Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland.
Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland.
Int J Environ Res Public Health. 2021 Sep 10;18(18):9552. doi: 10.3390/ijerph18189552.
Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction.
The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis.
According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle.
Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.
肌筋膜疼痛是整个人群残疾的一个重要原因，也是颞下颌关节紊乱症（TMD）的常见症状。其治疗技术差异很大；然而，近年来，由于咀嚼肌内针刺疗法的简单性和有效性，特别是在减轻疼痛方面，人们对其越来越感兴趣。
本研究的构建基于 PICOS 和 PRISMA 方案。基于 PubMed 和 BASE 搜索引擎进行了系统的文献检索。对上述数据库的搜索共产生了 367 篇文章。通过筛选程序和全文分析，纳入了 28 篇文章进行详细分析。
根据分析数据，临床医生要么采用湿式针刺疗法，要么采用干式针刺疗法来治疗肌筋膜疼痛。在临床试验中，研究最深入、显著流行的方法是将肉毒杆菌毒素注射到咬肌和颞肌中。其他常见的方法是应用局部麻醉剂或干式针刺疗法；然而，我们注意到引入了完全新的物质，如富含血小板的血浆或胶原蛋白。在分析的文章中，针刺疗法的目标肌肉最常通过手动触诊定位，尽管有各种描述的导航支持系统：肌电图、MRI 或 EIP 电疗设备，这些系统通常有助于找到位于更深处的翼内肌和翼外肌。
咀嚼肌内针刺疗法是一种简单、安全、易于操作的治疗方法，效果令人满意，但仍需要高质量的临床试验来研究特别是非肉毒毒素物质的注射和翼内肌和翼外肌的针刺。
