A young lady came into my practice last week complaining of pain on the right side of her face. Her discomfort had been growing in intensity since she finished her orthodontic treatment a few days before.
She had pain on loading in the right side and pain to palpation behind the right condyle when her jaw was open. The right masseter, temporalis, medial pterygoid and splenius capitus were painful to palpation and she described the degree as a seven out of 10. The same muscles on the left side are slightly tender to palpation.
There is no noise in either joint; she had no history of joint signs or symptoms, no deviation on opening and a normal range of motion. Her CBCT shows normal joint anatomy and condylar position.
The images of the models were made after she was in an anterior deprogrammer for 15 minutes. At that time she could squeeze with no discomfort in the joint, although the muscles were still very sore. The only teeth in contact are the right canines. So the question is: What the heck is going on? Is this an orthodontic misadventure or all muscle contraction that is causing the posterior open bite?