Natural Course of TMJ Closed Lock

Acute closed lock of the temporomandibular joint manifests with limited mouth opening that may be accompanied by tenderness localized to the affected joint. The disorder may appear suddenly or may develop as a worsening of painful clicking and intermittent locking episodes. Assisted/stretch mouth opening usually adds little to the magnitude of opening and may elicit pain in the affected joint.

It is generally agreed that some self-improvement of signs and symptoms may occur over time, and chronic closed lock is usually less severe than the acute form. The question as to what degree are pain and dysfunction improved spontaneously and by how much time significant recovery is achieved has not been answered yet in the literature.

Few authors studied the natural course of untreated closed lock. Other authors compared “no therapy” to various treatment modalities. The results in the literature are mixed and confusing.

The aim of this presentation is to describe the author’s experience in treating patients with acute and chronic closed lock of the temporomandibular joint, and in observing the long-term outcomes of untreated patients.

The insights include conclusions on factors that may predict good spontaneous resolution of untreated patients and factors that may suggest poor prognosis of the disorder when left untreated. In addition, discussion of the available therapeutic options at the different stages of the disorder is given.