Presenter: Mark Piper, DMD, MD

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Finite distortions of TMJ soft-tissues and bony dimensions can create dramatic changes in occlusion in both children and adults. Drawing from a database of 20,000 temporomandibular joints imaged with CT and MRI, this course distinguishes between malocclusion leading to internal derangements versus internal derangements creating the malocclusion. Discussion includes the clinical correlation between mechanically-injured temporomandibular joints and Class II molar occlusion, apertognathia, occlusal asymmetry, posterior interferences, and occlusal wear. Attendees will be given specific guidelines for diagnosing joint-based foundational malocclusion through the examination of the facial skeleton and the static and dynamic occlusion. Findings from CBCT and MRI scans will be related to orthodontic, restorative, and orthognathic treatment failures and to masticatory system pain. Special attention will be directed to mandibular condylar growth injury in children and the resulting development of severe malocclusion, skeletal distortion, and sleep apnea.