Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disorders

Abstract

Background and Objectives: The objective of our clinical trial was to determine the effectiveness of the deep dry needling technique (DDN) (neuromuscular deprogramming) as a first step in the treatment of temporomandibular disorders. Methods and Materials: The double-blind randomized clinical trial comprised 36 patients meeting the inclusion criteria who had signed the corresponding informed consent form. The participants were randomly distributed into two groups, the Experimental group (Group E) and the Control group (Group C). Group E received bilateral DDN on the masseter muscle, while Group C received a simulation of the technique (PN). All the participants were evaluated three times: pre-needling, 10 min post-needling, and through a follow-up evaluation after 15 days. These evaluations included, among other tests: pain evaluation using the Visual Analog Scale (VAS) and bilateral muscle palpation with a pressure algometer; evaluation of the opening pattern and range of the mouth, articular sounds and dental occlusion using T-scans; and electromyography, which was used to evaluate the muscle tone of the masseter muscles, in order to control changes in mandibular position. Results: Digital control of occlusion using Tec-Scan (digital occlusion analysis) showed a significant reduction both in the time of posterior disclusion and in the time needed to reach maximum force in an MI position after needling the muscle, which demonstrated that there were variations in the static position and the trajectory of the jaw. The symmetry of the arch while opening and closing the mouth was recovered in a centric relation, with an increase in the opening range of the mouth after the procedure. Conclusions: facial pain is significantly reduced and is accompanied by a notable reduction in muscle activity after needling its trigger points.

Effectiveness of Dry Needling versus Manual Therapy in Myofascial Temporomandibular Disorders: A Single-Blind Randomized Controlled Trial

“…Two previous reviews have shown that dry needling may be effective for improving PPT in patients with TMDs, although these findings present a very low quality of evidence [ 36 , 37 ]. As such, the findings of our study and others recently published, such as those by Dib-Zakkour et al (2022), can provide robustness to the meta-analyses that were performed [ 32 ].…”

Temporomandibular Joint Dysfunctions: A Systematic Review of Treatment Approaches

“…Considering the DC/TMD [ 8 ], and despite the absence of reporting the cause of the TMD in several studies [ 17 , 21 , 22 , 23 , 24 , 25 ], we found TMD of myogenic origin in Brochado et al [ 14 ] and in the one developed by Urbanski et al [ 27 ], in which participants present TMDs with a muscular component. Joint pain as a disorder was found in two of the included studies [ 19 , 20 ].…”

“…Dalewski et al [ 20 ] examined three intervention modalities: nonsteroidal anti-inflammatory drugs, dry needling, and a control group. However, Dib-Zakkour et al [ 21 ] investigated the effectiveness of dry needling as an initial treatment step for TMDs. Another emerging treatment option was the use of electroacupuncture for TMJ pain.…”

“…Based on this, out of the fifteen articles included in this review, nine articles [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 25 , 27 ] exhibit good methodological quality. Three of the fifteen articles [ 21 , 23 , 24 ] show regular quality, while two [ 26 , 27 ] exhibit poor quality, having obtained a score of 3 points. Lastly, the work carried out by Nambi et al [ 22 ] presents the highest score among the 15 articles, 9/10, indicating excellent methodological quality.…”

“…The study by Dib-Zakkour et al [ 21 ] demonstrated that the bilateral application of deep dry needling on the masseter muscle resulted in significant reductions in facial pain and muscle activity following trigger point needling. This finding is consistent with the results obtained by Ziaeifar et al [ 33 ], whose study showed significant changes in neck pain intensity and disability levels after dry needling sessions.…”