Reported opening limitations as a TMD symptom: A clinical report on diagnoses and outcome

Objective: To study diagnoses of reported mouth opening limitations and the outcome after treatment, to better understand the symptom and the prognosis. Methods: New referrals to an Orofacial Pain & Temporomandibular Disorders (TMD) Clinic with the symptom of “jaw locking” in the referral were considered for this clinical prospective report. This referrals constituted 5.8 % of all the referrals during a ten month period, and 40 patients were included. Case history, clinical examination and diagnoses were made according to the RDC/TMD criteria. MRI and CT examinations of the temporomandibular joint were performed when indicated. Reported symptoms and clinical signs were compared for different diagnoses. The treatment was non-invasive and conservative, no patient underwent surgery. At end of treatment, the clinical examination was repeated, the primary and definite diagnoses were compared, and the improvement after treatment was evaluated. Results: The main diagnoses were disc displacement with reduction (DDwR), 23 %, disc displacement without reduction (DDwoR), 30 %, and myofascial pain with limited opening (wLO), 45 %. General hypermobility was significantly more frequent in the disc displacement diagnosis compared with myofascial pain (p < .05). After treatment, the mean opening capacity was good, regardless of the diagnosis. Conclusions: A report of jaw locking is not indicative of a single diagnosis of TMD. A diagnosis based on the history and a clinical examination is generally accurate. The symptom of opening limitations responds well to conservative treatment methods.