Vicente-Barrero etal.1515 Vicente-Barrero M, Yu-Lu SL, Zhang B, Bocanegra-Pérez S, Durán-Moreno D, López-Márquez A, et al. The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome. Med Oral Patol Oral Cir Bucal. 2012;17(6):e1028-33.
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20 patients |
Evaluate the effectiveness and results of the use of acupuncture or IOA in patients with TMD. |
Randomized clinical selection1 group: IOA1 group: acupuncture |
Points: ExHN5, TA 5, TA 21, TA 17, VB 2, VB 34, E6, E36, IG4. Depth: 3.5mm, 15 sessions of 30 min. |
Acupuncture comparatively showed to be more effective than IOA in the treatment of TMD. |
Jung et al.1616 Jung A, Shin BC, Lee MS, Sim H, Ernst E. Acupuncture for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized, sham-controlled trials. J Dent. 2011;39(5):341-50.
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7 studies |
Evaluate the clinical evidence pro and cons the acupuncture treatment compared to physical therapy as TMD treatment. |
Systematic review and meta-analysis |
6 studies evaluated acupuncture.Average of 1 session to 3 weeks of treatment.Most used points: IG4 (most used), ID3, ID18, ID2, E6, E7. |
The studies indicated that acupuncture has a significant effect on pain, but the results related to the penetrating needling, the fake acupuncture, real acupuncture with Qi sensation, did not show any significant difference among them. |
La Touche et al.1717 La Touche R, Angulo-Díaz-Parreño S, de-la-Hoz JL, Fernández-Carnero J, Ge HY, Linares MT, et al. Effectiveness of acupuncture in the treatment of temporomandibular disorders of muscular origin: a systematic review of the last decade. J Altern Complement Med. 2010;16(1):107-12.
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4 studies |
Evaluate the effectiveness of the acupuncture to treat muscle DTM published in the last decade. |
Systematic review |
The selected points were E7, IG4, IG2, ID3, E6. Depth: 6 to 30mm, duration: 15 to 30 min. |
The study suggests that acupuncture is beneficial in short-term muscle pain. The use of E7, E6, and IG4 is suggested for the treatment of TMD. |
Rancan et al.1818 Rancan SV, Bataglion C, Bataglion SA, Bechara OM, Semprini M, Siéssere S, et al. Acupuncture and temporomandibular disorders: a 3-month follow-up EMG study. J Altern Complement Med. 2009;15(12):1307-10.
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17 patients |
Investigate the electromyographic activation levels and the bite force in the molar region, before and after 3 months of acupuncture in subjects with TMD. |
Before-and-after type of clinical trial |
Most used points: IG4, E6, E7, B2, VB14, VB20, ID18, ID19, F3, E44, R3, ExHn3.10 sessions lasting 20 minutes. |
The data suggest that acupuncture interferes with the functional capacity of the masticatory system, changing the electromyographic activity patterns, bite force potential and decreases pain. |
Borin et al. 1919 Borin GS, Corrêa EC, Silva AM, Milanesi JM. Acupuntura como recurso terapêutico na dor e na gravidade da desordem temporomandibular. Fisioter Pesqui. 2011;18(3):217-22.
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40 patients. |
Evaluate the effect of acupuncture on pain level and TMD severity. |
Randomized clinical trial.1 group: acupuncture1 group: untreated control group. |
Most used points: E7, E5, 17, ExHn5, VB3, VB43, IG4, ExHn3. Treatment 2 times a week for 5 weeks, 30 min. |
Acupuncture has shown to be effective in decreasing the level of pain and TMD severity. |
Borin et al2020 Borin GS, Corrêa EC, Silva AM, Milanesi JM. Avaliação eletromiográfica dos músculos da mastigação de indivíduos com desordem temporomandibular submetidos à acupuntura. Rev Soc Bras Fonoaudiol. 2012;17(1):1-8.
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40 patients |
Evaluate the effect of acupuncture on the electromyographic activity of the masticatory muscles in patients with TMD. |
Clinical trial1 group: acupuncture1 group: untreated control group. |
Used points: E7, E5, TA17, ExHn5, VB34, IG4, ExHn3. Treatment 2 times a week for 5 weeks, 30 min. |
Acupuncture reduced the electric activity at mandibular rest position of the temporal muscles, provided greater balance between the masseter and temporal muscle function. Acupuncture did not act evenly on the masticatory muscles in chewing and maximum intercuspation. |
Grillo et al.2121 Grillo CM, Canales GD, Wada RS, Alves MC, Barbosa CM, Berzin F, et al. Could acupuncture be useful in the treatment of temporomandibular dysfunction? J Acupunct Meridian Stud. 2015;8(4):192-9.
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40 patients |
Evaluate the effect of acupuncture in patients with myogenic TMD compared to the control group using IOA. |
Randomized clinical trial.1 group: acupuncture1 group: IOA and information on TMD, diet, parafunctional activities 1 x week for IOA adjustment. |
Used points: IG4, IG11, ID19, F2, VB20, VB21, VB34, B2, VC23, TA23. Once a week, 20 min for 4 weeks. |
Acupuncture reduced pain intensity and improved the movement of the jaw. The two treatments have proven to be effective strategies to control TMD pain. |
Camargo, Grillo andSousa2222 Camargo BA, Grillo CM, Sousa ML. Temporomandibular disorder pain improvement with acupuncture: preliminary longitudinal descriptive study. Rev Dor. 2014;15(3):159-62.
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31 patients |
Describe the results obtained on the reduction of TMD pain intensity in patients attending the public service with a minimum of 3 acupuncture sessions. |
Descriptive study.1 group: acupunctureTreatment aiming at the rebalance becomes different for each patient. |
Used points: C7, PC6, ID3, VB20, TA23.Once a week, 3 sessions, 20 min. |
With 3 sessions it was possible to control the pain of patients with TMD. Therefore, it is understood that its use may contribute to the public service. |
Shen andGoddard2323 Shen YF, Goddard G. The short-term effects of acupuncture on myofascial pain patients after clenching. Pain Pract. 2007;7(3):256-64.
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15 participants. |
Evaluate the short-term effect of acupuncture on myofascial pain. |
Blind randomized clinical trial.1 group: acupuncture1 group: simulated acupuncture (needle did not penetrate) applied at 1cm distal to IG4. |
Used points: IG4. 1 intervention of 15 min, depth: 10 to 20mm. |
There was a significant statistical difference in pain tolerance with acupuncture. It has also reduced fascial, cervical and head pain. The tolerance to pain in the masticatory muscles increased significantly with acupuncture, more than with the simulated acupuncture. |
Smith etal.2424 Smith P, Mosscrop D, Davies S, Sloan P, Al-Ani Z. The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: a randomised controlled trial. J Dent. 2007;35(3):259-67.
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27 patients |
Compare the effect of the real acupuncture and the simulated acupuncture in the treatment of the TMJ myofascial pain to establish the real effectiveness of acupuncture. |
Double-blind, randomized controlled trial 1 group: simulated acupuncture (no penetration)1 group: real acupuncture |
Used points: E7, bilateral, 6 interventions of 20 min with manual stimulation at 5 and 10 min., for 3 weeks, depth: 6 to 12 mm. |
Acupuncture had a positive effect on TMD signs and symptoms. |
McNeely, Olivo andMagee2525 McNeely ML, Olivo SA, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther. 2006;86(5):710-25.
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12 studies |
Evaluate the methodological quality and summarize the evidence from studies, randomized controlled clinical trials, that analyzed the effectiveness of physiotherapy interventions in TMD. |
Systematic review |
Two studies concerning acupuncture. In the one with better quality, acupuncture significantly reduced pain compared to the other therapy. The other study did not show any difference between real and simulated acupuncture. |
Most of the studies had a bad methodological quality. It is worth mentioning that exercises are effective in reducing TMD symptoms and that acupuncture still needs further studies. |
Nogueira etal.2626 Nogueira CM, Nascimento MG, Malouf AB, Didier MS, Caldas Júnior AF, Kosminsky M. Acupuncture and percutaneous electric nerve Stimulation to control chronic masticatory myalgia: preliminary study. Rev Dor. 2015;16(3):162-5.
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23 patients |
Compare the analgesic effect of acupuncture with PENS on masticatory myalgia. |
Randomized clinical trial.1 group: acupuncture.1 group: PENS on the painful site needle and 100 Hz electrotherapy. |
Used points: Shenmen, IG4, E36, F3, VG20, Yintang. 2 acupuncture sessions per week for 20 min., 5 weeks, 10 to 20 mm depth. |
Acupuncture and PENS are effective in decreasing the masticatory myalgia in the masseter muscle in the short term. |
Grillo et al.2727 Grillo CM, Canales GL, Wada RS, Barbosa CM, Berzin F, Sousa ML. Psychological aspects of temporomandibular disorder patients: evaluation after acupuncture treatment. Rev Dor. 2015;16(2):114-8.
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40 patients |
Evaluate the effects of acupuncture on psychological aspects in women with chronic pain related to the diagnosis of TMD. |
Clinical trial1 group: acupuncture.1 group: IOA when sleeping, diet information and parafunctional activities. |
Used points: IG4, IG11, ID19, F2, VB20, VB21, VB34, B2, VC23, TA23 on the right side. 4 sessions, once a week for 20 min. |
Both groups improved because of the chronic nature. It is recommended a longer treatment period to extend the acupuncture benefits. |
La Touche et al.2828 La Touche R, Goddard G, De-la-Hoz JL, Wang K, Paris-Alemany A, Angulo-Díaz-Parreño S, et al. Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2010;26(6):541-50.
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9 studies. |
Perform an analysis to evaluate the quality of the studies and the effectiveness of acupuncture in pain relief. |
Systematic review and meta-analysis of randomized clinical screening |
Used points: E6, E7, VB20, Ex2, IG4, ID2, ID3, E36, Depth: 6 to 30 mm, 15 to 30 min duration. |
It is suggested that acupuncture is an effective short-term adjuvant treatment for analgesia in patients with TMD. |
Cho andWhang2929 Cho SH, Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain. 2010;24(2):152-62.
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14 studies, |
Evaluate the effectiveness of acupuncture for symptomatic treatment of TMD in a review of randomized clinical trials. |
Systematic review |
Used points: E7, IG4, ID19 were the most frequent, approximately 1 to 30 sessions. |
This review provided moderate evidence that acupuncture is effective to reduce TMD symptoms; further studies are needed. |
Rosted, Bundgaard and Pedersen3030 Rosted P, Bundgaard M, Pedersen AM. The use of acupuncture in the treatment of temporomandibular dysfunction--an audit. Acupunct Med. 2006;24(1):16-22.
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60 patients |
Investigate whether the results using acupuncture to treat patients with TMD, in a general dental practice, are comparable with the results of acupuncture achieved in previous studies in university clinics. Check if the therapeutic approach used differs from the one used in university clinics. |
Clinical trials |
Used points E5, E6, E7, E8, ID18,ID19, VB8, and EX2 (Taiyang). Thirteen dentists used relevant points in the cervical region for a headache, VB20, VB21 B10. 24 dentists used the VG20 and EX6 points to induce relaxation. Average of 3.4 sessions of 15min. |
Acupuncture is a simple, safe, and potentially useful and effective in the treatment of TMD in the general dental practice. |
Goddard et al.3131 Goddard G, Karibe H, McNeill C, Villafuerte E. acupuncture and sham acupuncture reduce muscle pain in myofascial pain patients. J Orofac Pain. 2002;16(1):71-6.
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18 patients |
Evaluate the effectiveness of a standardized acupuncture protocol in patients with myofascial pain in the jaw muscles |
Blind randomized clinical trial1 group: acupuncture1 group: fake acupuncture (needle inserted at 1 cm of the acupuncture points) IG4, E6, 2 to 4mm depth. |
Used points: IG4 and E6 bilaterally, depth of 10 to 30 mm, until getting Qi sensation. Duration of 30 min twittering for 5 seconds. at 15 minutes. |
There was no significant difference in pain reduction between the two groups. |
Fernández-Carnero et al.3232 Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge HY, et al. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. J Orofac Pain. 2010:24(1);106-12.
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12 patients |
Investigate the effectiveness of needling on the active MTPs of the masseter muscle in patients with TMD. |
Randomized clinical trial.1 group: Deep DN1 group: placebo needling on painful site. |
Deep DN with twitting maneuver for 5 times until the stimulation of muscle contraction. Two interventions at a 7-day interval. |
Deep DN on the trigger point of the masseter muscle promoted pain reduction, increasing its level of tolerance and increasing the bite force. There was an improvement in the mouth opening in the short term. |
Uemoto et al.3333 Uemoto L, Garcia MA, Gouvêa AV, Vilella OV, Alfaya TA. Laser therapy and needling in myofascial trigger point deactivation. J Oral Sci. 2013;55(2):175-81.
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21 patients |
Compare laser therapy and needle therapy in patients with myofascial pain syndrome. |
Randomized clinical trial, 1 group: laser therapy,1 group: control1 group: DN |
Total of 4 sessions with an interval of 48 and 72h. DN on the MTP of the right-side masseter muscle and needling with an injection of 2% lidocaine with no epinephrine on the left side. The laser therapy group received infra-red laser, with a dose of 4J/cm3 on the right side and 8J/cm2 on the left side. |
It showed that the injection of 2% lidocaine and laser therapy are effective to disactivate the MTG. DN proved to be effective in reducing pain according to the visual analog scale. |
Itoh et al.3434 Itoh K, Asai S, Ohyabu H, Imai K, Kitakoji H. Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial. J Acupunct Meridian Stud. 2012;5(2):57-62.
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16 patients |
Determine if acupuncture on the MTPs is effective compared to fake acupuncture. |
Blind randomized clinical trial1 group: fake acupuncture1 group acupuncture on the MTPs. |
Acupuncture on MTPs was performed by a 5 to 15mm insertion, provoking local contraction with an average of 4.2 insertions for 15 min.Once a week, 30 min for 5 weeks. In fake acupuncture, the needling was simulated with no needle penetration, for 10 minutes with an average of 4.8 insertions. |
Acupuncture on the MTPs showed to be more effective than fake acupuncture. |
Gonzalez-Perez etal.3535 Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P. Deep dry needling of trigger points located in the lateral pterygoid muscle: efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction. Med Oral Patol Oral Cir Bucal. 2015;20(3):e326-33.
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48 patients |
Investigate if deep DN in the lateral pterygoid muscle could reduce pain and improve jaw mobility in comparison with a methocarbamol/paracetamol treatment. |
Randomized open label clinical trial.1 group: DN1 group: 380mg methocarbamol, 300mg acetaminophen, 1 dose every 6h for 3 weeks. |
DN in the lateral pterygoid muscle, once a week for 3 weeks. |
Deep DN proved to be more effective than the use of pharmacological substances in reducing pain, mouth opening, laterality, and jaw protrusion. |