The Surgery and Odontostomatology Doctoral Program, University of Salamanca, 37007 Salamanca, Spain.
Department of Surgery, University of Salamanca, 37007 Salamanca, Spain.
Medicina (Kaunas). 2022 Feb 9;58(2):256. doi: 10.3390/medicina58020256.
: The objective of our clinical trial was to determine the effectiveness of the deep dry needling technique (DDN) (neuromuscular deprogramming) as a first step in the treatment of temporomandibular disorders. : The double-blind randomized clinical trial comprised 36 patients meeting the inclusion criteria who had signed the corresponding informed consent form. The participants were randomly distributed into two groups, the Experimental group (Group E) and the Control group (Group C). Group E received bilateral DDN on the masseter muscle, while Group C received a simulation of the technique (PN). All the participants were evaluated three times: pre-needling, 10 min post-needling, and through a follow-up evaluation after 15 days. These evaluations included, among other tests: pain evaluation using the Visual Analog Scale (VAS) and bilateral muscle palpation with a pressure algometer; evaluation of the opening pattern and range of the mouth, articular sounds and dental occlusion using T-scans; and electromyography, which was used to evaluate the muscle tone of the masseter muscles, in order to control changes in mandibular position. : Digital control of occlusion using Tec-Scan (digital occlusion analysis) showed a significant reduction both in the time of posterior disclusion and in the time needed to reach maximum force in an MI position after needling the muscle, which demonstrated that there were variations in the static position and the trajectory of the jaw. The symmetry of the arch while opening and closing the mouth was recovered in a centric relation, with an increase in the opening range of the mouth after the procedure. : facial pain is significantly reduced and is accompanied by a notable reduction in muscle activity after needling its trigger points.
: 我们的临床试验目的是确定深部干针技术(DDN)(神经肌肉重编程)作为治疗颞下颌关节紊乱的第一步的有效性。这项双盲随机临床试验包括 36 名符合纳入标准并签署相应知情同意书的患者。参与者被随机分为两组,实验组(E 组)和对照组(C 组)。E 组接受双侧咬肌 DDN,而 C 组接受模拟技术(PN)。所有参与者均进行了 3 次评估:针刺前、针刺后 10 分钟和 15 天后的随访评估。这些评估包括:视觉模拟评分法(VAS)评估疼痛、双侧肌肉触诊压力计;T 扫描评估开口模式和范围、关节音和牙合;肌电图用于评估咬肌的肌张力,以控制下颌位置的变化。 Tec-Scan 进行数字控制咬合(数字咬合分析)显示,针刺肌肉后,后牙合时间和达到最大肌力所需的时间均显著减少,这表明静态位置和下颌轨迹发生了变化。开口和闭口时弓的对称性在正中关系中得到恢复,术后张口范围增加。 : 面部疼痛明显减轻,针刺其触发点后肌肉活动明显减少。