Rosted Palle, Bundgaard Mads, Pedersen Anne Marie Lynge
Sheffield University, Sheffield, UK.
Acupunct Med. 2006 Mar;24(1):16-22. doi: 10.1136/aim.24.1.16.
Temporomandibular dysfunction often represents a major therapeutic problem in a dental practice. Evidence from clinical studies suggests that acupuncture may be useful in the treatment of temporomandibular dysfunction. However, most studies have been performed in university settings. The aims of this study were to determine if the results of acupuncture treatment of temporomandibular dysfunction in general dental practice are comparable to the results obtained in previous studies in university clinics, and whether the treatment approach differs from that used in previous studies.
The case reports submitted by 15 dentists applying for the diploma of the British Dental Acupuncture Society were combined into one audit. All dentists were informed before submitting the forms that the data might be used for scientific purposes. The criteria for Pain Syndrome Dysfunction were used as inclusion criteria. A visual analogue scale (VAS) was used to assess the pain intensity before and after acupuncture treatment. The acupuncture points and technique used were recorded for each treatment.
A total number of 70 case reports were received. Ten patients were excluded, as they did not fulfil the criteria. The remaining 60 patients (50 female) fulfilled an average of 3.2 of the Pain Syndrome Dysfunction criteria, out of a possible five. Their mean age was 40.6 years (range 14-68). The average duration of temporomandibular dysfunction was 32 months (range 1-180). The patients received a mean of 3.4 treatments, each treatment lasting on average 12 minutes. The dentists used only manual stimulation, and mainly acupuncture points over the temporomandibular joint and in the masticatory muscles, points on the neck, and additional relaxing points. The mean pain scores were 7.35 (SD 1.52) before treatment and 2.67 (SD 0.58) after treatment (P < 0.001). A beneficial effect was observed in 85% with an average reduction in the pain intensity of 75%.
This audit shows that the results of using acupuncture in the treatment of temporomandibular dysfunction in a general dental practice are comparable to those obtained in clinical studies in university settings. Also the therapeutic approach of using acupuncture is similar. Thus, acupuncture is a simple, relatively safe and potentially efficacious and useful technique in the management of temporomandibular dysfunction in a general dental practice.
颞下颌关节紊乱症在牙科诊疗中常常是一个主要的治疗难题。临床研究证据表明，针灸可能对颞下颌关节紊乱症的治疗有用。然而，大多数研究是在大学环境中进行的。本研究的目的是确定在普通牙科诊所中针灸治疗颞下颌关节紊乱症的结果是否与先前在大学诊所的研究结果相当，以及治疗方法是否与先前研究中使用的方法不同。
将15位申请英国牙科针灸学会文凭的牙医提交的病例报告合并为一次审核。在提交表格之前，所有牙医均被告知这些数据可能会用于科学目的。采用疼痛综合征功能障碍标准作为纳入标准。使用视觉模拟量表（VAS）评估针灸治疗前后的疼痛强度。记录每次治疗所使用的穴位和技术。
共收到70份病例报告。10名患者因不符合标准而被排除。其余60名患者（50名女性）平均符合3.2项疼痛综合征功能障碍标准（满分5项）。他们的平均年龄为40.6岁（范围14 - 68岁）。颞下颌关节紊乱症的平均病程为32个月（范围1 - 180个月）。患者平均接受3.4次治疗，每次治疗平均持续12分钟。牙医仅使用手动刺激，主要是颞下颌关节和咀嚼肌上的穴位、颈部穴位以及其他放松穴位。治疗前平均疼痛评分为7.35（标准差1.52），治疗后为2.67（标准差0.58）（P < 0.001）。85%的患者观察到有益效果，疼痛强度平均降低75%。
本次审核表明，在普通牙科诊所中使用针灸治疗颞下颌关节紊乱症的结果与在大学环境中的临床研究结果相当。而且使用针灸的治疗方法也相似。因此，针灸在普通牙科诊所管理颞下颌关节紊乱症方面是一种简单、相对安全且可能有效且有用的技术。
