A three-year follow-up of patients with reciprocal temporomandibular joint clicking.

It has been suggested in the literature that reciprocal temporomandibular joint clicking progresses to locking, but little information is available on the longitudinal course of this stage of internal derangement. Seventy patients with reciprocal clicking were therefore followed for 3 years. Reciprocal clicking remained unchanged in fifty patients (71%) and disappeared in twenty patients (29%). Fourteen patients (20%), in whom clicking disappeared, attained normal mouth opening, whereas locking developed in six patients (9%). At the initial examination, these six patients had more pain, more frequent joint tenderness, greater frequency of missing molar support and more often dental abrasion on the affected side than the patients who did not develop locking. It was concluded that reciprocal clicking does not usually progress to locking. However, locking is more likely to occur in patients who initially have pronounced pain, joint tenderness, dental abrasion, and no molar support on the affected side.