일부 군인의 스트레스 증상과 구강악습관 및 턱관절 장애의 관련성

김유미 ( Youmi Kim ),채새봄 ( Saebom Chae ) 국군의무사령부 2022 대한군진의학학술지 Vol.53 No.1

Objective: This study is to examine the correlation between oral habits, stress and temporomandibular joint disorders. In addition, this study is to examine the effects of general characteristics, oral habits, and stress on the temporomandibular joint disorders of soldiers, and to examine the difference in the degree of subjective temporomandibular joint pain before and after enlistment. Method: A survey was conducted on 89 soldiers who visited the Armed Forces Goyang Hospital dental clinic with discomfort in the temporomandibular joint disorders. Oral habits, stress, temporomandibular joint disorders, and general characteristics of the subjects were investigated. The exclusion criteria were those receiving temporomandibular joint disorders treatment (drugs, devices, physical therapy, etc.). A questionnaire was distributed to the subjects who agreed to the study, and they were asked to respond in a self-written form. The collected data were analyzed using t-test, paired t-test, oneway ANOVA, correlation tests and multiple regression analysis Results: Oral habits were positively correlated with stress and temporomandibular joint disorders. The factors affecting the temporomandibular joint disorders were teeth grinding and insomnia among the oral habits had a statistically significant effect on the temporomandibular joint disorders. Subjective temporomandibular joint pain increased after enlistment compared to before enlistment. Conclusion: These results indicate that the reduction of oral and oral habits is necessary to lower the prevalence of temporomandibular joint disorder among soldiers. It is necessary to establish a temporomandibular joint prevention education system to control oral and oral habits.

턱관절장애와 관련된 교합변화의 치료

정재광(Jae-Kwang Jung) 대한치과의사협회 2013 대한치과의사협회지 Vol.51 No.2

Temporomandibular joint disorder(TMJD) was mainly characterized with joint pain, motion limitation, joint sound, resulted from pathologic conditions in temporomandibular joint and around tissue. As temporomandibular joint is one of decisive factors determining the occlusion, disorders in temporomandibular joint may cause the occlusal changes. The causes of occlusal changes related with TMJD can be classified into 2 categories; (1) those related to progression of disorder, 2) those related to treatment of the disorder. The clinical manifestation of occlusal changes depend on their causes and affected site. Therefore, whenever possible, treatment should be directed to the relief of the underlying causes. However, it is not always possible to relieve the underlying conditions. Moreover, some occlusal changes may remain irreversible even after the considerable improvement in clinical symptoms. Regarding the treatment of the permanent occlusal changes, it has been reported that the extensive occlusal treatment including occlusal adjustment, prosthodontic treatment, orthodontic treatment should be applied. Here, we present with a case report of occlusal change caused by the progressive temporomandibular joint disorder, together with introducing the intermaxillary traction appliance as the possible treatment option.

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).

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.

측두하악관절장애 환자의 자기공명영상에서 관찰되는 악관절 삼출

고지영,김기덕,박창서 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.2

Purpose : The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods : Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result : Joint effusion was found 8.0% in normal disc position,32.6% in DDcR, and 59.2% in DDsR (83.1% in early state and 23.1% in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4%) (p 〈 0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62,1%)(p〈 0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.(Korean J Oral Maxillofac Radiol 2001;31:73-84)

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.

Temporomandibular Joint Disorders as a Cause of Aural Fullness

Yongxin Peng 대한이비인후과학회 2017 Clinical and Experimental Otorhinolaryngology Vol.10 No.3

Objectives. Temporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint. Methods. One hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, between January 2010 and January 2015. Patients’ medical history indicated that they had previously been diagnosed and treated for otitis media or sensorineural hearing loss but without positive results. Patients were subjected to pure tone audiometry and acoustic immittance screening using GSI-61 clinical audiometer and GSI TympStar middle ear analyzer respectively. Patients were examined by questionnaire, X-ray and/or computed tomography scan of temporomandibular joint. TMD was categorized according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were then treated for TMD. Results. All the patients showed normal eardrum and type A tympanogram. The patients of 60.7% (68/112) were classified as group I TMD disorders (muscle disorders), 34.8% (39/112) were group II (disc displacements), and 4.5% (5/112) were group III (arthralgia, osteoarthritis, and osteoarthrosis). Aural fullness was completely resolved or significantly improved in 67 and 34 patients respectively following treatments aimed at improving TMD, with a combined effectiveness of 90.2% (101/112). TMD treatments are especially effective (94.1%) in group I TMD. Conclusion. TMD as a potential cause of aural fullness should be considered in otolaryngology practice.

측두하악관절 장애 환자의 임상증상과 자기공명영상에 관한 비교 연구

최용석,황의환,이상래,Choi Yong-Suk,Hwang Eui-Hwan,Lee Sang-Rae 대한영상치의학회 2003 Imaging Science in Dentistry Vol.33 No.2

Purpose : To determine the relationship between clinical symptoms and magnetic resoncance (MR) images in patients presenting with temoporomandibular joint (TMJ) disorders. Materials and Methods: This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. Results : There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. Conclusion: In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joints did not necessarily imply that the joints are normal according to MR image findings.

이출혈을 동반한 측두하악관절염 1예

강민영,정성욱,김대철 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.4

Temporomandibular joint disorder (TMD) is a generic term used for any problem concerning the jaw joint. The clinical signs of TMD are crepitus associated with movement, restriction of jaw movements, and pain within the joint cavity. But ear bleeding and an external auditory canal (EAC) mass as presenting symptoms are rare. We report the case of 78-year-old man with TMD, whose initial symptoms were ear bleeding, and temporomandibular pain intensifying when he is chewing, accompanied by an EAC mass. Physical examination revealed a reddish mass that originated from the anterior wall of EAC and bled when touched. Computed tomography showed a mass with soft tissue density and a bony defect in the anterior EAC wall. After conducting arthrocentesis and lavage repetitively, the wound was healed completely. It is likely that the patient’s ear bleeding was due to patent foramen of Huschke or erosion of the anterior wall of EAC due to temporomandibular joint inflammation. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4):274-8

Infection of the temporomandibular joint: a report of three cases

Hyung-Mo Kim,Tae-Wan Kim,Ju-Hong Hwang,Dong-Joo Lee,Na-Rae Park,Seung-Il Song 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.6

An intracapsular and pericapsular infection of the temporomandibular joint (TMJ) is rare. The invasion of bacteria into the joint space can occur through several routes. Among them, hematogenous spread is most common. This report describes three cases of abscess formation in the TMJ (intracapsular and pericapsular infection). The patients were treated with supportive care and surgical intervention (incision and drainage) under hospitalization, and their symptoms had improved. Pain of the TMJ is a typical symptom of temporomandibular joint disorders (TMD). On the other hand, an infection of the TMJ can also cause pain on the affected side, and can be misdiagnosed as routine TMD. Therefore, the possibility of an infection of the TMJ cavity should be considered when treating TMD.