Uneven Jaw Possibly Due to TMJ? (photo)

I'm 22, and my jaw has grown like this since puberty. At around age 12 I hurt my jaw while chewing something really large. After the injury it would lock while trying to chew. I doesn't lock up anymore, but I can still click it around by the joints. Would injectable fillers be an option to even this up?

Doctor Answers 1

Congenital mandibular asymmetry + trauma to condyle

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What you are describing sounds like you had an existing congential mandibular asymmetry and later on you experienced a trauma while eating something big? Obviously, we would require an extensive clinical and radiographic examination before we can offer any valuable treatment recommendations.


You're still young, and the positive events are that you are not experiencing any severe pain, just clicking noise (is this only on the affected side or both sides?)... the fact that you are not locking up means that your articular disc may already be displaced and not recapturing (ie. going back on top of condyle where it should be).


The best way to manage this is through a multi-disciplinary approach. First you would need to see an orthodontist and describe your history and symptoms. Based on what your dental findings are (a lot of times your skeletal problems will reflect in your occlusion), the orthodontist will recommend you to see an oral & maxillofacial surgeon. If the surgeon determines that your condyles are affected and need treatment, he or she will either recommend a condylar surgery such as arthrocentesis in addition to orthognathic surgery. IF the problem is quite extensive, you may have to be referred to another sub-specialist who only treats the temporomandibular joints (the jaw joint). 


Of course, you would have an option of more conservative approach which does not involve surgery, but this would be mostly palliative approach and not offer any definitive correction. For example, a dental splint therapy with physiotherapy can improve your jaw posture and relieve pain or locking problems. However, you would have to wear the splint 24/7 and see the dentist regularly for observations.


Good luck with your decisions and future treatment!

Rockville Orthodontist

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