20 year old post ortho open anterior bite with daily temperol headaches

Mammillons give away the open anterior bite, but note the midline asymmetry and how the bones go crossbite on the posterior left.

The posterior second molars dominate the bite.


This 20 year old is open anterior and left crossbite with an orthodontic history. She has pain in the left condyle and regular migraines. The symptoms accelerated after her wisdom teeth were extracted. The growth asymmetry is in the upper left maxilla. This patient also has a restricted left airway and a short left ramus/condyle with a skeletal left posterior crossbite.


The only way to get the bones and the teeth to match is orthognathic surgery and the patient will not do that. The trick here is lifetime maintenance. The deprogramming splint eliminated the migraines and left condyle pain.