Left condylar head fracture due to chronic degenerative disease and necrosis. Sudden onset fracture produced mandibular shifting and uncoupling.

Osteophyte development producing mandibular shifting and open bite

Clinical observation of mandibular shifting and open bite.Right Osteochondroma discovered upon imaging.

Progressive anterior open bite developed over several year period. Clinical evidenceof wear facets and wear patterning which cannot contact at this time.

Saggital view of a normal TMJ MRI in MIP with chronic disc displacementand diminiative condylar development from osteochondrosis.

Further examples of Osteochondrosis of childhood a growth deficiency of the condyle.

Example of the condyle in a neutral position in MIP with discal displacement and the same joint when manipulated in FSJP. As the joint looses vertical and horizontal

dimension, anterior uncoupling develops.

Anterior uncoupling in MIP and fulcrumming off the last molars.

Unilateral Osteochondrosis of childhood (left) with anterior uncoupling at the sitefurthest from the joint, the ipsilateral cuspids. Note the size differences between the right and left condyles where the left condyle presents with normal anatomy just of smaller dimension.

MIP

FSJP

Complaints of bite changes

Mip (habitual bite) Fully seated joint

MIP vs FSJP

1 o’clock disc

Bruxism

Normal TMJAVN