자기공명영상에서 관찰되는 측두하악관절의 관절강내 삼출과 동통 및 관절원판 변위와의 관계

유상수,기우천,최재갑,Ryu, Sang-Soo,Kee, Woo-Cheon,Chol, Jae-Kap 대한안면통증구강내과학회 2000 Journal of Oral Medicine and Pain Vol.25 No.1

The authors assessed if there is a relationship between joint effusion and the presence of pain, and between joint effusion and disc displacement in 446 temporomandibular joints of 223 subjects who visited the Department of Oral Medicine, Kyungpook National University Hospital with the complaints of temporomandibular joint problem. The amount of joint effusion and the position of disc were determined from magnetic resonance images of the temporomandibular joints. The position of disc was classified into normal disc position, disc displacement with reduction (DDWR), and disc displacement without reduction (DDWOR). The amount of joint effusion was graded according to the extent of joint area of high signal intensity on T2-weighted MR images. These findings were correlated with one another and statistically analyzed. The results were as follows; 1. The incidence of temporomandibular joint pain Was higher in the joints with higher amount of joint effusion (P<0.001). 2. The proportion of temporomandibular joints with higher amount of effusion increased in the joints with more advanced articular disc displacement (P<0.001).

악관절내장증의 자기공명영상진단 : 악관절조영술과 수술소견과의 비교

김미혜 대한영상의학회 1993 대한영상의학회지 Vol.29 No.4

We retrospectively reviewed the MRI findings of 100 temporomandibular joints in 78 patients who had complained temporomandibular joint dysfunction. MRI findings were classified according to Wilke's staging criteria. And these findings were compared with arthrographic findings in 22 joints and surgical findings in 44 joints. According to Wilkes's staging, they were classified into 6 stages of abnormality : stage 0 (33 cases), stage I (19 cases), stage II(10 cases), stage III (18 cases), stage IV (6 cases), stage V (14 cases), Among the 22 cases in which arthrography and MRI were done, both studies were well correlated in 10joints. In 7 joints, MRI was superior to arthrography, which correctly demonstrated the meniscal displacement in 2 joints and meniscal deformity in 5 joints. In 5 joints, arthrography was superior to MR, which demonstrated the perforation (1 joint), adhesion (2 joints) and recapture of meniscus (2 joints). Compared with surgical findings, MRI correctly demonstrated the displacement of meniscus in all 44 joints. However, in case of the 10 meniscal perforation, MRI demonstrated the meniscal discontinuity in only 4 joints. Retrospective MR findings in 10 proven cases were the defect in posterior attachment in 4, far anterior meniscal displacement without recapture in 8, condylar spur in 4, and close bone to bone contact in 1. In conclusion, MRI as a primary diagnostic modality of temporomandibular joint derangment, is superior for the grading of displacement and deformity of meniscus but inferior for the evaluation of perforation, adhesion and recapture of meniscus to conventional arthrography, In case of the suspected meniscal perforation, arthrographic correlation is recommanded preoperatively.

Comparison of the effects of temporomandibular joint and cervical vertebra treatment on pain and functional improvement in persons with tension-type headaches

Junghyun Kwon,유원종 물리치료재활과학회 2019 Physical therapy rehabilitation science Vol.8 No.4

Objective: The purpose of this study was to evaluate the effects of temporomandibular joint and cervical vertebra treatment in persons with tension-type headaches on pain, tenderness, and functional improvement. Design: Three-group pretest-posttest design. Methods: Subjects with tension-type headaches were divided into the temporomandibular joint and cervical vertebra treatment group (n=11), temporomandibular joint treatment group (n=11), and cervical vertebra treatment group (n=11), and pre- and post-evaluation was performed. The temporomandibular joint treatment group underwent compression massage and joint ply of the muscles around the temporomandibular joint. The cervical vertebra group received deep tendon massage and Myofascial Release of the cervical muscles. The temporomandibular joint and cervical vertebra treatment group performed both types of treatment. Treatment was performed for 50 minutes, three times a week for 4 weeks. Measurement tools included the Korean version of the short form-McGill Pain Questionnaire (SF-MPQ, K), Headache Impact test-6 (HIT-6), Neck Disability Index (NDI), and the Digital Algometer FPX25. Results: The groups showed significant differences in SF-MPQ, HIT-6 test, NDI, and Alogometer FPX25 test scores before and after intervention (p<0.05). The differences between the groups were most significant in the group that received treatment of the temporomandibular joint and cervical vertebra (p<0.05). Conclusions: In this study, the treatment of the temporomandibular joint and cervical vertebra was shown to be effective for improving pain, quality of life, and cervical vertebra in persons with tension-type headaches. This data may be helpful in identifying treatment techniques for tension-type headaches in the future.

Comparison of the effects of temporomandibular joint and cervical vertebra treatment on pain and functional improvement in persons with tension-type headaches

Kwon, Junghyun,Yu, Wonjong korean Academy of Physical Therapy Rehabilitation 2019 Physical therapy rehabilitation science Vol.8 No.4

Objective: The purpose of this study was to evaluate the effects of temporomandibular joint and cervical vertebra treatment in persons with tension-type headaches on pain, tenderness, and functional improvement. Design: Three-group pretest-posttest design. Methods: Subjects with tension-type headaches were divided into the temporomandibular joint and cervical vertebra treatment group (n=11), temporomandibular joint treatment group (n=11), and cervical vertebra treatment group (n=11), and pre- and post-evaluation was performed. The temporomandibular joint treatment group underwent compression massage and joint ply of the muscles around the temporomandibular joint. The cervical vertebra group received deep tendon massage and Myofascial Release of the cervical muscles. The temporomandibular joint and cervical vertebra treatment group performed both types of treatment. Treatment was performed for 50 minutes, three times a week for 4 weeks. Measurement tools included the Korean version of the short form-McGill Pain Questionnaire (SF-MPQ, K), Headache Impact test-6 (HIT-6), Neck Disability Index (NDI), and the Digital Algometer FPX25. Results: The groups showed significant differences in SF-MPQ, HIT-6 test, NDI, and Alogometer FPX25 test scores before and after intervention (p<0.05). The differences between the groups were most significant in the group that received treatment of the temporomandibular joint and cervical vertebra (p<0.05). Conclusions: In this study, the treatment of the temporomandibular joint and cervical vertebra was shown to be effective for improving pain, quality of life, and cervical vertebra in persons with tension-type headaches. This data may be helpful in identifying treatment techniques for tension-type headaches in the future.

악관절 자기공명영상 소견상 Joint Effusion에 관한 연구

김준배(Joon Bae Kim) 대한구강악안면외과학회 1999 대한구강악안면외과학회지 Vol.25 No.1

The purpose of this study was to correlate MR evidence of joint effusion in the temporomandibular joint with disc displacement, disc reducibility, bony change of articular surface, joint pain, muscular tenderness and headache. The temporomandibular joints of 70 TMD patients (94 affected sites and 46 unaffected sites) and 20 asymptomatic volunteers were imaged bilaterally. Sagittal and coronal T1, proton density, and T2-weighted images were obtained. Image findings of joint effusion were correlated with the patholosic changes of articular structures and pain-related symptoms. The results were as follows 1. MR showed effusion in 5.0% of asymptomatic joints, 28.3% of unaffected joints and 54.3% of affected joints. Joint effusion was more prevalent in symptomatic joints than symptom-free joints. 2. Disc displacement was observed 2.8% in asymptomatic joints, 37.0% in unaffected joints and 79.8% in affected joints. Joint effusion was more prevalent in disc-displaced joints and the rate of joint effusion increased according to the severity of disc displacement. 3. Nonreduced disc displacement was observed 2.5% in asymptomatic joints, 15.2% in unaffected joints and 53.2% in affected joints. Joint effusion was more prevalent in the disc-displaced joints without reduction. 4. The bony change of articular surface was observed 6.5% in unaffected joints and 12.8% in affected joints. Joint effusion was more prevalent in articular surface-damaged joints but the rate of joint effusion was high in the affected joints with mild damaged articular surface. 5. Joint effusion was seen in 56.9% of mild painful joints and in 85.7% of moderate to severe painful joint A strong association was seen between joint effusion and moderate to severe joint pain. 6. Joint effusion was seen in 51.2% of the joints with mild muscular tenderness and in 56.6% of the moderate to severe painful joint. There was little difference between the presence and the absence of the muscular tenderness. 7. Joint effusion was seen in 51.7% of the joints without headache and in 58.8% of the joint with headache. There was little difference between the presence and the absence of headache, but joint effusion was seen as a high rate(72.7%) in the joints having moderate to severe headache.

측두하악장애 환자에서 과두크기와 관절융기의 후방경사에 관한연구

박원희,이영수,우순섭,심광섭 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

The purpose of this study was to investigate the interrelationship between temporomandibular joint disorders, and the condyle size and angle of the posterior slope of the articular eminence. The subjects used in this study were 100 patients with temporomandibular joint disorders and 100 volunteers with normal temporomandibular joints. All the patients and the volunteers were subjected to take panoramic and temporomandibular radiographs for the morphologic evaluation. This films were traced, measured, and analyzed. The data were processed with SPSS/PC+package for statistical analysis. The obtained results were as follows : 1. The posterior slope of the articular eminence in the group of temporomandibular joint disorders was larger than that in the normal group (p<0.05). The mean articular eminence angle was 31.6。±6.3 in the group of temporomandibular joint disorder, and 29.9。±8.4 in the normal group. 2. There were no statistically significant differences in the discrepancies of the left and right articular eminence angular measurements between the group (p>0.05). 3. There were no statistically significant differences in the condylar ratio between the groups (p>0.05). 4. There were no statistically significant differences in the discrepancies of the left and right ramus length measurements between the groups (p>0.05). 5. The relative size of condyle to fossa in the group of temporomandibular disorders was smaller than that in the normal group(p<0.05).

축두하악관절판 연골세포증식에 대한 배양액의 비교

한승규,김우경,Mark E. Mason 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

Recent advances in cell culture and tissue engineering permit the successful treatment of deep articular defects with autologous chondrocyte transplantation. While chondrocyte culturing from articular cartilage is commonplace, in vitro growth of chondrocytes from temporomandibular joint fibrocartilage has not been defined. Likewise, the concept of autologous chondrocyte transplantation has not been applied to the temporomandibular joint. Since fibrocartilage differs structurally and functionally from articular cartilage, an effective culturing method for this tissue is essential as well. The ultimate goal of this project is to enable the use of autologous temporomandibular joint chondrocyte transplantation for the regeneration of damaged or missing components of the joint. The aim of this pilot study is to develop an effective cell culturing technique for chondrocytes harvested from the temporomandibular joint disc of dogs. Cartilage of the temporomandibular joint disc of drug-free mongrel dogs was dissected, dissociated, and centrifuged for chondrocyte collection. Blood specimen was collected from the same animal to produce the autologous serum. Chondrocytes were then dispersed in 24-well plates and incubated in one of four media, DMEM (Dulbecco`s modified Eagle`s medium), Ham`s F-12, DMEM/F-12, or Iscove`s MDM(modified Dulbecco`s medium). Each medium was also mixed with either 10% fetal bovine serum or 10% autologous serum. Temporomandibular joint disc chondrocytic proliferation was tested in all the culture media with sera on the fifth day. The initial plating count was held constant throughout at 1×10⁴ cells/well and eight samples were evaluated in each culture. The results demonstrated that fetal bovine serum worked much better than autologous serum in all evaluated media and that DMEM/F-12 mixed with 10% fetal bovine serum was the most optimal culture condition for expansion of temporomandibular joint disc chondrocytes.

TM Joint의 물리치료를 통한 훈련이 모음의 음향학적 특성에 미치는 영향

민동기(Min, Dong-Gi),이재홍(Lee, Jae-Hong) 한국산학기술학회 2011 한국산학기술학회논문지 Vol.12 No.5

턱관절의 물리치료를 통한 훈련으로 모음 조음에 관여하는 구강 공명강을 증가시켜, 턱관절의 정상적 인 발성패턴을 유지하도록 하여 턱관절장애 환자의 모음의 음향학적 특성 변화를 보고자 하였다. 연구 대상은 턱관절장애로 진단 받은 3명의 20∼30대 성인 남자를 대상으로 하였다. 실험방법은 대상자간 중다기초선 설계 를 이용하여 기초선 단계, 치료 단계, 유지 단계로 진행하였다. 치료는 한 회기를 30분으로 하여 주 3회 실시 하였고 3회기를 한 평가단위로 5회의 중간평가를 실시하였다. 평가방법은 Praat 음성 분석프로그램을 이용하여 /ㅏ/ 모음의 연장 발성에 대한 제 1포먼트 주파수(F1), 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)를 분석하 였다. 물리치료를 통한 훈련 프로그램을 실시한 결과 턱관절장애 환자의 제 1포먼트 주파수(F1), 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)는 치료 전 보다 증가하는 변화를 보였고, 이는 모음의 개구도와 관계된 제 1 포먼트 주파수(F1) 뿐만 아니라 모음의 전후설, 성대의 움직임과 관련이 있는 제 2포먼트 주파수(F2) 그리고 기본주파수(F0)의 변화도 함께 보임으로써 턱관절과 모음 및 음성 산출의 연관성을 보여주었다. This study was to examine the change of vowel acoustic characteristics of the temporomandibular joint disorder patients by maintaining normal vocalization pattern of the temporomandibular joint through increasing the range of motion, that was, the oral cavity sonorant cavity of the temporomandibular joint, related to vowel articulation through temporomandibular training using the physical therapy. The subjects of this study were 3 male adults in 20-30s that were diagnosed with temporomandibular joint disorder. As a result of conducting temporomandibular training program using the physical therapy, the 1st Formant Frequency(F1), 2nd Formant Frequency(F2), and Fundamental Frequency(F0) of the temporomandibular joint disorder patients were increased compared to before and this showed the change of the 1st Formant Frequency(F1) related to the open mouth grade of a vowel, as well as the 2nd Formant Frequency(F2), and Fundamental Frequency(F0) related to the front-back of a vowel which shows the relationship between the temporomandibular joint, vowels and voice calculation.

Development and growth of the human fetal sacroiliac joint revisited: a comparison with the temporomandibular joint

Ji Hyun Kim,Zhe Wu Jin,Shogo Hayashi,Gen Murakami,Hiroshi Abe,José Francisco Rodríguez Vázquez 대한해부학회 2023 Anatomy & Cell Biology Vol.56 No.2

The human fetal sacroiliac joint (SIJ) is characterized by unequal development of the paired bones and delayedcavitation. Thus, during the long in utero period, the bony ilium becomes adjacent to the cartilaginous sacrum. This mor­phology may be analogous to that of the temporomandibular joint (TMJ). We examined horizontal histological sections of 24 fetuses at 10–30 weeks and compared the timing and sequences of joint cartilage development, cavitation, and ossification of the ilium. We also examined histological sections of the TMJ and humeroradial joint, because these also contain a disk or disk-like structure. In the ilium, endochondral ossification started in the anterior side of the SIJ, extended posteriorly and reached the joint at 12 weeks GA, and then extended over the joint at 15 weeks GA. Likewise, the joint cartilage appeared at the anterior end of the future SIJ at 12 weeks GA, and extended along the bony ilium posteriorly to cover the entire SIJ at 26 weeks GA. The cavitation started at 15 weeks GA. Therefore, joint cartilage development seemed to follow the ossification of the ilium by extending along the SIJ, and cavitation then occurred. This sequence “ossification, followed by joint cartilage formation, and then cavitation” did not occur in the TMJ or humeroradial joint. The TMJ had a periosteum-like membrane that covered the joint surface, but the humeroradial joint did not. After muscle contraction starts, it is likely that the mechanical stress from the bony ilium induces development of joint cartilage.

성인의 악관절 증상과 요추질환의 관련성

황수현,유지수 한국치위생과학회 2018 치위생과학회지 Vol.18 No.2

The purpose of this study was to examine the association between the symptoms of temporomandibular joint disorders and lumbar diseases in adults when the prevalence rate of osteoarthritis is increasing and to help develop health policies that can improve oral health and health in general. The study used representative data from the 5th Korea National Health and Nutrition Examination Survey phase 3 (2012). In total, we analyzed the data of 3,017 individuals aged over 50 years who participated in the health-related survey and underwent radiography of the lumbar joints. PASW statistics ver. 18.0 was used for analysis. This study revealed the following results: 16.1% experienced at least one symptom of temporomandibular joint disorders within the recent single year, 20.6% experienced lower back pain in the recent three months, and 30.6% had lumbar osteoarthritis revealed using radiography of the lumbar joints. Symptoms of temporomandibular joint disorders, lower back pain, and lumbar osteoarthritis were correlated with each other; the respondents who experienced symptoms of temporomandibular joint disorders had 1.70 times (95% confidence interval [CI], 1.30∼2.22) higher prevalence of lower back pain and 1.20 times (95% CI, 0.86∼1.68) higher prevalence of lumbar osteoarthritis than in those with no such difficulties. The results of this study confirmed that the symptoms of temporomandibular joint disorders affected lumbar diseases in adulthood. Therefore, adequate treatment and prevention of the symptoms of temporomandibular joint disorders in adults is expected to make crucial contributions to decreases in the prevalence rate of lumbar diseases and an improvement in the quality of life.