he Magnetic. resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.
Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

Humans ; Temporomandibular Joint Disorders ; diagnosis ; therapy

Chondromatosis, Synovial ; diagnosis ; therapy ; Humans ; Temporomandibular Joint Disorders ; diagnosis ; therapy

PURPOSE: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. METHODS: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. RESULTS: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. CONCLUSIONS: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.
Chronic Periodontitis* ; Diagnosis ; Humans ; Mastication* ; Osteoarthritis ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Temporomandibular Joint ; Temporomandibular Joint Disorders*

PURPOSE: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. MATERIALS AND EMTHODS: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. RESULTS: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. CONCLUSION: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.
Bruxism ; Diagnosis ; Dislocations* ; Humans ; Mouth ; Splints ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

PURPOSE: Most of the reports on instrumentalists' experiences of temporomandibular disorders (TMD) have been reported not by clinical examinations but by subjective questionnaires. The aim of this study was to investigate the clinical signs and subjective symptoms of TMD in a large number of instrumentalists objectively. MATERIALS AND METHODS: A total of 739 musicians from a diverse range of instrument groups completed a TMD questionnaire. Among those who reported at least one symptom of TMD, 71 volunteers underwent clinical examinations and radiography for diag-nosis. RESULTS: Overall, 453 participants (61.3%) reported having one or more symptoms of TMD. The most frequently reported symptom was a clicking or popping sound, followed by temporomandibular joint (TMJ) pain, muscle pain, crepitus, and mouth opening limitations. Compared with lower-string instrumentalists, a clicking or popping sound was about 1.8 and 2 times more frequent in woodwind and brass instrumentalists, respectively. TMJ pain was about 3.2, 2.8, and 3.2 times more frequent in upper-string, woodwind, and brass instrumentalists, respectively. Muscle pain was about 1.5 times more frequent in instrumentalists with an elevated arm position than in those with a neutral arm position. The most frequent diagnosis was myalgia or myofascial pain (MFP), followed by disc displacement with reduction. Myalgia or MFP was 4.6 times more frequent in those practicing for no less than 3.5 hours daily than in those practicing for less than 3.5 hours. CONCLUSION: The results indicate that playing instruments can play a contributory role in the development of TMD.
Arm ; Diagnosis ; Mouth ; Myalgia ; Radiography ; Temporomandibular Joint ; Temporomandibular Joint Disorders* ; Volunteers

PURPOSE: Most of the reports on instrumentalists' experiences of temporomandibular disorders (TMD) have been reported not by clinical examinations but by subjective questionnaires. The aim of this study was to investigate the clinical signs and subjective symptoms of TMD in a large number of instrumentalists objectively. MATERIALS AND METHODS: A total of 739 musicians from a diverse range of instrument groups completed a TMD questionnaire. Among those who reported at least one symptom of TMD, 71 volunteers underwent clinical examinations and radiography for diag-nosis. RESULTS: Overall, 453 participants (61.3%) reported having one or more symptoms of TMD. The most frequently reported symptom was a clicking or popping sound, followed by temporomandibular joint (TMJ) pain, muscle pain, crepitus, and mouth opening limitations. Compared with lower-string instrumentalists, a clicking or popping sound was about 1.8 and 2 times more frequent in woodwind and brass instrumentalists, respectively. TMJ pain was about 3.2, 2.8, and 3.2 times more frequent in upper-string, woodwind, and brass instrumentalists, respectively. Muscle pain was about 1.5 times more frequent in instrumentalists with an elevated arm position than in those with a neutral arm position. The most frequent diagnosis was myalgia or myofascial pain (MFP), followed by disc displacement with reduction. Myalgia or MFP was 4.6 times more frequent in those practicing for no less than 3.5 hours daily than in those practicing for less than 3.5 hours. CONCLUSION: The results indicate that playing instruments can play a contributory role in the development of TMD.
Arm ; Diagnosis ; Mouth ; Myalgia ; Radiography ; Temporomandibular Joint ; Temporomandibular Joint Disorders* ; Volunteers

This study was conducted for the assessment of the usefulness of masseteric silent period on electromyogram as a diagnostic method for temporomandibular disorder. Of students and dentists in Dental College of Yonsei University and patients, 36 experimental subjects with symptoms such as clicking sound, pain in the temporomandibular joint area and limitation of jaw movement, and 33 control subjects without such symptoms were selected for this study. On each subject electromyographic masseter muscle silent period followed by mention tap was recorded with surface electrodes and analysed with computerized system. The following results were obtained: 1. The mean silent period was 36.97 +/- 9.23 msec in experimental group, and 25.62 +/- 5.24 msec in control group respectively. 2. There were no statistically significant differences in silent period between male and female in either experimental and control group. 3. Silent periods in experimental group were more prolonged than those of control group. (P<0.01) Taken all together, electromyographic masseter muscle silent period may be useful for diagnosis and evaluation of temporomandibular disorder.
Dentists ; Diagnosis ; Electrodes ; Female ; Humans ; Jaw ; Male ; Masseter Muscle ; Temporomandibular Joint ; Temporomandibular Joint Disorders*

Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.
Diagnosis ; Humans ; Hyperplasia* ; Mandible ; Mouth* ; Temporomandibular Joint ; Temporomandibular Joint Disorders ; Trismus ; Zygoma

PURPOSE: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement (ID) were tested by comparing the results of them with those of magnetic resonance imaging (MRI). METHODS: 75 patients (150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. RESULTS: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction (ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction (ADDWOR). CONCLUSION: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.
Diagnosis* ; Humans ; Magnetic Resonance Imaging* ; Mass Screening ; Mouth ; Sensitivity and Specificity ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*