Temporomandibular disorders and the use of traditional and laser acupuncture: a systematic review.

OBJECTIVE: To evaluate current studies to establish and compare the efficacy of traditional and laser acupuncture in reducing the signs and symptoms of temporomandibular disorders (TMD). METHODS: PubMed, Cochrane, Scopus, and Web of Science databases were searched. Clinical, controlled, and randomized trials written in English and having used traditional or laser acupuncture as therapy for TMD and RDC/TMD or DC/TMD as a diagnostic criterion for TMD were included. RESULTS: Six studies that evaluated the intensity of pain and the level of mouth opening of the patients submitted to acupuncture were selected, and all showed improvement. However, similar results were also observed in the groups treated with occlusal splint and placebo acupuncture. Only one study evaluated laser acupuncture and showed a higher proportion of patients with remission of symptoms in the experimental group. CONCLUSION: The traditional acupuncture seems to relieve the signs and symptoms of TMD, as well as laser acupuncture when associated with occlusal splint. However, more rigorous and high-quality clinical trials are needed.

Short-Term Effect of Scalp Acupuncture on Pain, Sleep Disorders, and Quality of Life in Patients with Temporomandibular Disorders: A A Randomized Clinical Trial.

OBJETIVE: To evaluate the effects of Chinese scalp acupuncture in patients diagnosed with temporomandibular disorders (TMD) on pain, sleep, and quality of life (QOL), and compare these results with the results from traditional therapies. METHODS: Sixty patients diagnosed with TMD using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) were allocated into four treatment groups: counseling (C = 15), occlusal splint (OS = 15), scalp acupuncture (SA = 15), and manual therapy (MT = 15). Participants were re-evaluated within 1 month. Three questionnaires were used to access sleep disorders, QOL, and pain: The Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-bref), and the Visual Analogue Scale (VAS), respectively. The data obtained were analyzed using the Statistical Package for the Social Science program (SPSS 22.0). RESULTS: The SA group significantly improved pain (P = .015), as well as the OS (P = .01) and MT groups (P = .014). Only the OS (P = .002) and MT (P = .029) groups improved sleep. MT group significantly improved QOL in terms of the physical domain of the WHOQOL-bref (P = .011) and the OS group in the psychological domain (P = .012). CONCLUSIONS: The scalp acupuncture proved to be another alternative for pain relief in patients with TMD, demonstrating positive results in the short term. However, it was not as effective in improving quality of life and sleep.

Manual Therapy in the Treatment of Myofascial Pain Related to Temporomandibular Disorders: A Systematic Review.

AIMS: To evaluate the effectiveness of manual therapy in the treatment of myofascial pain related to temporomandibular disorders. METHODS: Randomized clinical trials were searched in the Cochrane Library, MEDLINE, Web of Science, Scopus, LILACS, and SciELO databases using the following keywords: temporomandibular joint disorders; craniomandibular disorders; myofascial pain syndromes; myofascial pain; exercise therapy; myofunctional therapy; physical therapy modalities; clinical trial; prospective studies; and longitudinal studies. Studies using the RDC/TMD and manual therapy for myofascial pain were included. All studies were evaluated using the Cochrane Risk of Bias tool. RESULTS: Five studies were included in the present review. Of 279 total patients, 156 were treated with manual therapy only or manual therapy with counseling. Manual therapy was efficient for pain relief in all studies evaluated; however, manual therapy was not better than counseling or botulinum toxin. CONCLUSION: Manual therapy was better than no treatment in one study and better than counseling in another study; however, manual therapy combined with counseling was not statistically better than counseling alone, and manual therapy alone was not better than botulinum toxin. Manual therapy combined with home therapy was better than home therapy alone in one study. Further studies are required due to the inconclusive data and poor homogeneity found in this review.

Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review.

AIMS: To carry out a systematic review of clinical trials published up to 2015 to determine the effectiveness of acupuncture in treating myofascial pain in temporomandibular disorder (TMD) patients. METHODS: The databases used were the Cochrane Library, PubMed, Scopus, and Web of Science; the dates of the articles surveyed ranged from 1990 to May 2015. The inclusion criteria were: (1) publications in English, Portuguese, or Spanish; (2) controlled clinical trials; (3) patients with TMD of muscular origin; and (4) studies that used acupuncture or laser acupuncture only for treatment. Reference lists of the included articles were hand searched. RESULTS: A total of four randomized clinical trials using acupuncture (traditional, trigger point, and laser) for TMD treatment met the eligibility criteria and were included. Although the studies featured small sample sizes and short-term follow-up periods, acupuncture yielded results similar to those observed in groups treated with occlusal splints and were significantly superior than those obtained from placebo acupuncture-treated groups. CONCLUSION: Despite the weak scientific evidence supporting its efficacy, acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial TMD. More controlled and randomized clinical trials with larger sample sizes are needed in this field of research to verify these initial findings.

All-ceramic crowns over single implant zircon abutment. Influence of young's modulus on mechanics.

PURPOSE: The aim of this study was to evaluate the influence of different Young moduli of the ceramic crown on the distribution of tensions in the region of the abutment-crown interface by making use of 2D finite element analysis. MATERIALS: Two representative models of a sagittally sectioned maxilla were built through AutoCad program showing an implant in the region of the upper central incisor and were restored by means of IPS e.max Press or Procera AllCeram on zircon abutment. Numerical analysis (Ansys 10.0) was performed under 2 loading conditions (50 N): on the lingual face, at 45 degrees with the implant's long axis (L1) and perpendicular to the incisal edge (L2). The von Mises equivalent stress (σvM) and maximum principal stress (σmax) were obtained. RESULTS: It was noticed that, independent of the restoring system, the maximum σvM values were in the incisal region of the cementation interface for both loading conditions. The IPS e.max Press system showed higher σvM on the adhesive interface with higher L1 influence. The same behavior was also observed as regards the σmax variation. CONCLUSIONS: It was concluded that a restoring system with a lower Young modulus shows higher stress concentration on the abutment-crown interface when cemented on an abutment with a high Young modulus. Thus, IPS e.max Press system provides higher stress concentration in the resin cement layer than Procera AllCeram system, suggesting that the resin cement layer shows lower failure risk when the Procera crown is used.