• Title, Summary, Keyword: 턱관절장애

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The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis (측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성)

  • Roh, Chang-Se;Jung, Yun-Hoa;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.81-90
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    • 2009
  • This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.

Comparison of Cold Pack and Capsaicin Application in Temporomandibular Disorder Treatment (측두하악장애 치료에 있어 냉찜질과 capsaicin적용에 관한 비교)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.219-225
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    • 2007
  • This investigation was carried out to evaluate the effect of pain control temporomandibular disorders with clinical application of capsaicin cream. 20 healthy subjects without systemic diseases were measured in current perception threshold and pain tolerance threshold with $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) after cold pack, 0.025% capsaicin and 0.075% capsaicin cream application. The obtained results were as follows : 1. The current perception threshold of C-fiber was significantly higher to the baseline on. There were significantly increased in C- fiber current perception threshold of 0.025% capsaicin cream and 0.075% capsaicin cream application comparison to cold pack. 2. There was significantly increased in pain tolerance threshold of cold pack and 0.075% capsaicin application comparison to one of baseline as $A{\beta}$-fiber, There was significantly higher after cold pack and 0.025% capsaicin cream application than baseline as $A{\delta}$-fiber. In C-fiber case, 0.025% capsaicin application's was significantly increased than baseline one. 3.There were significantly higher C-fiber of 0.075% capsaicin application than baseline in visual analogue scale marking pain level of pain tolerance threshold.

Evaluation of Quality of Life according to Temporomandibular Disorder Symptoms in Dental Hospital Worker (치과병원 종사자에서 측두하악관절장애 증상에 따른 삶의 질 평가)

  • Kim, Dong-Kook;Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.61-72
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    • 2012
  • Temporomandibular disorder(TMD) is relatively prevalent disease, and quality of life may be impaired in TMD patients. Like general population, dental hospital workers are also exposed to the risk of TMD. But, many of them tend to overlook or tolerate their symptoms for lack of time and interest. Therefore, problems may become more serious, causing interference of performing task and decrease of quality of life. The aim of this study were to obtain data for TMD prevalence in dental hospital workers and to evaluate quality of life according to TMD symptoms. Subjects were recruited from Wonkwang University Dental Hospital. After consent, subjects completed quality of life questionnaire and were evaluated for subjective and objective signs and symptoms of TMD. Subjects were classified into 4 groups : (1) normal group (2) joint disorder group, (3) local myalgia group, and (4) myofascial pain group. The result of the study indicated that TMD negatively influences the quality of life in dental hospital worker. TMD symptoms can deteriorate quality of life in dental hospital worker. Future effort to make protocol for proper management is needed.

The Analysis and Study of First Visit Outpatients in Oral Medicine (구강내과에 내원한 신환에 관한 분석 연구)

  • Ko, Myung-Yun;Heo, Jun-Young;Ok, Su-Min;Kim, Kyung-Hee;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.137-142
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    • 2013
  • Oral Medicine includes temporomandibular disorder, orofacial pains such as neuropathic pain, soft tissue diseases, halitosis, laser treatment, snoring, sleep apnea and identification through forensic dentistry etc. Such diseases are relatively common and cause great inconvenience and pain to the patients, as well as incur fatal health scare at times. In terms of oral medicine, the number of orofacial patients is growing due to a change in the life style and an increased stress as time goes in contemporary society and the demand of areas requiring oral medical professionalism, such as soft tissue lesions, snoring and sleep apnea, forensic dentistry evaluation and others are rapidly ascending. Consequently, among the areas in dental science, the calls for the expertism in oral medicine and its role are mounting. Analyzing the distribution according to disease entity, symptoms, duration of disease, and the prehistory courses of new patients visiting the department of oral medicine in a year provides information of the role and the relative importance of oral medicine in prospect and enables effective diagnosis and treatments for the patients. Therefore, in the present study, by analyzing new patients visiting the oral medicine clinic in our dental hospital for a year and by evaluating the role and the professionalism in future oral medicine, the authors concluded the followings: 1. It was founded that new patients to oral medicine mainly had temporomandibular disorders, soft tissue diseases, and neuropathic pains. 2. The number of patients with temporomandibular disorder appeared to be the highest percentage and the order within this was the patients with combined disorders, muscle disorder, and internal derangement of joint disc. 3. The number of patients with xerostomia appeared to be the highest percentage within soft tissue disease, followed by lichen planus and recurrent apthous ulcers. 4. The number of patients with burning mouth syndrome appeared to be the highest percentage within neuropathic pain.

Alteration of Anaerobic Bacteria and S. mutans Count in Oral Cavity after Occlusal Stabilization Appliance Use (교합안정장치 사용에 따른 구강 내 혐기성 세균과 S. mutans의 변화)

  • Byun, Jin-Seok;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.375-381
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    • 2007
  • Occlusal stabilization appliance is one of the most common treatment option for management of temporomandibular disorders. It acts in oral cavity for several hours per day, and usually it will take at least 6 months to 2 years of total wearing periods to take a treatment goal. In the oral cavity, occlusal stabilization appliance, unintentional manner, is able to acts as a reservoir of bacteria and protect bacteria from saliva and oxygen. This condition is so favorable to many bacteria such as S. mutans and other anaerobes, usually have been reported as causative factors of dental caries, periodontal disease and oral malodor. In this study, we investigated anaerobic bacteria and S. mutans count before and after occlusal stabilization appliance use to evaluate the possible role of occlusal stabilization appliance as protector of these bacteria. Four men(average 27.5 years) wore maxillary occlusal stabilization appliance at each night(average 9 hours) for 5 days. we swabbed saliva-plaque mixed sample at 3 different site(maxillary left 2nd molar, maxillary left central incisor, mandibular left 2nd molar) before and after occlusal stabilization appliance use. Each samples were plated in (1) anaerobic blood agar medium, (2) selective S. mutans medium(MS-MUTV) and incubated in anaerobic chamber($CO^2$ 10%, $37^{\circ}C$) for 72 hours. Each bacterial colony forming unit(CFU) were counted with naked eyes. From obtained data, we can conclude as follows: 1. There was some changes about anaerobic bacteria and S. mutans count in oral cavity after occlusal stabilization appliance use. 2. The number of anaerobic bacteria was significantly increased at maxillary 2nd molar(P=0.003), maxillary central incisor(P=0.020) after occlusal stabilization appliance use compared with before. 3. Occlusal stabilization appliance use itself had indirect effect to increase the number of anaerobic bacteria at other uncovered opponent tooth site. 4. The number of S. mutans was significantly increased at maxillary 2nd molar(P=0.043), maxillary central incisor (P=0.049) after occlusal stabilization appliance use compared with before. 5. Occlusal stabilization appliance use itself had not any effect on the number of S. mutans at other uncovered opponent tooth site.

Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

Appraisal of Clinical Practice Guidelines of Temporomandibular Disorders Using AGREE II (Appraisal of Guidelines for Research & Evaluation II) (AGREE II를 이용한 턱관절 장애의 국내외 기개발 임상진료지침의 평가)

  • Yoon, Ye-Ji;Park, Hye-Sung;Kim, Hyungsuk;Jeon, Junyung;Park, Jae-Hyun;Shin, Woochul;Kim, Seyoon;Bae, Jun-hyeong;Yun, Jung-min;Kim, Koh-Woon;Ha, In-Hyuk;Lee, Yoon-Jae;Kim, Me-riong;Song, Mi-Yeon;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.67-74
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    • 2017
  • Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.

The Effect of Korean Medical Treatments with Functional Cerebrospinal Therapy on Patients from Traffic Accidents with Temporomandibular Joint Disorder (기능적 뇌척주요법을 병행한 한방치료가 턱관절 장애가 있는 교통사고 환자에 미치는 영향)

  • Seo, Yeon Ju;Seo, Jong Cheol;Kim, Shin Young;Yoon, Hyun Min;Jang, Sun Hee;Song, Chun Ho;Lee, Young Jun;Cho, Sung Woo;Kang, Seok Hwan;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.149-163
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    • 2016
  • Objectives : The purpose of this study is to determine the effect of Functional Cerebrospinal Therapy(FCST) on patients from traffic accidents with Temporomandibular Joint Disorder. Methods : We reviewed the medical records of 33 patients who were treated for injuries stemming from traffic accidents at the Dong-Eui University Korean Medicine Hospital from December 29th, 2015 to August 29th, 2016. The patients were divided into 2 groups: Group A(n = 15) and Group B(n = 18). In Group A, patients received Korean medical treatments with FCST using an Accurate Balancing Appliance(ABA) - a standard intra-oral appliance. In Group B, patients received Korean medical treatments without FCST. To estimate the efficacy of the treatments in decreasing pain, we analyzed the Visual Analogue Scale(VAS), Neck Disability Index(NDI) and Oswestry Disability Index(ODI). Results : In Group A, VAS of headache(VAS H), VAS of neck & nuchal pain(VAS N), VAS of shoulder pain(VAS S), and VAS of low back pain(VAS L) were significantly improved during each period. In Group B, VAS H was significantly improved during each period, except the period from the first visit to two weeks later. VAS N, S, L were significantly improved during each period, except the period from the first visit to one week later. The total VAS improvement during each period in Group A was significantly higher than Group B. In both groups, NDI and ODI were improved significantly during each period. The improvement of NDI and ODI during each period in Group A was significantly higher than Group B. Conclusion : According to the results, FCST using ABA may be an effective treatment for patients from traffic accidents.

Muscle Stiffness and Elasticity of Masticatory Muscles on Gum Chewing (껌씹기가 저작근의 경도와 탄성도에 미치는 효과)

  • Won, Tae-Hee;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.421-429
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    • 2007
  • Some researchers suggested that tactile sensor system would be useful in evaluating masticatory muscles of TMD patients, but there were few studies on the effects of chewing with time. The aim of this study was to investigate the change of elasticity and stiffness for masseter and temporal muscles of normal subjects before, during and after gum chewing and to obtain the baseline data for further researches on the elasticity and stiffness for masticatory muscles of TMD patients. Stiffness and elasticity of their anterior temporalis and inferior masseter muscle were measured bilaterally by a tactile sensor system. Each subject was instructed to sit on a chair for evaluation of masticatory muscles. Before operating the sensor, the thickest skin area over anterior temporalis and inferior masseter muscles were selected as the points to be pressed by a tactile sensor, and marked with a pen. While the teeth of subjects were lightly contacted, the probe of the tactile sensor was placed perpendicularly over the marked point over the skin, followed by computer-controlled movement including gently pressing straight down on the muscle for a second and retracting. All subjects were instructed to chew gum (Excellent Breath, Taiyo Co., Japan) bilaterally with a velocity of 2 times per second for 40 minutes after the first measurement had been performed for the baseline data of all subjects. The measurements had been repeated during chewing with 10 minutes of interval and continued for 40 minutes with same interval after chewing. Resultantly, the decrease of elasticity and the increase of stiffness in masticatory muscles can be seen significantly within 10 minutes after chewing and those were maintained during chewing without significant change with chewing time. The elasticity of muscles was recovered within 10 minutes after stopping chewing, but the stiffness was recovered more lately than elasticity by about 10 minutes. Based on these results, it can be concluded that elasticity and stiffness of muscles would be good indicators to evaluate the masticatory muscles objectively, when more supported by further researches.