Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Clinical Assessment of Patients with Mandibular Condyle hypoplasia

하악 과두저형성증 환자의 임상적 평가

  • Yi, Young-Chul (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Cho, Bong-Hae (Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University) ;
  • Ok, Soo-Min (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Heo, Jun-Young (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Kim, Kyung-Hee (Dept. of Oral Medicine, Pusan Paik Hospital, Inje University) ;
  • Ahn, Young-Woo (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Ko, Myung-Yun (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Jeong, Sung-Hee (Department of Oral Medicine, School of Dentistry, Pusan National University)
  • 이영철 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 조봉혜 (부산대학교 치의학전문대학원 구강악안면방사선학 교실) ;
  • 옥수민 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 허준영 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 김경희 (인제대학교 부산백병원 구강내과학교실) ;
  • 안용우 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 고명연 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 정성희 (부산대학교 치의학전문대학원 구강내과학 교실)
  • Received : 2013.04.08
  • Accepted : 2013.05.03
  • Published : 2013.06.30
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Abstract

Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.

측두하악장애를 주소로 하는 환자 276명에 대해 임상검사와 방사선검사를 시행하였다. 하악과두 저형성으로 진단된 189명의 실험군과 골관절염으로 진단된 87명의 대조군을 임상적으로 비교하여 다음과 같은 결과를 얻었다. 1. 하악 과두저형성은 골관절염과 임상적으로 많은 부분이 유사하였다. 2. 하악 과두저형성은 골관절염에 비하여 방사선적 진단부위와 통증부위의 일치율이 현저하게 낮았다. 3. 하악 과두저형성 양측이환군이 편측이환군에 비해 교합불편감 및 이악물기습관이 많았다. 4. 편측이환군 비교시 하악 과두저형성은 편측저작습관이 높았으며, 개구제한감을 더 많이 느꼈다. 골관절염은 아침의 불편감 및 두통을 많이 호소하였으며 진단부위와 단순관절음 일치율이 높았다. 5. 양측이환군 비교시 하악 과두저형성이 골관절염보다 평상시 두통을 더 많이 호소하였으며, 수평피개량도 컸다.

Keywords

References

  1. Shafer WG, Hine MK, Levy BM: A Textbook of Oral Pathology(ed 3). Philadelphia, PA, Saunders. 1974:649.
  2. World Health Organization: Application of the International Classification of Diseases to Dentistry and Stomatology. Geneva 1995:74.
  3. Wright EF, Flaggert JJ: Acquired condylar hypoplasia: Case report. Pediatr Dent. 1993;15(6):427-8.
  4. Ferguson MW, Wbitlock RI: An unusual case of acquired unilateral condylar hypoplasia. Br J Oral Surg. 1978;16(2):156-62. https://doi.org/10.1016/0007-117X(78)90026-4
  5. Rabey GP: Bilateral mandibular condylisis: A morphoanalytic diagnosis. Br J Oral Surg. 1977;15(2): 121-34. https://doi.org/10.1016/0007-117X(77)90044-0
  6. Speculand B: Unilateral condylar hypoplasia with ankylosis: Radiographic findings. Br J Oral Surg. 1982;20(1):1-13. https://doi.org/10.1016/0007-117X(82)90001-4
  7. Berger SS, Stewart RE: Mandibular hypoplasia secondary to perinatal trauma: Report of case. J Oral Surg. 1977;35(7):578-82.
  8. MacLeod SP, Macintyre DR: Bilateral hypoplasia of mandibular condyles in Hurler's syndrome. Oral Surg Oral Med Oral Pathol. 1993;75(5):659-60. https://doi.org/10.1016/0030-4220(93)90244-X
  9. Tank W, Wright D, Iizuka T: Unilateral dysplasia of the mandibular condyle: report of a case. J Oral Maxillofac Surg. 1998;56(6):765-9. https://doi.org/10.1016/S0278-2391(98)90816-3
  10. Ferri J, Carneiro JM, Lemiere E, Vereecke F, Baralle MM: Severe congenital hypoplasia of the mandibular condyle-diagnosis and treatment: a report of 2 cases. J Oral Maxillofac Surg. 2006;64(6):972-80. https://doi.org/10.1016/j.joms.2006.02.019
  11. Björk A, Kuroda T: Congenital bilateral hypoplasia of the mandibular condyles associated with congenital bilateral palpebral ptosis. A radiographic analysis of the craniofacial growth by the implant method in one case. Am J Orthod. 1968;54(8):584-600. https://doi.org/10.1016/0002-9416(68)90179-6
  12. Stegenga B, de Bont LG, Boering G: Osteoarthrosis as the cause of craniomandibular pain and dysfunction: a unifying concept. J Oral Maxillofac Surg. 1989;47 (3):249-56. https://doi.org/10.1016/0278-2391(89)90227-9
  13. K. Yamada, I. Saito, K. Hanada, T. Hayashi: Observation of three cases of temporo-mandibualr joint osteoarthritis and mandibular morphology during adolescence using helical CT. J Oral Rehabilitation 2004;30:298-305.
  14. Chung SC, Kim YK et al.: Orofacial pains and temporomandibular disorders. 2nd ed. Shinhung 1996:149-153.
  15. Rasmussen OC. : Temporomandibular arthropathy. Clinical, radiologic, and therapeutic aspects, with emphasis on diagnosis. Int J Oral Surg. 1983 Dec;12(6):365-97. https://doi.org/10.1016/S0300-9785(83)80029-5
  16. Rasmussen OC. : Clinical findings during the course of temporomandibular arthropathy. Scand J Dent Res. 1981;89(3):283-8.
  17. Kamelchuk LS, Major PW.: Degenerative disease of the temporomandibular joint. J Orofac Pain. 1995;9 (2):168-80.
  18. 정성창 등. 악관절 장애와 교합, 1999, 군자출판사, pp 326-330.
  19. 전용현, 허윤경, 정재광, 채종문, 최재갑: 10대 하악과두 흡수 환자의 임상적 평가 및 악안면 골격형태에 대한 연구. 대한구강내과학회지 2010;35(1):61-73.
  20. Roh CS, Jung YH, Tae IH, Ko MY, Ahn YW. : The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis. Korean J Oral Med 2009;34(1):81-90.
  21. Dworkin SF, LeResche L. : Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992 Fall;6(4):301-55.
  22. Lim YK, Kim MJ, Kim YJ, Song YH, Lee DY : Distribution and clinical features of patients with degenerative change of the mandibular condyle. The Korean journal of orthodontics 2006;36(6):402-411.
  23. Tegelberg A, Kopp S. Clinical findings in the stomatognathic system for individuals with rheumatoid arthritis and osteoarthrosis. Acta Odontol Scand 1987;45:65-75. https://doi.org/10.3109/00016358709098359
  24. Seligman DA, Pullinger AG. Association of occlusal variables among refined TM patient diagnostic groups. J Craniomandib Disord 1989;3:227-36.
  25. Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop 1996;110: 117-27. https://doi.org/10.1016/S0889-5406(96)70099-9
  26. Dibbets JM, van der Weele LT: Prevalence of structural bony change in the mandibular condyle. J Craniomandib Disord 1992;6:254-9.
  27. Susami T, Kuroda T, Yano Y, Nakamura T. Growth changes and orthodontic treatment in a patient with condylolysis. Am J Orthod Dentofacial Orthop 1992; 64:460-6.
  28. Jo JH, Park MW, Kim YK, Lee JY: The Occurrence of Degenerative Change in the Mandibular Condyles of Korean Patients with Temporomandibular Disorders. Korean J Oral medicine 2011:36(1):53-63.
  29. Gray RJM. Pain dysfunction syndrome and osteoarthrosis related to unilateral and bilateral temporomandibular joint symptoms. J Dent 1986;14:156-159. https://doi.org/10.1016/0300-5712(86)90017-5
  30. Boering G. Temporomandibular joint arthrosis? A clinical and radiographic investigatio 1994, Drukkerij Van Denderen Groningen, pp.185-214, 315-360.
  31. Kaplan AS, Assael LA. Arthritis. In John Dyson(Ed). Temporomandibular Disorders: Diagnosis and Treatment. Vol. 1. Philadelphia, 1991, W.B.Saunders Co., pp. 169.