Table 4.
Table of characteristics of studies comparing acupuncture treatment with a placebo control group.
| Author, year | Population (Age, Sex, and Geographic location) | Signs and Symptoms | Intervention | Comparison | Outcome |
|---|---|---|---|---|---|
| Kletschaka et al., 2010 | 23 patients females between 18 and 65 years. Vienna University Dental Clinic, Austria. |
Craniomandibular pains |
Treatment protocol: needle puncture acupuncture; Acupoints: Local: Maxilla and Mandible retromolar and vestibulars; Distal: LI 4 and SI 3; ear and sternum. Frequency and duration: 1 session of 20 min. |
Treatment protocol: placebo laser acupuncture; Acupoints: Local: Maxilla and Mandible retromolar and vestibulars; Distal: LI 4 and SI 3; ear and sternum. Laser intensity: no radiation. Frequency and duration: 15s each point for 20 min. |
Assessment method: Subjective Pain by VAS (0–100) and mouth opening in mm. Follow-up: no. Subjective pain before treatment: CG: 34,1 ± 22,7 and EG: 44,0 ± 23,3. Subjective pain after treatment: CG: 27,8 ± 16,2 and EG: 24,9 ± 22,2. Mouth opening before treatment: CG and EG: NS. Mouth opening after treatment: CG and EG: NS. Puncture acupuncture treatment promoted immediate significant improvement in subjective pain (P = 0.03) with relief of (19.1 ± 11.9) and slight improvement in mouth opening without significance when compared to sham laser acupuncture. |
| Schmid-Schawap et al., 2006 | 23 female patients 17 and 68 years. Unit for Dysfunction at the University Clinic of Dentistry, Austria. | TMJ pain and tenderness on pressure of the craniomandibular musculature. |
Treatment protocol: needle puncture acupuncture; Acupoints: Local: Maxilla and Mandible retromolar and vestibulars; Distal: LI 4, SI 2, SI3, ear and sternum. Frequency and duration: 1 session of 20 min. |
Treatment protocol: placebo laser acupuncture; Acupoints: Local: Maxilla and Mandible retromolar. Distal: SI 2, SI 3, and ear. Laser intensity: no radiation. Frequency and duration: 15s each point for 20 min. |
Assessment method: subjective pain by VAS (0–100); mouth opening in mm. Follow-up: no. Subjective pain before treatment: CG: 34.1 ± 22.7 and EG: 44.0 ± 23.3. Subjective pain after treatment: CG: 27.8 ± 16.2 and EG: 24.9 ± 22.2. Mouth opening before treatment: CG: 36.2 ± 11.7 and EG: 40.4 ± 9.6. Mouth opening after treatment: CG: 37.2 ± 12.1 and EG: 45.4 ± 7.6. Puncture acupuncture treatment promoted immediate significant improvement in subjective pain (P = 0.03) with relief of 19.1 ± 11.9 and slight improvement in mouth opening when compared to sham laser acupuncture. |
| Simma et al., 2009 | 23 female patinets between 18 and 64 years. Department of Prosthetic Dentistry of the Medical University of Vienna, Austria. | Dysfunction and pain in the stomatognatic system not attributable to a known underlying disease or disorder. |
Treatment protocol: needle puncture acupuncture; Acupoints: Local: Maxilla and Mandible retromolar and vestibulums. Distal: LI 4, SI 2, SI3, ear, sternum, adler large points and others. Frequency and duration: 1 session of unspecified duration. |
Treatment protocol: placebo laser acupuncture; Acupoints: Local: Maxilla and Mandible retromolar and vestibulums. Distal: LI 4, SI 2, SI3, ear, sternum, adler large points and others. Laser intensity: no radiation. Frequency and duration: 1 session and each point for 2 min. |
Assessment method: Subjective pain by VAS; Pain intensity after palpation on orofacial areas: atlanto-occipital junction and muscles: temporal (anterior, mediali, and posterior), cranio-mandibular junction, pterygoid, masseter, digastricus, and sternocleidomastoideus by sum of pain ratings (0–3). Follow-up: no. Subjective pain before treatment: CG: 41,0 (34,0) and EG: 40,5 (34,0). Subjective pain after treatment: CG: 30,0 (28,5) and EG: 16,5 (33,0). Palpation pain before treatment: CG: 19.0 (15.0) and EG: 22.5 (7.8). Palpation pain after treatment: CG: 16.0 (20.0) and EG: 8.0 (10.0). Treatment with immediate needle acupuncture was shown to significantly reduce subjective pain (P = 0.031) and muscle pain (P < 0.001) when compared to sham laser. |
| Sales-Neto et al., 2020 | 32 Female patients between 18 and 60 years. Orofacial Pain Service of the Clinics Hospital of UFMG in Belo Horizonte, Brazil | Masticatory myofascial pain and pain intensity ≥4 VAS for at least three months. |
Treatment protocol: needle puncture acupuncture; Acupoints: large intestine 4 (Hegu), gall bladder 34 (Yanglingquan), stomach 36 (Zusanli), small intestine 18 (Quanliao), small intestine 19 (Tinggong), stomach 6 (Jiache), stomach 7 (Xiaguam), gall bladder 20 (Fengchi). Frequency and duration: 5 sessions one per week for 20 min. |
Treatment protocol: placebo needle puncture acupuncture; Acupoints: large intestine 4 (Hegu), gall bladder 34 (Yanglingquan), stomach 36 (Zusanli), small intestine 18 (Quanliao), small intestine 19 (Tinggong), stomach 6 (Jiache), stomach 7 (Xiaguam), gall bladder 20 (Fengchi). Frequency and duration: 5 sessions one per week for 20 min. |
Assessment method: Subjective pain by VAS (0-10) and mandibular function by MOPDS. Follow-up: no. Subjective pain before treatment: CG: 5 (0–10) and EG: 6.5 (3–10). Subjective pain after treatment: CG: 3.5 (0–6) and EG: 1(0–9). Mandibular function before treatment: CG: 11.9 (9.2) and EG: 12.9 (7.8). Mandibular function after treatment: CG: 8.9 (7.9) and EG: 8 (6.1). Both groups showed improvements for subjective pain and jaw function, without statistical significance when comparing them. Being higher for EG with subjective pain relief (≅5.5) and mandibular function (≅5). |
| Smith et al., 2007 | 27 patients females and males between 40,5 (13,63) years. TMD Clinic, at the School of Dentistry, The University of Manchester, United Kingdom. | Pain on palpation of the associated muscles; limitation or deviation of mandibular movement; intermittent joint sounds such clicking or cracking (but not crepitus); headache; were present for at least 6 months. |
Treatment protocol: needle puncture acupuncture; Acupoints: ST7. Frequency and duration: 3 sessions one per week for 20 min. |
Treatment protocol: placebo needle puncture acupuncture; Acupoints: ST7. Frequency and duration: 3 sessions one per week for 20 min. |
Assessment method: Subjective pain by VAS (0-10); and maximum mouth opening in mm by Vernier style bite gauge. Follow-up: no. Subjective pain before treatment: CG: 1.41 and EG: 6.21. Subjective pain after treatment: CG: 1.33 and EG: 2.89. Maximum mouth opening before treatment: CG: 40.75 and EG: 36.06. Maximum mouth opening after treatment: CG: 39.25 and EG: 39.26. Both groups promoted improvements in Subjective pain with greater relief for EG (3.31). And there was an improvement in mouth opening (3.2) for EG. |
| Madani et al., 2020 | 45 patients females and males between 15 and 71 years. Occlusion and TMD Department of Mashhad Dental School, Mashhad University of Medical Sciences, Iran. | Limited mouth opening or function and the presence of pain in masticatory muscles and/or TMJs, either in clenching or in jaw movements | Treatment protocol: laser acupuncture; G1: LLLT Points: posterior and superior of the mandibular condyles, Inside the external acoustic meatus, and on tender muscle points. Laser intensity: wavelength of 810 nm and 200 mW. Frequency and duration: 2 times a week for 10 weeks for 30s each point. G2: LAT Acupoints: ST6, ST7, and LI4. Laser intensity: wavelength of 810 nm and 200 mW. Frequency and duration: 2 times a week for 10 weeks for 30s each point. |
Treatment protocol: laser acupuncture; Points: posterior and superior of the mandibular condyles, Inside the external acoustic meatus, and on tender muscle points. Laser intensity: off. Frequency and duration: 2 times a week for 10 weeks for 30s each point. |
Assessment method: Pain intensity after palpation (1.0 kg force in external muscle and 0.5 kg in intra-oral muscle) on orofacial areas: masseter, tendon of temporal, insertion of internal pterygoid and TMJ by VAS (0–10); and maximum mouth opening by digital caliper in mm; Follow-up: one month. Palpation pain before treatment: CG, G1 and G2: 6,1 a 6,5 VAS. Palpation pain after treatment: CG: 5,06, G1: 1,40, and G2: 1,77. Mouth opening before treatment: CG: 33.1 ± 12,80, G1: 34.6 ± 9.78, and G2: 39.2 ± 7.18. Mouth opening after treatment: CG: 38.6 ± 7.72, G1: 41.57 ± 8.21, and G2: 40.82 ± 8.97. For pain on palpation, there were significant improvements in the 3 groups among them, with the greatest relief being for G1 (5.1) and it continued to be significant after one month of the last application. For mouth opening there were improvements, but not significant among them, being the greatest for G1 (≅7). |
CG, control group; EG, experimental group; LA, laser acupuncture; LAT, laser acupuncture therapy; LLLT, low-level laser therapy; MOPDS, Manchester Orofacial Pain Disability Scale; NS, not specified; OD, occlusal device; TMJ, temporomandibular joint; VAS, visual analogue pain scale.