[Spear Education] Piper Classification and TMJ Imaging with Dr McKee – PDP080

Stop taking OPGs/Panoral radiographs for TMD...they have limited benefit! In this episode I discuss the Piper Classification of TMJ with Dr Jim McKee from the Spear faculty. We also cover exactly when and why imaging of the TMJ may be beneficial (MRIs and CBCTs). I have found the Piper classification easy to implement and I hope this episode helps you understand it. https://youtu.be/n4lRWAQeA5A Check out full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Observe the patient's path of opening. If someone's jaw opening makes a 'V' shape, that's a DEVIATION. If someone's jaw opens, and then it goes all the way to one side, and it doesn't go back to the middle, that's a DEFLECTION. If you want to Download the PDF version of the Piper Classification of TMJ Infographic we made, click here! Piper Classification PDF Dr Jim McKee is part of Spear Education - a platform that has taught me so much of my occlusion. In this episode I asked Dr. Jim McKee: What is the Piper Classification of TMJ?What are the risks of having to rehabilitate someone where you haven't the health of the TMJ? (19:22)Are there any other useful TMD classifications? (21:01)Is there any benefit of taking a Panoral radiograph? (24:48)What is the difference between an MRI and CBCT for someone with a TMJ pathology? (26:51) What type of imaging is best for TMD? (28:58)What additional information can a CBCT provide above an MRI? (33:59)How do we decide the most appropriate imaging technique? (35:22) Dr McKee's thoughts on idiopathic condylar resorption in adult patients? (32:58)Should we be taking routine MRI/CBCT for TMJ health diagnosis? Or only for patients who have a joint based history? (36:62)Is there a clinical way to determine which classifications patients are in (Piper III vs Piper IV)? (39:23)Is TMJ disorder always a progressive disorder? (40:51)How to manage asymptomatic clicks? (42:17)Deviation or Deflection as part of full workup and imaging of the way to get the exact diagnosis? (44:07)How does the Piper classification influence Restorative management? (47:12) If you enjoyed this episode, check out TMJ Physiotherapy – When to Refer and How They can Help  Check out SPEAR EDUCATION, a two-day seminar, where Dr. Jim McKee teaches 25% of the course! Click here for Full Episode Transcription: Opening Snippet: I used to work in the emergency department of a very large dental hospital. This is like a year and a half out of Dental school and I’ll never forget this one patient I had, right? She came in and it’s an emergency that had never seen before. Jaz’s Introduction:Like 99% was like acute pulpitis or an abscess. And you know we were doing extirpations and stuff. Now, this lady came in and she was literally like her mandible was all to one side. She was literally all deranged, she was in agony, she’s pointing to a jaw joint, I forget which side she was pointing on now, but she was in absolute agony and just everything about her bite looked way OFF, right? and I had no idea or the diagnosis was. I didn’t know. I had no idea what to do. So naturally what I did.The first thing I thought was okay. Looks like it could be something to do with the TMJ. I’m thinking TMD. Therefore, what do we do? Why don’t we get a radiograph? Okay? Because that’s we do with teeth, right? We take a radiograph. So, I suggested again O.P.G. okay? So I sent this lady for an OPG. Okay? Anyway, the OPG/OPT comes back and you can’t really notice anything unusual in it. And I show it to my consultant and my consultant absolutely flips to me. I mean it’s like ‘Jaz, what the hell you take an OPG for?” Right? Because an OPG is not going to show you much when it comes to TMD. Alright?So that was the lesson number one I had several years ago, and I want to share that with you. And on that topic, I’ve had brought on, someone absolutely amazing today is from the spear faculty.