Journal of Temporomandibular Joint
Online ISSN : 1884-4308
Print ISSN : 0915-3004
ISSN-L : 0915-3004
Volume 5, Issue 1
Displaying 1-18 of 18 articles from this issue
  • Toshiya KUWAHARA, Takao MARUYAMA
    1993 Volume 5 Issue 1 Pages 1-13
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    Both recovery and maintenance of the normal function of the stomatognathic system are essential in the treatment of craniomandibular disorders. Detailed examination, precise diagnosis and systematic treatment method are needed for successful treatment.
    In this paper, we discuss the diagnosis and treatment methods, including bite plane therapy and occlusal reconstruction.
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  • Kenji KAKUDO, Junichiro KOTANI, Satoshi ADACHI, Akihiro KIMURA, Rikiya ...
    1993 Volume 5 Issue 1 Pages 14-21
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    This is a study of the intraarticular pressure-volume relation and the methodology for measuring intraarticular pressure (IAP) in both the monkey knee joint and the human temporomandibular joint. Two catheters were inserted into the monkey knee joint, and there was an external transducer on one route of the catheter and a microsyringe on the other route. Measurement of the IAP was made by the rapid bolus injection technique and measures of the intraarticular pressure-volume relation were calculated. Measures of intraarticular pressure-volume relationship included (a) IAP before volume injection (P0), (b) peak IAP caused by volume injection (Pp), and (c) the intra-arterial pressure volume index (IAPVI) calculated as the ratio of ΔV to logPp/P0.
    We propose the IAPVI as a very useful index to express the peculiarity of IAP dynamics. The IAPVI of the human temporomandibular joint (TMJ) is calculated by a similar method. It is clinically useful that IAPVI is applied as an index to evaluate the IAP dynamics of the human TMJ.
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  • Yoshinari MORIMOTO, Etsuo SHOHARA, Tatsuo MASUDA, Tetsuji KAWAKAMI, Ma ...
    1993 Volume 5 Issue 1 Pages 22-29
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    There have been few reports concerning sensory and sympathetic innervation of the temporomandibular joint (TMJ). We investigated it by using horseradish peroxidase (HRP).
    Experiments were performed using 20 Wister rats. The animals were divided into four experimental groups; 40% HRP (1-3μl) was injected into the TMJ capsule of one side (group 1). HRP was injected into the TMJ capsule of one side and the tooth pulp of upper first molar of the contralateral side (group 2). After sectioning the external carotid artery and the sympathetic plexus, HRP was injected into the ipsilateral TMJ capsule (group 3). After sectioning the auriculotemporal nerve, HRP was injected into the ipsilateral TMJ capsule (group 4). After a 24-hour survival period, the animals were perfused with fixative and the superior cervical (SCG), stellate (SG) and trigeminal (TRG) ganglia were dissected, sectioned and processed with tetraethyl benzidine method.
    Labeled cells were recognized in the ipsilateral SCG and TRG. In SCG they were distributed uniformly. In TRG they were found in the submandibular division (group 1).
    The mean diameter of labeled cells in SCG was 19.2±2.1μm. In TRG the mean diameter of labeled cells of TMJ (23.3±5.4μm) was significantly smaller than that of the tooth pulp (27.8±5.5μm) (group 2). Almost no labeling was obtained in SCG after sectioning of the sympathetic plexus (group 3). No labeling of TMJ was recognized in SCG and the number of labeled cells of TMJ (2.6±1.5) was reduced by 1/10 in group 2 by sectioning the auriculotemporal nerve (group 4).
    The sympathetic components which originate from SCG are supposed to innervate TMJ through intervention of the nerve after ascending along the external carotic plexus. In the rat about 90% of the sensory fibers innervating TMJ are considered to be carried by the auricurotemporal nerve, which seem to contain more frequent ratio of smaller Aδ and C fibers that those for tooth pulp.
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  • Osteological consideration
    Masashi SUGISAKI, Akihiro IKAI, Haruyasu TANABE
    1993 Volume 5 Issue 1 Pages 30-36
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    Several reports have suggested the risk of injury to the middle cranial fossa at arthroscope penetration into the superior joint space of the temporomandibular joint. However, there has been no anatomical study on the safe angle of penetration into the superior joint space. In this study, we investigated 96 mandibular fossa of Japanese dry skulls with three dimensional measurements in order to decide on the dangerous angle for injury to the fossa when the arthroscope penetrated the lateral roof of the fossa.
    The results showed that in the horizontal plane, the dangerous angle was an inclination of at six degrees to the back, and 18 degrees downward in the frontal plane in the frontal plane. The histogram of the measurements showed that an inclination to the back of over 30 degrees and downward 0 to 10 degrees gave freedom from danger in arthroscope penetration.
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  • Part 1. Evaluation non-pain subjects using a new type of pressure pain meter
    Masashi SUGISAKI, Akihiro IKAI, Haruyasu TANABE, Akira ERIGUCHI
    1993 Volume 5 Issue 1 Pages 37-47
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    Muscle and/or joint tenderness is defined as a patient report of pain on palpation, but there is less interobserver agreement for pain-related measures. The use of various types of pressure pain meter for determining the pressure pain threshold has demonstrated the strong validity and adequate reliability of pressure pain threshold measurement. However there is no agreement about sex dimorphism. The objective of this study was to establish the range of normal values for the pressure pain threshold of 46 non-pain volunteers (Men: 23, Women: 23), including positional variation and sex dimorphism. We used a new type of pressure pain meter that increased at constant rate of 0.5kg/sq. cm/sec for measurements.
    The results showed that the pressure pain thresholds for men were significantly higher at all sites compared with that for women. The pressure pain threshold at the posterior margin of the ramus was significantly lower than the values measured at other points, and the pressure pain threshold at the mid-portion of the masseter was higher than that at the inferior portion of the masseter in both sexes. The variances for the pressure pain threshold were 0.75 to 1.21kg in men and 0.8 to 1.31kg in women in a range of 25-75%.
    These results suggest that the new type pressure pain meter is useful for determining the pressure pain threshold value. Furthermore, the need to determine the appropriate pressure at each site according to the sex of the subject was shown. Furthermore, the inter-individual pressure pain threshold varied widely, so that determination of the normal range might be difficult without assessment of individual sensitivity to pain.
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  • Hideyoshi NISHIYAMA, Hao-Zong WU, Akira TAKAHASHI, Shumei MURAKAMI, Ma ...
    1993 Volume 5 Issue 1 Pages 48-61
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    The aim of this study was to clarify the portion forming the contour of the mandibular head by temporomandibular joint (TMJ) frontal projection, and to clarify whether the shape of the mandibular head by TMJ frontal projection conformed to that by Yale's classification.
    The projections evaluated in the present study were Grant-Lanting, modified Grant-Lanting, Clementschitsch, transmaxillary, Takaku, and Zimmer projections.
    Lateral roentgenographic cephalography at maximal opening of the mouth was performed in the following two groups: 20 healthy volunteers with an inter-incisal opening more than 40mm, and 20 patients of cranio-mandibular disorders with an inter-incisal opening less than 35mm. The mean vertical angulation identical to the central X-ray beam of each TMJ frontal projection against the mandibular occlusal plane was obtained from those cephalograms.
    The tangential point of the central X-ray beam in each TMJ frontal projection to the contour of the mandibular head was examined as the portion forming outline of the mandibular head in the lateral view of 58 mandibular heads of human dry skulls.
    The shape of the mandibular head by TMJ frontal projection and that by Yale's classification were compared by using photographs of the same human dry skulls.
    The results of the study were as follows:
    1) The portion forming the contour of the mandibular head by frontal projection was within the posterior surface of the mandibular head, and the lower portion of the posterior surface was depicted as the mouth opened more widely.
    2) The condylar contour by frontal projection showed the outline of the posterior surface of the mandibular head, and did not conform to the shape of the mandibular head by Yale's classification.
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  • Masatoshi OHNISHI, Kayoko OHTSUKI, Yushi MATSUMOTO, Tokuo WAKAO, Takas ...
    1993 Volume 5 Issue 1 Pages 62-77
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    Conservative procedures are often selected to treat condylar process fractures of the mandible, partly because of anatomical and functional complexities and partly because of the technical difficulty of open reduction, which include skin incision, resulting scarring, and the possibility of facial nerve and parotid gland injury.
    However, we believe that the rationale for fracture treatment is to reduce and fixated broken bones to anatomical positions and that surgical procedures should be instituted as necessary. With this conviction, we studies a modified surgical procedure to reduce condylar process fractures of the mandible through an intra-oral approach.
    This modified procedure involves mucosal incision at the anterior margin of the mandibular ramus prior to reducing the articular process. The region from the articular process is then fixate with a titanium miniplating system or a banding system, which we devised and developed. In the case of band fixation the region is wrapped in headband form.
    In our banding system fixation the band is made of pure titanium and is 6mm to 8mm wide and 0.3mm thick. It is the form of a plate, allowing easy operability. This procedure has the advantages of no skin incision, no skin scarring, and minimal risk of facial nerve and parotid gland injury.
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  • Hiromasa MATSUGI, Setsuko TAKEDA, Yukihiro TATEMOTO, Tokio OSAKI
    1993 Volume 5 Issue 1 Pages 78-88
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    We classified temporomandibular joint dysfunction (TMJD) into muscular, intracapsular and mixed types. The clinical effects of conservative treatment were examined in 300 patients some of them taking mandibular kinesiography. The results are as follows.
    1. The intracapsular type was the most frequent (158 cases), and there were few of the other two types (71 cases in both groups).
    2. Among the symptoms, pain was the mosthighly successfully controlled (85.2% in muscular pain and 68.6% in joint pain), but the abnormal joint sounds were the most resistant to treatment being unchanged in 38.2% of all subjects.
    3. Complete recovery was obtained in 59.2%, 31.0% and 32.9% of muscular, mixed and intracapsular type cases, respectively, and partial improvement was noted in 35.2%, 59.2% and 50.6% of the each type in the above order, respectively. In the muscular type, the symptoms disappeared only after the initial conservative treatment without splint application. However, all conservative approaches including splints were applied to most of the intracapsular and mixed group.
    4. Corresponding with the clinical effects, mandibular movement became smooth with the increase of the speed of mandibular movement and decrease of its deviation.
    From these results, it appears that conservative treatments are useful for TMJD if their limitations and the application of adequate approaches to each type of TMJD are considered.
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  • Ken-ichi KOMATSU, Yoshitaka TAKACHI, Satoko TAKACHI, Syohko MARUYA, Wa ...
    1993 Volume 5 Issue 1 Pages 89-100
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    A clinico-statistical study of 650 patients with temporomandibular joint arthrosis who visted the Clinic of Dentistry and Oral Surgery, Hirosaki University Hospital over a period of 10 years from January 1980 until December 1989.
    The following results were obtained. The number of patients with this disease tended to increase year by year, and the mean percentage of these patients, out of all new patients, was 7.4% during the past ten years. The patients consisted of 173 males and 477 females, and the predominance of female was significant. By age group, 27.2% of the patients were in their twenties, 16.6% in their teens, 16.5% in their thirties, followed by those in the fifties, forties, and over sixties. The distribution of age groups had two peaks. The illness was manifested laterally in 85.5%, and bilaterally in 14.2% of cases. A single symptom was more common than many at the onset of the disease, and the chief complaint at the first visit to our clinic. TMJ pain was the most observed among these symptoms. The interval between noticing symptoms and visiting our clinic was within 6 months in 57.2% of cases. Before consultation in our clinic 51.4% of patients had visited other clinics. Most patients had two or three symptoms on the first visit. TMJ pain was recognized in 70% of cases, TMJ noise in 46.2% and trismus in 42.5%.
    The remedies included medication and dental treatment such as occlusal splint, occlusal adjustment, extraction of the tooth and so on. Combination therapy, medication and occlusal splint therapy were applied in 60% of cases. Marked or partial improvement of TMJ symptoms was observed in 45.1% of the patients, though treatment was discontinued in 53.6% of case.
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  • Hironobu UMEDA, Hidetaka HANAFUSA, Masahiko EGUSA, Shigeki KOYAMA, Kat ...
    1993 Volume 5 Issue 1 Pages 101-107
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    In temporomandibular joint arthrosis, certain localized pains induce a vicious circle, painspasm-pain. To cut off the streak and control pain, we applied Idomethine KOWA PAP® (ID-P) to 14 patients who had temporomandibular joint arthrosis, and examined its effect clinically. ID-P, contains indomethacin which is effective in relieving pain, is characterized as harmless to digestive organs. The results showed marked improvement of pain without side effects, but not of limitation of movement. This suggests ID-P is a way to control pain related to temporomandibular joint arthrosis conservatively.
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  • Yukihiro FUJITA, Shigeki SUGISAKI, Kunimichi SOMA, Masatoshi OHNISHI
    1993 Volume 5 Issue 1 Pages 108-119
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    This is a case report of posterior displacement of the right articular disc. This dislocation was identified by using our functional analyzing system and the lateral section of double contrast CT.
    The treatment for this case was as follows:
    The patient was instructed to close and bite firmly on the occlusal splint which provided a single posterior contact on the affected side, and pivoted the condyle downward-backward around the pivoting point.
    After complete recapture, all first premolars were extracted and multi-bracket direct bonding was performed for orthodontic occlusal reconstruction.
    In the retention period, the disc-recaptured vertical dimension was maintained by the extrusion of the posterior teeth, and the symptoms of the patient's TMJ completely disappeared.
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  • Successful operation using an intraoral approach
    Fumihiko MATSUSHITA, Michio SHIKIMORI, Ichiro YAMADA, Yoshimasa KITAGA ...
    1993 Volume 5 Issue 1 Pages 120-126
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    A case of osteoma of the mandibular condyle, successfully theated by an intraoral approach is presented. It was found during cervical traction for herniated disc.
    A 47-year-old woman complaing of a back pain visited an orthopedic surgery clinic. Heavy trismus appeared suddenly two days after the beginning of the treatment of cervical traction. She was admitted to our department where a diagnosis of a osteoma of the mandibular condyle was made. Postoperatively, open bite appeared with mentum deviation to the operated side because of the shortening of the ramus length, so we tried occlusal splint therapy-to reposition to the centric occlusion and to protect the TMJ for the subsequent traction.
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  • So OZAWA, Kazue ITO, Yoshikazu SUEI, Keiji TANIMOTO, Takuro WADA, Kazu ...
    1993 Volume 5 Issue 1 Pages 127-134
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
    To the best of our knowledge, “Spontaneous anterior dislocation”, a kind of temporomandibular joint disk abnormality with definitive differential diagnosis has not been reported yet. In this paper, a patient whose right temporomandibular joint had clinical signs and symptoms quite similar to anterior disk dislocation with reduction is reported.
    A 11-year-old female patient had had click in the right temporomandibular joint for 3 years. The maximum interincisal opening was 46mm. Initial click occurred at 40mm of opening and the closing click at 18mm. The right temporomandibular joint area was slightly tender to palpation. No abnormal findings were observed regarding the bony articular surfaces on the polytomograph. The sagittal condylar movement pattern of the right temporomandibular joint showed atypical figure 8 pattern by Axiograph® examination.
    Magnetic resonance in the sagittal plane of the right temporomandibular joint demonstrated normal superior disk position at the closed position, and also demonstrated the disk position anterior to the condyle in maximum opening.
    From these findings, we diagnosed this case as a “Spontaneous anterior dislocation” of the right temporomandibular joint disk.
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  • [in Japanese]
    1993 Volume 5 Issue 1 Pages 135-136
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
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  • 1993 Volume 5 Issue 1 Pages 137-145
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
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  • 1993 Volume 5 Issue 1 Pages 146-152_1
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
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  • 1993 Volume 5 Issue 1 Pages 153-200
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
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  • 1993 Volume 5 Issue 1 Pages 201-248
    Published: May 20, 1993
    Released on J-STAGE: August 06, 2010
    JOURNAL FREE ACCESS
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