Acupuncture therapeutic protocols for the management of temporomandibular disorders

Abstract

A total of 125 articles were found and 21 were included. Acupuncture treatment alone or as additional therapy, or even compared to other techniques, was superior and effective to improve pain and function of patients with temporomandibular disorders and most commonly used acupoints were IG4, E6, E7 and F3. CONCLUSION: This study has shown that acupuncture is a technique recommended by national and international literature to treat muscular temporomandibular disorders, promoting pain relief and/or total intensity, improvement of joint movements and oral function and decrease of masticatory muscles hyperactivity. Keywords: Acupuncture analgesia, Acupuncture points, Facial pain, Temporomandibular disorder syndrome, Temporomandibular joint disorder. Correspondence to:André Luís Porporatti Al. Octávio Pinheiro Brizolla, 9-75 -Vila Universitária 17012-901Bauru, SP, Brasil. E-mail:andreporporatti@yahoo.com.br © Sociedade Brasileira para o Estudo da Dor RESUMO JUSTIFICATIVA E OBJETIVOS: Na grande maioria dos casos, o tratamento das disfunções temporomandibulares deve ser um processo não invasivo, interdisciplinar e integrativo. Dentro da medicina tradicional chinesa, a acupuntura é uma ótima ferramenta que visa a terapia e cura dessas doenças. O objetivo deste estudo foi conduzir uma revisão crítica da literatura para verificar a eficácia da acupuntura tradicional chinesa no tratamento da disfunção temporomandibular do tipo muscular, bem como identificar os principais acupontos. CONTEÚDO: Foi realizada uma pesquisa nas bases de dados Pubmed, LILACS, Scielo e Cochrane para identificar artigos científicos relevantes para o estudo. Os artigos foram selecionados no período de janeiro de 2000 a maio de 2013. Encontrou-se um total de 125 artigos, sendo que 21 foram incluídos. O tratamento de acupuntura isolado ou como terapia complementar, ou ainda comparado com outras técnicas, se mostrou superior e eficiente na melhora da dor e da função de pacientes com disfunção temporomandibular, e os pontos de acupuntura mais citados foram IG4, E6, E7 e F3. CONCLUSÃO: Este estudo demonstrou que a acupuntura é uma técnica recomendada pela literatura nacional e internacional para o tratamento de disfunções temporomandibulares de origem muscular, promovendo alivio e/ou redução total da intensidade dolorosa, melhora nos movimentos mandibulares e na função oral e diminuição da hiperatividade muscular dos mús-culos da mastigação. Descritores: Analgesia por acupuntura, Dor facial, Pontos de acupuntura, Síndrome da disfunção da articulação temporomandibular, Transtornos da articulação temporomandibular. INTRODUCTIONOrofacial pain is associated to head, face and neck soft tissues and may be defined as dysfunction and pain affecting sensory and motor transmission in the trigeminal nervous system 1 . Among pains affecting this region there are temporomandibular disorders (TMD) which represent a collective term related to a group of musculoskeletal and joint problems which affect the temporomandibular joint (TMJ) and associated structures 1,2 . TM...

Effectiveness of acupuncture for temporomandibular disorders and associated symptoms

“…Acupuncture uses individuals' bioenergetic balance, promoting sensation of wellbeing (endogenous opioids release) and dramatically decreasing muscle tension points and/or trigger-points, frequent in TMD patients 29 . So, it is important tool to manage patients with joint 16 and muscle 24 disorders, with good clinical results 24,30,31 . According to the principles of the technique, needle entrance in skin causes micro-inflammation which moves natural serotonin, encephalin and endorphin production.…”

“…So, body response is faster, decreasing symptoms intensity, often making them disappear. Acupuncture stimulates blood circulation dynamics due to regional microdilation and relaxation; it releases hormones, such as cortisol and endorphins; increases host resistance by means of stimulating hypothalamus, hypophysis and other important glands for systemic recovery; it normalizes body functions and stimulates metabolism of different organs 24,28 . So, it is characterized as potent analgesic, sedative and relaxant, which is the basis for its application in dental treatments 32 .…”

“…In cases of extreme pain, improvement might be immediate, being that as from the second session treatment may be once a week in a total of six sessions and may continue for three months until symptoms remission 17 . Some more recent studies evaluating the effects of acupuncture in TMD 16,[22][23][24]31,34,35,38 , and published in the last five years, are described in table 1. There is no standard clinical protocol to select points used in each treatment.…”

“…Among these techniques, one should stress acupuncture [10][11][12][13][14][15][16][17] . Due to its recent use in dentistry, its noninvasive character and effective results, it has been successfully used for this purpose 14,16,[18][19][20][21][22][23][24] . Acupuncture is a millenary technique of Traditional Chinese Medicine (TCM) which has been justified and structured on philosophical, rather than scientific basis 25 .…”

“…Acupuncture aims at developing body balance by intervening in the physical body to help reestablishing lost harmony between physical and psychic parts 25 . Literature suggests that, in TMD patients, acupuncture speeds serotonin, encephalin and endorphin release, being effective to increase jaw movement amplitude and oral function, decreasing muscle hyperactivity, favoring masticatory muscles relaxation, thus decreasing pain 24 . Acupuncture is no longer considered an alternative method, but rather it started to be a treatment alternative without major adverse effects for using own body substances to control pain 14 .…”