and pericranial muscles including the occipitofrontalis muscle were examined with digital palpation. Pain to palpation (i.e. tenderness) was scored from 0 to 3 according to the patients' response, and frequencies were calculated of pain to palpation scores for each site of the pericranial muscles. Results: Twelve patients among 218 TMD patients (5.5%) showed pain to palpation (scores of 1, 2) on the occipitalis or frontalis sites, and seven patients (3.2%) had moderate pain (a score of 2) to palpation. Among 218 TMD patients, there was only one patient whose primary symptomatic site of headache corresponded with the result of pain to palpation of the occipitofrontalis muscle. Conclusion: It can be concluded that examination with palpation of the occipitofrontalis muscle could be considered in the evaluation of TMD patients' headache symptom when other factors have been ruled out.