The pano verifies all the maxilla bone issues that include temporal bones at different heights, cloudy left sinus compared to right. Nasal septum is closing off the airway spaces. All the major dentistry is in the upper left. Many patients over the years that have a root canal in the middle of the skeletal asymmetry force like this example have a long history of migraine style headaches especially in the morning.
This patient has multiple issues. Her left neck is chronically tight, the left TMJ is painful, and she has regular left temporal headaches. The teeth were retrofitted between the bones in orthodontics and the continued growth of the mandible onl intensified the wedge. The force on this occlusion has been heavy posterior left all her life. The facial profile matches the shape of the force pattern. The history is mostly pain in the TM joints, pain in the teeth at times, but a lifetime history of left side sinus, temporal and neck pain.
The real trick in this case is years of healing . Years down the road the TM joints will clean up and the old muscles patterns down the road are always an issue. It will be a decade of teaching her old anatomy patterns a new trick. An equilibration will need to be done to help achieve some balance and then the patient will be held in a splint at night to protect the TMJs. Regular perio and TMD maintenance is required.