Clear aligner therapy and symptoms of temporomandibular disorders: a case report

The etiology of temporomandibular disorders (TMDs) is remarkably diverse. This case report highlights the use of clear aligners as a probable cofactor of TMD in an adult patient. A 56-year-old woman who presented with a chief concern of crowding was missing teeth in both arches and had generalized tooth wear, an indistinct history of temporomandibular joint musculoskeletal pain, and a self-reported history of clenching. Based on the patient's preferences, clear aligner therapy (CAT) was initiated with a limited treatment goal of providing improved esthetics by reducing the overjet, expanding the arches, and aligning the anterior teeth. A few weeks into CAT, the patient developed acute masticatory facial pain. Therefore, the course of CAT was adjusted in favor of an individualized protocol to alleviate her occlusal symptoms until orthodontic treatment was completed. Dental providers must consider the potential contributory role of CAT in TMDs in patients who adapt poorly to occlusal changes and offer a patient-centered approach to manage the problem.