The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome

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The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome.

OBJECTIVES: The goal of the present study was to evaluate the results of applying acupuncture or occlusal decompression splints in the treatment of patients diagnosed with the temporomandibular joint pain-dysfunction syndrome. DESIGN OF THE STUDY: We conducted a randomized clinical trial including 20 patients to whom the mentioned treatments were applied. Results were evaluated through an analogue pain scale, measurements of mouth opening and jaw lateral deviation in millimetres, and assessment of sensitivity to pressure on different points: preauricular, masseter muscle, temporal muscle and trapezius. Parameters were evaluated before and 30 days after the treatment. For standardized pressure, we used a pressure algometer. RESULTS: Patients treated with decompression splints showed reductions in subjective pain and pain upon pressure on temporal, masseter and trapezius muscles, as well as increased mouth opening after the treatment. Patients treated with acupuncture showed pain reduction in the short term and improvements in all of the evaluated para-meters (stronger pressure was required to produce pain; mouth opening was improved). CONCLUSION: Acupuncture was an effective complement and/or an acceptable alternative to decompression splints in the treatment of myofascial pain and temporomandibular joint pain-dysfunction syndrome.

[Osteonecrosis of the jaw secondary to oral alendronate: Report of three cases]. / Osteonecrosis maxilar secundaria al uso de bisfosfonatos por vía oral: Exposición de tres casos clínicos relacionados con alendronato.

Osteonecrosis of the jaw associated to biphosphonate use is more common in cancer patients with bone metastases, that are using intravenous diphosphonates. When these drugs are used orally the risk of the complication is lower. We report 3 diabetic women aged 69, 76 and 82 years, receiving alendronate 70 mg every one week. The unveiling event was the extraction of several teeth without the use of antibiotics. All had bone pain, purulent discharge, loss of bone and halitosis. All improved five months after discontinuing alendronate.

Osteonecrosis maxilar secundaria al uso de bisfosfonatos por vía oral: Exposición de tres casos clínicos relacionados con alendronato / Osteonecrosis of the jaw secondary to oral alendronate: Report of three cases

Osteonecrosis of the jaw associated to biphosphonate use is more common in cancer patients with bone metastases, that are using intravenous diphosphonates. When these drugs are used orally the risk of the complication is lower. We report 3 diabetic women aged 69, 76 and 82 years, receiving alendronate 70 mg every one week. The unveiling event was the extraction of several teeth without the use of antibiotics. All had bone pain, purulent discharge, loss of bone and halitosis. All improved five months after discontinuing alendronate.

Bisphosphonate-associated osteonecrosis of the jaw. A proposal for conservative treatment

The use of bisphosphonates (BPs) has proven effective in the treatment of bone-related diseases, despite the potentialrisk of developing osteonecrosis of the jaw (ONJ). So far, results for the treatment of ONJ have not been satisfactory.In our study, we have treated two patients diagnosed with ONJ. In addition to local treatments a hydrogel wasapplied, with promising results. The fistulae disappeared 2-3 weeks into the treatment. After a six-month follow-upperiod there has been no sign of recurrence. The extent of maxillary bone exposure has diminished notably, althoughnot entirely disappeared. In all cases, the patients exhibit no other symptoms (they suffer from no pain or swelling orfunctional impotence). For this reason we believe this protocol might be useful in the case of patients who suffer frompain and fistulation secondary to BP-associated ONJ to improve the state of their lesions until definitive treatmentcan be undertaken.Although these findings are not conclusive, given that we are reporting data on two patients only, we believe thatthis might be an alternative treatment in refractory cases where other therapies are counter-indicated. A controlledrandomized and prospective study would be required to confirm our findings (AU)