Temporomandibular Joint Disorder (TMJD/TMD) Studies
1. The aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs). By combining the studies (n=96) and analyzing the results, it was concluded that acupuncture is more effective than placebo in reducing pain intensity in TMD (standardized mean difference 0.83; 95% confidence interval, 0.41-1.25; P=0.00012). The results of this meta-analysis suggest that acupuncture is a reasonable adjunctive treatment for producing a short-term analgesic effect in patients with painful TMD symptoms.
3. This study aimed to retrospectively examine the efficacy and safety of acupuncture for the relief of pain originating from temporomandibular joint disorder and trigeminal neuralgia. Participants included patients suffering from trigeminal neuralgia or temporomandibular disorder with osseous pathology ruled out by panoramic X-rays.
Participants received a series of 8-10 weekly acupuncture treatments and rated their pain via a visual analogue scale. From assessment of a total of 39 patients, analysis of pain severity before and after treatment showed that acupuncture intervention was highly beneficial for patients with temporomandibular joint disorder (88.6%, p < 0.01). The data also demonstrated that acupuncture was both efficacious in acute patients (91%, p < 0.01) and chronic patients (70%, p < 0.05) and elicited no side effects during the course of treatment.
Acupuncture treatment was a safe and efficient methodology for relieving the pain of patients suffering from temporomandibular disorder with no detectable osseous joint component. Based on these results, a randomized clinical trial is being initiated at the Stomatologic Clinic at the Tel Aviv Sourasky Medical Center to assess the role of acupuncture in treating temporomandibular joint disorder.
4. Temporomandibular dysfunction often represents a major therapeutic problem in a dental practice. Evidence from clinical studies suggests that acupuncture may be useful in the treatment of temporomandibular dysfunction. However, most studies have been performed in university settings. The aims of this study were to determine if the results of acupuncture treatment of temporomandibular dysfunction in general dental practice are comparable to the results obtained in previous studies in university clinics, and whether the treatment approach differs from that used in previous studies.
A total number of 70 case reports were received. Ten patients were excluded, as they did not fulfil the criteria. The remaining 60 patients (50 female) fulfilled an average of 3.2 of the Pain Syndrome Dysfunction criteria, out of a possible five. Their mean age was 40.6 years (range 14-68). The average duration of temporomandibular dysfunction was 32 months (range 1-180). The patients received a mean of 3.4 treatments, each treatment lasting on average 12 minutes. The dentists used only manual stimulation, and mainly acupuncture points over the temporomandibular joint and in the masticatory muscles, points on the neck, and additional relaxing points.
This audit shows that the results of using acupuncture in the treatment of temporomandibular dysfunction in a general dental practice are comparable to those obtained in clinical studies in university settings. Also the therapeutic approach of using acupuncture is similar. Thus, acupuncture is a simple, relatively safe and potentially efficacious and useful technique in the management of temporomandibular dysfunction in a general dental practice.
5. The aim of this study was to investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD). Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject.
Subjects showed greater improvements in all the outcomes when receiving the deep dry needling compared to the sham dry needling. The application of dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD.
6. The purpose of this study was to investigate the levels of electromyographic (EMG) activation and maximal molar bite force before and after a 3-month acupuncture therapy in individuals with temporomandibular disorder (Helkimo Index) from a pool of subjects attending the Special Care Course of the Ribeirão Preto Dental School, São Paulo University, Brazil. All 17 patients, aged between 37 and 50 years (44.2 +/- 4.84 years), with an average weight of 71 +/- 9.45 kg and height of 1.64 +/- 0.07 m, were clinically examined with regard to pain and dysfunctions of the masticatory system. The data collected at rest, protrusion, left and right laterality, and clenching were normalized by maximum voluntary contraction. Maximal bite force in right and left molar regions were registered using a dynamometer with a capacity of up to 1000 N, adapted for oral conditions. The highest value out of three recordings was considered to be the individual's maximal bite force. The results were statistically analyzed using the paired t test (SPSS version 15.0) during the comparison before and after treatment.
Researchers found decreased EMG activity at rest, protrusion, left and right laterality, and clenching; as well as increased values of maximal bite force after acupuncture treatment. Acupuncture promoted alterations in the EMG activity of masticatory muscles, increased maximal molar bite force, and led to remission of the subjects' painful symptomatology.
8. The purpose of this study was to compare the effect of real acupuncture and sham acupuncture in the treatment of temporomandibulat joint myofascial pain, in order to establish the true efficacy of acupuncture. The study was a double blind randomised controlled trial conducted in the TMD Clinic, at the School of Dentistry, The University of Manchester. The study revealed that acupuncture had a positive influence on the signs and symptoms of TMJ MP.
The results demonstrated that real acupuncture had a greater influence on clinical outcome measure of TMJ MP than those of sham acupuncture, and the majority of these reached a level of statistical significance.
9. The purpose of this study was To assess the feasibility and acceptability of studying whole systems of Traditional Chinese Medicine (TCM) and Naturopathic medicine (NM) in the treatment of temporomandibular disorders (TMD), and to determine whether there is indication to support further research. The study used a randomized controlled clinical trial design of whole system TCM and NM versus state-of-the-art specialty care (SC). Researchers studied one hundred and sixty (160) women 25-55 years of age attending a KPNW TMD specialty clinic.
TCM and NM demonstrated significantly greater in-treatment reductions for worst facial pain compared to SC (adjusted regression analysis; higher negative values indicate greater improvement, = -1.11 +/- 0.43, p = 0.010 and -1.02 +/- 0.45, p = 0.025 for TCM and NM, respectively, compared to SC) and at 3 months post-treatment (-1.07 +/- 0.51, p = 0.037 and -1.27 +/- 0.54, p = 0.019 for TCM and NM versus SC, respectively). Additionally, TCM provided significantly greater decreases in average pain than SC; NM provided significantly greater decreases than SC or TCM in TMD-related psychosocial interference.These alternative medicine approaches each resulted in significantly greater reduction of pain and psychosocial interference than SC.
10. To explore simple and effective treatment method for temporomandibular joint disorders by investigating 96 temporomandibular joint disorder patients using electroacupuncture pulse stimulation and massage therapy. Ninety-six patients with temporomandibular joint disorder including 54 patients with myofacial pain and 42 patients with external pterygoid muscle spasm, were invloved and then divided into electroacupuncture group and massage combined with electroacupuncture group equally and randomly, with 48 cases in each group. Patients in the electroacupuncture group only received electroacupuncture pulse stimulation therapy alone at the acupoints in the affected sides.
Researchers concluded electroacupuncture pulse stimulation combined with massage therapy has a good therapeutic effect on early temporomandibular joint disorders.