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TMJ Disorder -TemporoMandibular Joint Message Board
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Old 02-03-2012, 06:00 AM   #1
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Location: Talsa, OK, USA.
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Ponyo HB User
"psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

I have TMJ for 8 months. My symptoms, apart from jaw joint pain and neck pain, are not that bad. But my MRI shows that I have anterior displacement without reduction with both discs are severely deformed. My main concern is my facial change cause by muscle tension (my temples and cheek are sunken in ) and this structural problem that may lead to more pain soon.

I haven't seen Dr. Clayton Chan yet (NM dentist in Las Vegas), but I've talked to his assistant and one of his students, and they think Dr. Chan can help me build a "psuedo-disc" (because They cannot recapture my disc at this point).

I also went to see Dr. Piper.(Oral Surgeon and TMJ dentist/ FL) He thinks I should do fat graft surgery to replace my disc. He said adults are not likely to build a natural "psuedo-disc." He's never seen any adults who can build a so-called "psuedo-disc" before.

Right now, I'm confused. What should I do? And who I should believe. Is it true that I can build up my "psuedo-disc" at this age (I'm 27)???


Ps. About the price...Dr. Chan is very expensive for splint treatment, compared to others ($10,500+525 per visit)

And Dr. Piper's price, I think, is quite reasonable for surgery (about 34,000$).

 
Old 02-03-2012, 07:41 AM   #2
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Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Quote:
Originally Posted by Ponyo View Post
I have TMJ for 8 months. My symptoms, apart from jaw joint pain and neck pain, are not that bad. But my MRI shows that I have anterior displacement without reduction with both discs are severely deformed. My main concern is my facial change cause by muscle tension (my temples and cheek are sunken in ) and this structural problem that may lead to more pain soon.

I haven't seen Dr. Clayton Chan yet (NM dentist in Las Vegas), but I've talked to his assistant and one of his students, and they think Dr. Chan can help me build a "psuedo-disc" (because They cannot recapture my disc at this point).

I also went to see Dr. Piper.(Oral Surgeon and TMJ dentist/ FL) He thinks I should do fat graft surgery to replace my disc. He said adults are not likely to build a natural "psuedo-disc." He's never seen any adults who can build a so-called "psuedo-disc" before.

Right now, I'm confused. What should I do? And who I should believe. Is it true that I can build up my "psuedo-disc" at this age (I'm 27)???


Ps. About the price...Dr. Chan is very expensive for splint treatment, compared to others ($10,500+525 per visit)

And Dr. Piper's price, I think, is quite reasonable for surgery (about 34,000$).

Well, it looks like after all is said and done, you will be spending close to the same amount with either doctor...only Dr. Clayton Chan's treatment is much more conservative than surgery.

I can't speak for Dr. Piper because I know nothing about him, but I can assure you that you'd be in good hands with Dr. Chan.

 
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Old 02-03-2012, 11:04 PM   #3
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Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Thanks so much saltyk9.
Have you had treatment with him or have known anyone who treated with him? Do you have any idea about "psuedo-disc???? Can we (adults) build it naturally at this age?

 
Old 02-06-2012, 08:04 AM   #4
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PatientZero HB UserPatientZero HB UserPatientZero HB User
Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Your condition is almost exactly like mine. Iíve had TMJ disorder for about 12 months. My MRI also shows that I have anterior displacement without reduction with both discs. (my left disc is the real problem because it is actually stuck on a bone spur so it canít pop back into place) Also like you I have very little jaw and neck pain and my temples and cheeks are sunken in.

First, I hate the sunken in temple and cheek look, but it isnít permanent and it always looks worse on thin people. Iím 48, 6 foot 1, and weigh 150lbs. My doctor jokes with me and says I should drink tons of fattening milk shakes.

Second, almost all non-surgical treatments are designed to help do 1 of 2 thingsÖ Pop the disc(s) back in place or create a pseudo-disc.

Dr. Piper was the first Oral Surgeon I went to and he wanted to do the fat graft surgery on me too. That is what he is best known for. At the time I was new to all this TMJ stuff so I didnít know about pseudo-disc(s). Then I went to Dr. Warburton (Oral Surgeon Univ of Maryland Dental School) he also came highly recommended just like Dr. Piper. What Dr. Warburton said was that since I had so little pain (level 1-2) and hardly any symptoms that I should wait and see if my body creates pseudo-discs. He also explained the whole pseudo-disk thing to me. He didnít say anything about it being an age thing (remember Iím oldÖ 48)

I also know Dr. Clayton Chan. He comes on facebook (TMJD notes) a lot and answers questions about NM dentistry. Iíll ask him more about pseudo-discs.

From what I can gather I think that people with more joint issues (like myself) have better chances of creating pseudo-discs then people with a lot of muscle issues.

How are you doing otherwise?

If there is anything elseÖ just ask.

Tom

 
Old 02-06-2012, 09:31 AM   #5
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Ponyo HB User
Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Wow! I'm so grad I found someone that has the same condition as mine, especially the sunken look. Have you ever asked the doctor why you got these sunken in cheeks and temples?
I think my case is a bit worse coz my both discs are severely deformed as well (Dr. Piper said this means splint cannot recapture the disc)
I talked to Dr. Stack (NYC) this morning and he thinks pseudo-disc is a commercial thing (it's not likely that adults can create a natural pseudo-disc, he said.)

I'm so confused at this point. Pls tell me what Dr. Chan thinks and keep in touch. I wanna know what is your decision about this, too. As a girl, I cannot stand this looks anymore (I'm very thin too, so it's worse).

Last edited by moderator2; 02-06-2012 at 02:57 PM. Reason: please do not ask members to post against the rules

 
Old 02-06-2012, 01:34 PM   #6
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PatientZero HB UserPatientZero HB UserPatientZero HB User
Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Most people that get TMJ will develop sunken cheeks and temples. What is basically happening is that your facially muscles are starting to atrophy because they are not being used as much. It tends to be more noticeable on thinner people. The good news is that it is totally reversible and the muscles will only sink in so much, so it doesn’t sink in forever. I notice it a lot on myself but most of my friends don’t. A few just say you look like you are losing weight.

I looked into Dr. Stack also… but I get nervous when dentists start making claims that they can cure everyone.


Take Care
Tom

Last edited by moderator2; 02-06-2012 at 02:57 PM. Reason: please do not post a commercial website, for any reason.

 
Old 02-08-2012, 11:01 AM   #7
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Ponyo HB User
Re: "psuedo-disc?? Dr. Clayton Chan or Dr. Mark Piper??".

Quote:
Originally Posted by PatientZero View Post
Most people that get TMJ will develop sunken cheeks and temples. What is basically happening is that your facially muscles are starting to atrophy because they are not being used as much. It tends to be more noticeable on thinner people. The good news is that it is totally reversible and the muscles will only sink in so much, so it doesnít sink in forever. I notice it a lot on myself but most of my friends donít. A few just say you look like you are losing weight.

I looked into Dr. Stack alsoÖ but I get nervous when dentists start making claims that they can cure everyone.


Take Care
Tom

I've talked to him, and he is very nice, I think...
I think for our cases, he told me he will try to recapture the disc with 2 splints: pivotal and followed by repositioning splint. If he cannot recapture the disc, then he will send me to do surgery. T T..

 
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