Analysis of jaw movements in patients with temporomandibular joint click

Although TMJ click is common, its relationship to subjective and objective evaluation and the position of the click within the envelope of motion is not fully understood. This study attempted to correlate these entities in 21 patients. Although specific conclusions are difficult to make from this study, the findings suggest the following: The most important etiologic factors in the click are bruxism, clenching, an occlusal slide from centric relation to centric occlusion of more than 1 mm, and lateral deviation. The most important clinical sign of TMJ clicking is palpable soreness in the lateral pterygoid and temporal muscles. Over 50% of patients with a click have bilateral click. A click occurs least often in retruded closing movement (7%) and most often in habitual movement (37%). Although it appears that closure in the retruded position may avoid click, further evaluation of the presence of click in retruded opening movement is indicated. A mean mandibular lateral deviation of 2.2 mm anteriorly is observed at the time of click.