Dr. Mark Piper’s Classification

I, II

I

III IV

IIa

reduction

bnon-reduction

V

Bone to Bone a Adapting

b Adapted

% Blood Flow Affected?

Left TMJ

Open

Open

Droter JR, An orthopaedic approach to the diagnosis and treatment of disorders of the temporomandibular joint.Dent Today 2005 Nov;24(11):82, 84-8

I Normal2 Ligaments or Cartilage damage3a Partial disc subluxation, with reduction3b Partial disc subluxation, non-reducing4a Complete disc dislocation, with reduction4b Complete disc dislocation, non-reducing5a No Disc, Bone to bone- Adapting5b No Disc, Bone to bone- Adapted

John R Droter DDSwww.JRDroter.com

Friday, January 25, 13

Dr. Mark Piper’s Classification

I, II

I

III IV

II

V

Bone to Bone a Adapting

b Adapted% Blood Flow Affected?

Right TMJ

areduction

bnon-reduction

Open

Open I Normal2 Ligaments or Cartilage damage3a Partial disc subluxation, with reduction3b Partial disc subluxation, non-reducing4a Complete disc dislocation, with reduction4b Complete disc dislocation, non-reducing5a No Disc, Bone to bone- Adapting5b No Disc, Bone to bone- AdaptedDroter JR, An orthopaedic approach to the diagnosis and

treatment of disorders of the temporomandibular joint.Dent Today 2005 Nov;24(11):82, 84-8

John R Droter DDSwww.JRDroter.com

Friday, January 25, 13

4a/4b QualifiersDisc Size- small, medium, largeDirection of dislocation- Anterior, Medial, Lateral, DistalThickness of posterior bandDistance posterior band in front of condyleConforming of dislocated disc to eminence

Perforation of Pseudo-discSubluxation of Pseudo-discOA Active without perforation of Pseudo-discOA Adapted without perforation of Pseudo-disc

The Expanded Piper Disc Classification

TMJ DamageI Normal Healthy Disc, Ligament and Cartilage2 Normal Disc Position but damage: Ligaments damage Cartilage Fibrillation Disc Distortion Perforation of Disc Disc unstable due to contralateral TMJ damage3ae Early Partial disc subluxation, with reduction3a Partial disc subluxation, with reduction3b Partial disc subluxation, non-reducing4ae Early Complete disc dislocation, with reduction4a Complete disc dislocation, with reduction4 adh Adhesed disc to eminence4b Complete disc dislocation, non-reducing4b/a Complete disc dislocation, non-reducing in function5a No Disc, Bone to bone- Adapting- OA Active5b No Disc, Bone to bone- Adapted- OA adapted

John R Droter DDS

Friday, January 25, 13