An excellent patient base is the strongest asset of a teaching institution. The Piper Education and Research Center is backed by over 10,000 patients from the Piper Clinic. During the past twenty-five years Dr. Piper has seen the whole spectrum of patients with temporomandibular disorders, abnormal occlusion, and facial pain. Many of these patients have experienced failed splint therapy, restorative dentistry, and orthodontics. Others have had osteotomies only to have their bite worsen. Some patients have had scores of surgical procedures. Most have failed pain management. Regardless of their starting background, one fact has held true for every patient ever seen at the Piper Clinic. Each has had a complete analysis of their joints with either tomograms or CAT scans. Up until 1987, every patient had an arthrogram to visualize their disk, and since then every joint has been imaged with a Magnetic Resonance (MR) scan. Every patient has had bimanual manipulation with mounted study cast records of their bite. Furthermore, every study cast has been synchronized with scans of the joint that are captured from exactly the same bite. Every patient has had a thorough analysis of their pain. The spectrum of Dr. Piper's pain evaluation often includes MR scans of brains and cervical spines to check for other sources of head pain as well as facial and cervical diagnostic nerve blocks including sympathetic nerve blocks for Reflex Sympathetic Dystrophy. We believe that the Piper Clinic patient base includes the highest standards of diagnosis available in the 21st century.

Since the early 1980's, Dr. Piper's efforts have extended far beyond diagnosis. The Piper Clinic has offered the full scope of treatment for patients. Splint therapy and occlusal management have been designed from the imaged condition of the joint, and that has helped us to realize that no single type of splint or occlusal technique is ideal for all "TMD" patients. Pain management techniques have been developed to help the most esoteric facial pain patients. Dr. Piper has developed new techniques of TMJ microsurgery. Through this surgery, temporomandibular joints are not only repaired, but emphasis is placed on the rehabilitation and correction of the crippled bite that was caused by joint damage. It was this experience under the microscope that helped Dr. Piper to develop the original concepts of Joint Based Occlusion. The Piper Clinic has worked closely with referring dentists and orthodontists to sequence bite management, and this sequencing has developed into the philosophy of Joint Based Dentistry. The population base of the Piper Clinic has included an age range of newborns with joint clicking, to children with joint based growth defects, to adults with chronic pain and dysfunction. With over 10,000 highly complex patients, two thirds of whom have been treated non-surgically, the Piper Clinic brings perhaps the strongest patient base to TMD continuing education.

	Our promise to doctors is that we will present the highest standards of diagnosis for any patient with a joint, occlusal, or pain problem.
	We promise to maintain the largest and most carefully documented data base of patients for the continuing education of other doctors.
	We promise to continually seek new technological advancements at the Piper Clinic and to share all of these advancements with our doctors who train at PERC.

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