In March of 2021, a 17 year old male presented with occasional TMJ pain after chewing meat & pizza. It started in January, 2018 and has gradually gotten worse. He started to have pain during yawning.
He was told that he ground his teeth at night, so he bought an OTC soft mouth guard to wear at night. Examination revealed lower 3rd molars in hyper-occlusion. Since he was an avid competitive crew team member, I advised him to stop wearing the soft mouth guard at night, but to wear it only when he was rowing.
Cone Beam CT Scans showed damage to his TMJ condyles with hyper-mobility in the left condyle. Occlusal Analysis with Centric Relation mounted dental casts revealed huge Protrusive interferences plus Lateral & Non-Working (Contra-Lateral) interferences, and an anterior centric slide.
A Keynote presentation was shown to him with movies of his condylar displacements on a semi-adjustable articulator. It also showed the Occlusal Correction in detail. He agreed to an Occlusal Adjustment done in 3 separate sessions. The treatment plan also involved extraction of all the 3rd molars, but was not done until after the 2nd adjustment when his pain was gone.
After the extractions were done in July, 2021, a third Occlusal Adjustment was done in September, 2021 to complete the treatment. At that time Centric Occlusion (MIP) = Centric Relation in a stable Centric bite.
Photos show his positive facial and postural changes. All pain symptoms were gone. No night guard was needed. A follow-up check in January, 2022 showed a happy young man.
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