백서 하악골의 기능적 전방위가 악관절 원판에 미치는 영향

장병천(Byung-Chun Jang),경희문(Hee-Moon Kyung),성재현(Jae-Hyun Sung),배용철(Yong-Chul Bae) 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.4

This study was conducted to examine the changes in the shape of the Sprague-Dawley rats´ articular disk following postural hyperpropulsion by observing their articular specimens through light and electronic microscopes after following 2-week and 4-week postural hyperpropulsion from their four weeks of age. The findings of this study are summarized as follows, It was shown that as compared with the control group, the experimental group indicated a significant increase in thickness of the 2-week groups´ anterior and postreior portion of the articular disc. The experimental group showed statistically more significant increase in thickness of the 4-week groups´ anterior portion of the articular disc than the control group. Light micrograph showed that the experimental group had more fibroblast in the anterior portion of the 2-week and 4-week groups than the comparing group. The 2-week groups showed in the findings through the electronic microscope that there were found the well developed and dilated HER which seems to actively synthesize the extracellular matrix including collagen, the cells with the well developed RER without distention which seems to actively synthesize the intracellular microfilaments due to the well developed free ribosome, and the typical chondroid cells. In addition, there was more fibroblast cell with the distended and well developed RER in the anterior area of the experimental group than that of the control group. The 4 week experimental group´s anterior area of the disk had more cells than that of the control group while fibroblast with the well developed RER and free ribosome was quite abundant. Based on the above result of this study, it was shown that the functional hyperpropulsion of the mandible causes the changes in the nature of the mechanical load to the certain portion of the articular disk. As a result, it seems that there may be occurred some changes in morphology of the disc by adaptation or confrontation with these changes at the cellular level.

백서 하악골의 기능적 전방위가 악관절 원판에 미치는 영향

배용철,경희문,장병천,성재현 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.4

This study was conducted to examine the changes in the shape of the Sprague-Dawley rats' articular disk following postural hyperpropulsion by observing their articular specimens through light and electronic microscopes after following 2-week and 4-week postural hyperpropulsion from their four weeks of age. The findings of this study are summarized as follow. It was shown that as compared with the control group, the experimental group indicated a significant increase in thickness of the 2-week groups' anterior and posterior portion of the articular disc. The experimental group showed statistically more significant increase in thickness of the 4-week groups' anterior portion of the articular disc than the control group. Light micrograph showed that the experimental group had more fibroblast in the anterior portion of the 2-week and 4-week groups than the comparing group. The 2-week groups showed in the findings through the electronic microscope that there were found the well developed and dilated RER which see-ms to actively synthesize the extracellular matrix including collagen, the cells with the well developed RER without distention which seems to actively synthesize the intracellular microfilaments due to the well developed free ribosome, and the typical chondroid cells. In addition, there was more fibroblast cell with the distended and well developed RER in the anterior area of the experimental group than that of the control group while fibroblast with the well developed RER and free ribosome was quite abundat. Based on the above result of this study, it was shown that the functional hyperpropulsion of the mandible causes the changes in the nature of the mechanical load to the certain portion of the articular disk. As a result, it seems that there may be occurred some changes in morphology of the disc by adaptation or confrontation with these changes at the cellular level.

양측성 및 편측성 이악물기시 상하악골 응력변화 및 변위에 관한 3차원 유한요소법적 연구

허훈,강동완,Heo, Hoon,Kang, Dong-Wan 대한치과보철학회 1999 대한치과보철학회지 Vol.37 No.1

This study is to analyze the stress and displacement on the jaws during the bilateral and unilateral clenching task on three dimensional finite element model of the dentated skull. For this study, the computed tomography(G.E.8800 Quick, USA) was used to scan the total length of human skull in the frontal plane at 1.9mm intervals. The CAD data were extracted from the tomograms through digitizer(Summa Sketch III, USA) and then reconstructed by means of the spline method in the CAD program. In this project, a commercial software I-DEAS(Master Series ver-sion 3.0, SDRC Inc, USA) was used for three-dimensional stress analysis on the finite element model. which consists of articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. The results are as follows. ; 1. During the bilateral clenching, each major muscle forces caused high stresses on various areas of skull: masseter muscle on articular disc and teeth ; temporal muscle on mandible and periodontal ligament ; medial pterygoid muscle on the temporomandibular joint. During the unilateral clenching, masseter muscle induced the maximum stress ; medial pterygoid muscle the minimum stress. 2. During the bilateral clenching, higher compressive stresses on articular disc were generated by the masseter muscle and higher deformation occurred on the most front outer sites. And during the unilateral clenching, temporal muscle and medial pterygoid muscle exerted their forces to twist temporomandibular joint area of the balancing side and induced a higher compressive stresses on the front outer sites of articular disc. 3. During the bilateral clenching, the masseter muscle bended the mandible outwardly, and then caused tensile stresses on the lingual surface of mandibular symphysis. And the medial pterygoid muscle caused tensile stresses on the labial surface of mandibular symphysis. 4. When each muscles were simultaneously applied on jaws, a high stress and displacement took place on mandible rather than on the maxilla. Also, a high stress and displacement took place during the unilateral clenching rather than during the bilateral clenching.

가토의 측두하악관절원판 결손에서 간세포 성장인자가 치유에 미치는 영향

김복주,성화식,김철훈,김규천,황희성,신상훈,Kim, Bok-Joo,Seong, Hwa-Sik,Kim, Chul-Hoon,Kim, Gyoo-Cheon,Hwang, Hee-Sung,Shin, Sang-Hun 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.1

Purpose: The purpose of this study is to investigate the therapeutic use of Hepatocyte growth factor(Adv.CMV.HGF) in temporomandibular joint disc defect. Materials and methods: Twelve New Zealand white rabbits, weighing 2.5 - 3.0 kg, were used in this experiment. Defects(2 mm in diameter) were created in their TMJ discs. Recombinant Adv.CMV.HGF with gelatin sponge($Gelfoam^{(R)}$) as carrier was implanted in the defects. We divided the rabbits into four batches according to the duration of the implantation - of 1, 4, 8, 12 weeks - and both left and right TMJ of each rabbit in all groups were used in the research : left joints were used as experiment group and right were control group. Each batch of rabbits was killed one, four, eight and twelve weeks after the experimentation respectively, and called Group A, B, C, and D. (Group A = 1 wk, B = 4 wks, C = 8 wks, and D = 12 wks) Results: The experimental group showed a significant increase in the number of chondroblasts and active cell differentiation at the margin of the defects. Compared to the control group, in the experiment group chondroblasts increased and chondrocytes showed a columnar arrangement, which is witnessed at the time of cell differentiation. Conclusion: This study supports the case that Avd.CMV.HGF may be useful in the repair of articular disc of the rabbit TMJ.

가령에 따른 백서 악관절 원판의 형태 및 미세구조적 변화

배용철,성재현,경희문,서혜경 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.2

백서에 있어서 가령에 따라 악관절 원판에 가하여지는 기계적 부하의 변화에 따른 악관절 원판의 형태, 탄성섬유 및 세포의 미세구조의 적응등의 변화양상을 관찰하기 위하여, 생후 1일, 7일, 17일, 27일, 55일, 1년 이상군의 백서의 악관절 부위를 적출하여 광학 및 전자현미경으로 관찰하여 다음과 같은 결론을 얻었다. 악관절 원판의 형태는 1일 및 7일군에서는 중앙부의 얇은 부위가 전후방으로 상당히 길게 뻗쳐 있고 전부 및 후부의 최대 풍융부를 향한 경사가 완만하여 하악와 및 하악과두에 적합되지 않는 양상을 보였으나, 17일군부터는 전부 및 후부가 하악와쪽으로 풍융해짐과 동시에 중앙부의 얇은 부위가 전후방으로 좁아지고 전부 및 후부의 최대 풍융부를 향한 경사가 급하여져, 악관절 원판이 하악과두를 감싸는 형태를 취하여 하악와 및 하악과두에 적합되어 가는 양상을 보였다. 가령에 따라 세포밀도는 점점 감소하였으며, 1일 및7일군에서는 세포내 골지장치, 과립성 내형질망, 유리 리보솜 등의 세포질 및 세포간 기질을 활발하게 합성하는 세포 소기관들이 발달 되어 있었으나 세포질내 세사는 발달되어 있지 않았다. 17일, 27일 및 55일에서는 기질합성에 관여하는 세포 소기관의 발달과 아울러 손가락 모양의 세포돌기, 용해소체, 사립체등의 세포간 기질의 개조에 관여하는 세포 소기관이 발달된 세포가 다수 관찰되었으며, 가령에 따라서 세포질내 세사가 점점 축적되어지는 양상을 보였고, 섬유성 물질에 둘러 싸인 chondroid cell들이 증가하였다. 1년이상군에서는 대부분이 세포가 chondroid cell로 구성되어 있었으며 세포질내의 대부분을 세사가 차지하고 세포내 소기관이 거의 발달되지 않는 등 대사 활동이 미약하며 주로 기계적 부하에 적응하기 위한 구조로 이루어져 있었으며 때로는 변성과정에 있는 세포도 다소 관찰되었다. The purpose of this study was to investigate changes in the shape and ultrastructrue of the articular disc of the rat mandibular joint with aging. Mechanical stress applied to the articular disc changes during neonatal, suckling, juvenile, adult and senile stages. Mandibular joints of 6 groups of rats (1-,7-,17-,27-,55-day and over-1-year groups) were removed en bloc and processed for light and electro microscopic study. The changes in the shape of articular disc were examined by light microscope in each group. Structural and ultrastructural changes in the articular disc were examined by light and electron microscope in each group. The results were as follows: In the 1-day and 7-day groups, the articular disc was long and slender in shape and the articular disc was not fitted with the shape of the mandibular fossa and condyle. However, after that time, the anterior and posterior portions of the articular disc were more bulged and the middle portion was shorter and biconcave. Thus the articuler disc was well fitted with the shape of the mandibular fossa and condyle. The cell density decreased wth aging. In the 1-day and 7-day groups, the Golgi apparatus, rough endoplasmic reticulum and free ribosome, which are involved in the synthesis of intracellular and extracellular matrix. were developed. In the 17-day, 27-day and 55-day groups, not only the cell organelles involved in the synthesis of the intracellular and exracellular matrix but also the cell organelles involved in the remodeling of the extracellular matrix(i.e., finger-like cell process, lysosome and mitochondria) were well developed. With advancing age, intracytoplasmic microfilaments were more accumulated and condroid cells increased. In the over-1-year group, the majority of cells of the articular disc were chondroid cells. The majority of cytoplasmic compartment were filled with intracytoplasmic microfilaments and cell organelles were not developed. Therefore, metabolic activites of the cell was markedly reduced and cells contained structures enduring mechanical stress, and cells which were in the process of degeneration were observed occasionally.

자기공명영상사진 상에 나타난 측두하악관절원판의 형태 및 그에 따른 치료 효과의 분석

권진학,기우천,최재갑,Kwon, Jin-Hak,Kee, Woo-Cheon,Chol, Jae-Kap 대한안면통증구강내과학회 2000 Journal of Oral Medicine and Pain Vol.25 No.1

The purposes of the study were (1) to see if there are various types of disc configuration in normal temporomandibular joint and, if so, (2) to examine whether a specific type of disc configuration is susceptible to disc displacement, and (3) to see if a specific type of disc configuration and position is related to early relief of clinical symptoms from the anterior disc displacement without reduction to conservative treatment. From the magnetic resonance (MR) images taken for the patients with symptoms of temporomandibular disorders, 235 images as normal joint group, 255 images as anterior disc displacement with reduction group, and 249 images as anterior disc displacement without reduction group were selected, After the TMJ image was scanned and processed with Photoshop program, the disc configuration was determined, The incidence of various types of disc configuration was analyzed according to age, sex, diagnostic group, and the promptness of symptom relief. The disc position was also examined in relation to the promptness of symptom relief. The results were as follows : 1. In the normal joint group, biconcave type appeared most frequently and reversed, biplanar type in order, Posterior band enlarged and folded type didn't appear at all. On the other hand, in the anterior disc displacement without reduction group, folded type appeared most frequently and also posterior band enlarged type were found often. 2. There were statistically significant differences between sex and configuration of disc in the normal joint group and no statistically significant differences in the anterior disc displacement with reduction group and anterior disc displacement without reduction group, 3. There were no statistically significant differences between age and configuration of disc in the normal, anterior disc displacement with reduction group and anterior disc displacement without reduction group. 4. In anterior disc displacement without reduction group, rapid response was observed in biconcave and reversed type and delayed response was observed in folded type.

The influence of disc wear on the behavior of the temporomandibular joint: a finite element analysis in a specific case

Duarte, Ricardo J.,Ramos, Antonio,Mesnard, Michel Techno-Press 2014 Advances in biomechanics & applications Vol.1 No.3

The aim of this study was to evaluate the influence of disc thickness on the normal behavior of the temporomandibular joint. Based on a specific patient case, CT scan images showing accentuated wear in the right disc were reconstructed and the geometrical and finite element model of the temporomandibular joint structures (cranium, mandible, articular cartilages and articular discs) was developed. The loads applied in this study were referent to the five most relevant muscular forces acting on the temporomandibular joint during daily tasks such as talking or eating. We observed that the left side structures of the temporomandibular joint (cranium, mandible and articular disc) were the most affected as a consequence of the wear on the opposite articular disc (right side). From these results, it was possible to evaluate the differences in the two sides of the joint and understand how a damaged articular disc influences the behavior of this joint and the possible consequences that can arise without treatment.

손목관절 관절원반의 퇴행변화 및 발달뼈의 안쪽관절면에 관한 연구

이규석,정인혁 관동대학교 의과학연구소 2001 關東醫大學術誌 Vol.5 No.1

This study was performed to observe the degenerative changes of the articular disc of the wrist joint and the medial facet of the lunate. The anteroposterior length of the articular disc was 15.3±2.2mm, the width was 10.6±1.1mm and the thickness was 1.5 ±0.3mm at the central portion, 4.7±0.9mm at the peripheral portion. The degenerative changes were appeared as perforation and the incidence was 68.9%. The perforation classified into the three types. Type I is the tearing perforation and the incidence was 33.3%. Type II is the widespread perforation and the incidence was 31.1%. Type III is round perforation and the incidence was 4.5%. The medial facet of the lunate was a variation of carpal bones. The articular facet was formed between lunate and hamate and the incidence was 62.2%. The width of the facet was 3.5(1.0-5.9)mm in average. The articular facet undergo the degenerative changes as the erode of the articular cartilage. The incidence of these erode occurs 10.7% at lunate, 14.3% at hamate,14.3% at both carpal bones.

Effect of Platelet-Rich Fibrin on Repair of Defect in the Articular Disc in Rabbit Temporomandibular Joint by Platelet-Rich Fibrin

( Hyun Su Baek ),( Hye Sung Lee ),( Bok Joo Kim ),( In Kyo Chung ),( Chul Hoon Kim ),( Sun Mi Jin ),( Hie Sung Hwang ),( Sang Hun Shin2 ) 한국조직공학·재생의학회 2011 조직공학과 재생의학 Vol.8 No.6

The objective of this study was to evaluate platelet-rich fibrin (PRF)’s effectiveness in repairing articular disc defect in the temporomandibular joint (TMJ) of rabbits. Eight rabbits were divided into four groups of two rabbits each, corresponding to groups A, B, C, and D. Both TMJs of all of the rabbits were used in the experiments: the right joints comprised the experimental groups, and the left ones, the control groups. The disc defect was circular and 2 mm in diameter. In the experimental groups, the PRF was compressed into the defect, whereas the control group defects were left untreated. A, B, C, and D groups were sacrificed at the 1st, 2nd, 4th and 6th weeks, respectively. The defects of each control group exhibited no specific changes. Contrastingly, in each experimental group, there was an increased number of chondroblasts at the margins of the defects, along with accelerated cell differentiation and a columnar cell arrangement observable at the time of cell differentiation. The experimental groups showed inflammatory cell infiltrations and fibrosis by the 1st week, maturation of chondrocytes by the 2nd week, and proliferation by the 4th week, after which the defects began to be filled with chondrocytes, a process that was complete after the 6th week. In the histological evaluation (H-E), the experimental groups showed significant increases of chondroblasts after the 2nd and 4th weeks, as well as regular columns of chondrocyte arrays observable during cell division. After 6 weeks, the defects were filled with chondrocytes.

Immediate Effect of Flexion-Distraction Spinal Manipulation on Intervertebral Height, Pain, and Spine Mobility in Patients with Lumbar Degenerative Disc Disease

피태진(Taejin Pi),정이정(Yijung Chung) 물리치료재활과학회 2021 Physical therapy rehabilitation science Vol.10 No.2

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebralheight, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group designMethods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into twogroups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distractionspinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental groupfor 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed usingvisual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight legraise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility(p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05),and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing painand improving function in patients with degenerative disc disease.