Dr.

Mark Piper’s Classification

John R Droter DDS
www.JRDroter.com
Left TMJ

I, II III IV V

I
Bone to Bone
% Blood Flow a Adapting
a Affected?
b Adapted
II reduction
Open
I Normal
2 Ligaments or Cartilage damage
b 3a Partial disc subluxation, with reduction
3b Partial disc subluxation, non-reducing
non-reduction
4a Complete disc dislocation, with reduction
Open 4b Complete disc dislocation, non-reducing
Droter JR, An orthopaedic approach to the diagnosis and
5a No Disc, Bone to bone- Adapting
treatment of disorders of the temporomandibular joint. 5b No Disc, Bone to bone- Adapted
Dent Today 2005 Nov;24(11):82, 84-8

Friday, January 25, 13

 Dr. Mark Piper’s Classification
John R Droter DDS
www.JRDroter.com
Right TMJ

I, II III IV V

Bone to Bone
I
a Adapting
% Blood Flow
Affected? b Adapted
a
II reduction
Open I Normal
2 Ligaments or Cartilage damage
3a Partial disc subluxation, with reduction
b 3b Partial disc subluxation, non-reducing
non-reduction 4a Complete disc dislocation, with reduction
4b Complete disc dislocation, non-reducing
Open
5a No Disc, Bone to bone- Adapting
Droter JR, An orthopaedic approach to the diagnosis and
treatment of disorders of the temporomandibular joint. 5b No Disc, Bone to bone- Adapted
Dent Today 2005 Nov;24(11):82, 84-8
Friday, January 25, 13
 The Expanded Piper
Disc Classification
TMJ Damage
I Normal Healthy Disc, Ligament and Cartilage
2 Normal Disc Position but damage:
Ligaments damage
Cartilage Fibrillation
Disc Distortion
Perforation of Disc
Disc unstable due to contralateral TMJ damage
3ae Early Partial disc subluxation, with reduction 4a/4b Qualifiers
3a Partial disc subluxation, with reduction Disc Size- small, medium, large
3b Partial disc subluxation, non-reducing Direction of dislocation-
4ae Early Complete disc dislocation, with reduction Anterior, Medial, Lateral, Distal
4a Complete disc dislocation, with reduction Thickness of posterior band
4 adh Adhesed disc to eminence Distance posterior band in front of condyle
4b Complete disc dislocation, non-reducing Conforming of dislocated disc to eminence
4b/a Complete disc dislocation, non-reducing in function
5a No Disc, Bone to bone- Adapting- OA Active Perforation of Pseudo-disc
5b No Disc, Bone to bone- Adapted- OA adapted Subluxation of Pseudo-disc
OA Active without perforation of Pseudo-disc
OA Adapted without perforation of Pseudo-disc

John R Droter DDS

Friday, January 25, 13