본 연구에서는 3D 프린팅 기술과 인체공학 순설계를 이용하여 턱관절 자기공명영상 동적 턱관절 검사 보조기구를 개발하고자 하였다. 3D 프린팅 기술 재료는 3D 프린터(Sindo, 3DWOX1, Korea), 3D 모델러 프로그램(Fusion 360, autodesk, USA), PLA(polylactic Acid) 필라멘트 소재를 이용하였고, 영상 검사는 3.0T 자기공명영상 장비 (Magnetom Vida, Siemens, Germany)를 사용하였다. 개발 방법은 성인 30명(남:13명, 여:17명, 평균나이 22.9±2.0세)의 안면뼈 CT(computed tomography) 검사의 단면 영상을 역학적으로 실측하여 상/하악궁의 형상을 모델링하였다. 모델링된 파일은 FDM(fused deposition modeling) 방식으로 3D 프린팅하였다. 출력된 보조기구는 자화 감수성 인공물 실험, 동적 영상 비교, 만족도 평가로 성능을 평가하였다. 그 결과, 자화감수성 인공물 발생은 개발된 개구 보조 장비와 비교하여 모든 영상에서 유의한 차이가 없었다. 동적 비교 영상에서는 TSE 기법이 모든 평가 법에서 가장 우수한 영상 품질을 보였다. 만족도 평가에서는 피검자는 평균 4.3점, 방사선사는 평균 4.4점으로 높은 만족도를 보였다. 결론적으로 인공물 발생이 없는 환자 맞춤형 보조기구에 개구의 동적 기능이 탑재된 보조기구 를 개발하였다.

Synovial cysts of the temporomandibular joint are rare. They commonly occur in the wrist, knee and feet. The main symptoms of synovial cysts occurring in the temporomandibular joint include preauricular pain and swelling, and surgical removal is the gold-standard treatment. A 54-year-old woman who presented with swelling of the right temporomandibular joint visited Kyungpook National University Dental Hospital. She had undergone enhanced computed tomography from another hospital, which showed a 1.1 × 0.8 × 1 cm well-defined rounded cystic lesion on the lateral area of the right temporomandibular joint. A synovial or ganglion cyst was suspected. The cystic lesion was surgically removed under general anesthesia and was histopathologically diagnosed as a synovial cyst. Histopathological findings show a lumen surrounded by loose fibrous tissue, and the lining is in a folded form and is composed of synovial cells.

Leiomyoma is a Benign tumor that develops in smooth muscles and is known to occur more in women in age between 40s and 50s. The most common site of leiomyoma is uterine (95 %). It occurred in oral region is very rare about 0.065 % and usually developed in upper and lower lips, palatal site, buccal site and tongues. The prognosis of leiomyoma is very positive. The recurrence rate is extremely low to 2 % below. In present study, we report a 78 year old female with a lesion located in temporomandibular joint cavity which was suspected as a malignant tumor. Additionally, this paper reports contains a literature review of oral leiomyoma. Rare location with painless leiomyoma of present case will be considered to be caution.

Synovial cysts are found mainly in periarticular areas of the wrist, ankle, and knee, but also rarely in the temporomandibular joint (TMJ). Only 1 case of bilateral synovial cysts in the region of the TMJ has been reported. This case report described bilateral cysts in the TMJ in a 54-year-old Korean woman. T2-weighted magnetic resonance imaging (MRI) revealed bilateral oval cystic lesions lateral to the condylar capsule, whereas computed tomography (CT) apparently did not show the right hand side lesion. The cyst on the left side was surgically excised, and fine needle aspiration was performed on the right hand cyst. After 24 months, the long term follow-up showed no sign of recurrence.

Background: In the treatment of temporomandibular joint (TMJ) disorder, the goals of traditional physical therapy are not only to reduce the inflammatory process leading to pain, but also to decrease joint overload and muscle hyperactivity. To achieve those goals, physical therapists generally use a photo-therapy, joint mobilization, and massage. Objects: To examine the impact of an unloading technique using non-elastic taping on the pain, opening mouth, functional level, and quality of life in patients with TMJ disorder. Method: Twenty patients with TMJ disorder were included in this study and randomly divided into the experimental (n1=10), and control (n2=10) groups. Traditional physical therapy including massage and stretching for 30 min was performed in both groups. Non-elastic taping was performed in the experimental group after traditional physical therapy, and they were recommended to keep the tape attached for 12 hours. Outcomes for pain, functional level, and quality of life were measured using a survey. The opening mouth was measured using a general ruler. Result: Significant differences were observed in the pain level, opening mouth, functional level, and quality of life after the intervention and on follow-up in both groups. However, we found that while the levels of all parameters were maintained throughout the follow-up period in the experimental group, the functional status level was not maintained throughout the follow-up period in the control group. Conclusion: Our unloading technique using non-elastic tape results comparable to those achieved by traditional physical therapy in the treatment of TMJ. However, the unloading taping method using non-elastic tape is more effective than traditional physical therapy in maintaining the impact of intervention

This study was to investigate the needs of the functional abnormality of the Temporomandibular joint. The purpose of this study was to find out basic concept for the Chiropractic-care necessity of the neuromuscular skeletal patients with functional abnormality of the temporomandibular joint. I evaluated the change of the range of motion, neck pain, headache by post xray, orthopedic test and patient's charts. The range of motion at temporomandibular joint was improved and the necessity of chiropractic care was recognized in the neuromuscular skeletal patients with having temporomandibular joint problems.

The purpose of this study is to identify the level of masseter muscle tension according to the levels of restricted movement and pain in the temporomandibular joint(TMJ), thereby verifying the fact that excessive masseter muscle tension can be a cause for restricted movement and pain in the TMJ. The subjects of this study were 81 men and women in their 20s and 30s, who feel uncomfortable with their masticatory function on the preferred chewing side. The subjects were measured in terms of the range of motion (ROM) and deviation of the TMJ and the degree of pain in the affected region. The ROM and deviation of the TMJ were measured using the Global Posture System(GPS) after instructing each subject to open his/her mouth to the fullest and taking photos of the subject with a digital camera. The tension of the masseter muscle was measured with a Pressure Threshold Meter(PTM). After the measurements, in order to compare the ROM of the TMJ, the subjects were divided into two groups based on the ROM of above 35mm and below 35mm. For the deviation and pain, based on the average of total subjects, the subjects were divided into two groups of above and below average. Thereafter, the levels of masseter muscle tension were compared between each pair of groups. According to the results, when each variable was compared between the respective two groups, in terms of the deviation, the pressure pain threshold(PPT) of the masseter muscle revealed a statistically significant difference(p<.05). However, the ROM and pain showed no statistically significant difference. Consequently, masseter muscle tension may cause restricted movement in the TMJ. In particular, the deviation and tension in the masseter muscle is considered to be a factor that causes deviation in the TMJ.

Both synovial cysts and synovial chondromatoses originate from synovial tissue, and only one case has been reported to occur simultaneously in a patient. Our patient presented with a swelling of the right preauricular area and pain on opening the mouth. Magnetic resonance images demonstrated two cystic structures in the superficial lobe of right parotid gland. Under the clinical impression of a cyst in the salivary gland, an enucleation was performed. However, the final diagnosis based on microscopic examination was a synovial cyst associated with the right temporomandibular joint and a synovial chondromatosis arising within the cystic wall. Awareness of this combined lesion will help make a diagnosis and establish a proper treatment plan.

We investigated the role of the central MAPK pathways in extra-territorial (referred) pain resulting from inflammation of the temporomandibular joint (TMJ). Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Under anesthesia, these animals were injected with 50 μL of complete Freund's adjuvant (CFA) into the TMJ using a Hamilton syringe. In the control group, saline was injected into the TMJ. To identify the extent of inflammation of the TMJ, Evans blue dye (0.1%, 5 mg/kg) was injected intravenously at 1, 3, 6, 9, 12 and 15 days after CFA injection. The concentration of Evans blue dye in the extracted TMJ tissue was found to be significantly higher in the CFA-treated animals than in the saline-treated group. Air-puff thresholds in the vibrissa pad area were evaluated 3 days before and at 3, 6, 9, 12, 15 and 18 days after CFA injection into the TMJ. Referred mechanical allodynia was established at 3 days, remained until 12 days, and recovered to preoperative levels at 18 days after CFA injection. This referred mechanical allodynia was observed in contralateral side area. To investigate the role of central MAPK pathways, MAPK inhibitors (10 μg) were administrated intracisternally 9 days after CFA injection. SB203580, a p38 MAPK inhibitor, significantly attenuated referred mechanical allodynia, as compared with the vehicle group. PD98059, a MEK inhibitor, also reduced CFA-induced referred mechanical allodynia. These results suggest that TMJ inflammation produces extra-territorial mechanical allodynia, and that this is mediated by central MAPK pathways.

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

It has been well known that excitatory amino acids, primarily glutamate, are involved in the transmission of nociception in pathological and physiological conditions in the spinal and brainstem level. Recently, peripheral glutamate also play a critical role in the peripheral nociceptive transmissions. The present study investigated the role of N-methyl-D-aspartic acid (NMDA) or non-NMDA ionotropic glutamate receptors in formalin-induced TMJ pain. Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Intra-articular injection was performed under halothane anesthesia. Under anesthesia, AP-7 (10, 100μM, 1mM/20 μL), a NMDA receptor antagonist, or CNQX disodium salt (0.5, 5, 50, 500 μM/20 μL), a non-NMDA receptor antagonist, were administered intra-articularly 10 min prior to the application of 5% formalin. For each animal, the number of behavioral responses, such as rubbing and/or scratching the TMJ region, was recorded for nine successive 5-min intervals. Intra-articular pretreatment with 1 mM of AP-7 or 50 μM CNQX significantly decreased the formalin-induced scratching behavioral responses during the second phase. Intra-articular pretreatment with 500μM of CNQX significantly decreased the formalin-induced scratching behavior during both the first and the second phase. These results indicate that the intra-articular administration of NMDA or non-NMDA receptor antagonists inhibit formalin-induced TMJ nociception, and peripheral ionotropic glutamate receptors may play an important role in the TMJ nociception.

The temporomandibular joint (TMJ) showed characteristic anatomy and functions contrast to the other joints. In particular, children or young adolescent with the progressive temporomandibular disorder (TMD) showed remarkable changes in their mandibular growth and occlusion. The purpose of this study was to elucidate the functional and biomechanical causes for the maxillofacial deformities of TMD. A typocranial experiment was performed using a plastic skull model by simulating the mandibular movement after condylectomy. The directional forces of masticatory and suprahyoid muscles were reproduced on the typocranial skull model by elastics connecting between mandible and adjacent bony structures. Resultantly, the mandible of unilaterally or bilaterally condylectomized mandible was rotated downward and backward by the activation of masticatory and suprahyoid muscles. When unilaterally or bilaterally condylectomized mandible was activated by masticatory, suprahyoid and perioral muscles, the mandible was less rotated downward and backward than the cases activated by masticatory and suprahyoid muscles only. In the typocranial experiment after unilateral condylectomy the mandible was rapidly deviated toward the affected side, but this deviation was much reduced when the mandible was intensely supported by perioral muscles. By the compensatory response against the overload of TMJ due to the mandible body resection the typocranial experiment also produced the deepening of antegonial notch by the increased force of mylohyoid and perioral muscles. These findings suggest that after condylectomy the posterior fibers of mylohyoid and perioral muscles become hypertrophic and induce the characteristic mandibular deformities, i.e., deepening of antegonial notch and bowing of posterior ramus, which are similar to the mandibular changes in the progressive TMD.

Osteoarthrosis in TMJ is known to accompany characteristic features of the craniofacial malformation and malocclusion. In order to explain the mechanism that brings about the typical mandibular changes relating to the frequent clinical symptom, i.e., the limited mouth opening in TMJ patients. The present study investigated the mandibular morphology of the rabbit, also intentional TMJ osteoarthrosis was performed on the TMJ of the rabbits and their morphological changes were observed. A total of 12 New Zealand house rabbits weighing an average of 3 kgwere used and all left side joints were surgically meniscectomized and right side joints were used as controls. The rabbits were sacrificed in one week, two weeks, one month, three months and 5 months after the menisectomy, and the removed TMJs were examined by histological and radiographical methods and analyzed statistically. It was found that the mandibular morphology caused by osteoarthritis in the TMJ was characterized by the decrease in size of the ascending ramus, posterior ramus bowing, deep antegonial notch and thickening of the cortex in inferior and posterior borders of the mandible, that the similar features were also observed in the rabbit mandible. When the menisectomy was performed in the unilateral side of rabbit TMJ, the mandibular changes including the increased depth of antegonial notch and posterior ramus bowing occurred only on the affected side. These data suggested that the limitation of the mandibular movement and altered masticatory pattern by meniscectomy affects the structural remodeling of the mandible and TMJ likely the TMJ osteoarthrosis

This paper offers an approach to physical therapy and rehabilitation procedure for the temporomandibular joint dysfunction (TMD). Forms of physical therapy are used in the treatment of chronic musculoskeletal pain conditions that include TMD joint disorders. However, there still remains a void in the study as to the various rehabilitative protocols used on those patients with TMD. Recent evidence in clinical trials show that physical therapy is helpful for patients with TMD. Exercise programs designed to improve physical fitness had beneficial effects on TMD pain and dysfunction. This study establishes treatment procedures of physical therapy and provides a method of evaluation for patients with TMD disorders.

The purposes of this study were to assess the effect of therapeutic exercise and to offer an approach to the physical therapy and rehabilitation procedure of the temporomandibular joint (TMJ) following surgery. In this research, 42 patients with TMJ surgery were assigned one of two groups. The experimental group included 21 patients who performed therapeutic exercise, and the control group included 21 patients who did not perform therapeutic exercise. Conservative therapy such as an ice pack, a hot pack, and pulsed ultrasound was applied to both groups. Treatment was applied twice a day during the admission period and, after discharge, everyday for six weeks. Visual analogue scale (VAS), incisal biting force, and joint ROM were measured before surgery and at 30 days after surgery. The results were as follows: VAS (p<0.05), mouth opening (p<0.01), lateral excursion to unaffected side (p<0.05), and protrusion (p<0.05) between experimental group and control group showed statistically significant differences. Incisal biting force and lateral excursion to affected side between experimental group and control group showed no statistically significant difference.