TMJ clicking and locking after Orthodontic treatment

MJ clicking or locking after completion of Orthodontic treatment; what does it mean?

 
TMJ clicking is often found in people with no other complaints and it usually means a benign finding. I recently saw a 16 years old young man who started having severe clicking about two weeks after completion of orthodontic treatment. He never had clicking previously and he feels as if the orthodontic treatment is to be blamed. He had traditional wire brackets and he was in them for about 3 years. During examination he has a loud click on jaw opening and a soft click on closing on both sides. On a transcranial X-ray, I found that the bony Health was optimum but there was a very steep articular eminence and a relatively long condylar neck. I explained to the patient that TMJ clicking is commonly associated with certain type of bony structures and a steep articular eminence can be associated with clicking whether he had orthodontic treatment or he didn’t. One possibility is that his condyle movement was restricted due to orthodontic wires/brackets and hence the disc displacement was avoided. As soon as the wires and brackets were removed, the joint mobility increased and his clicking complaint started. I did not recommend any treatment as his only complaint was clicking. 
 
I would love to hear from you if you have had similar patients (if you are a treating doctor) or if you have similar complaints (patients). Email me at brij@nyctmj.com