Temporomandibular disorders and the use of traditional and laser acupuncture: a systematic review

OBJECTIVE

To evaluate current studies to establish and compare the efficacy of traditional and laser acupuncture in reducing the signs and symptoms of temporomandibular disorders (TMD).

METHODS

PubMed, Cochrane, Scopus, and Web of Science databases were searched. Clinical, controlled, and randomized trials written in English and having used traditional or laser acupuncture as therapy for TMD and RDC/TMD or DC/TMD as a diagnostic criterion for TMD were included.

RESULTS

Six studies that evaluated the intensity of pain and the level of mouth opening of the patients submitted to acupuncture were selected, and all showed improvement. However, similar results were also observed in the groups treated with occlusal splint and placebo acupuncture. Only one study evaluated laser acupuncture and showed a higher proportion of patients with remission of symptoms in the experimental group.

CONCLUSION

The traditional acupuncture seems to relieve the signs and symptoms of TMD, as well as laser acupuncture when associated with occlusal splint. However, more rigorous and high-quality clinical trials are needed.

Cefaleia relacionada ao uso do EPI durante a pandemia do COVID-19 em cirurgiões dentistas

A pandemia de Covid-19 trouxe um aumento do uso de equipamentos de proteção individual (EPI) pelos profissionais da saúde, além de um aumento do relato de episódios de cefaleia. Dessa forma, esse estudo verificou a presença e as características da cefaleia pelo uso de EPI em cirurgiões-dentistas (CD) durante a pandemia de COVID-19. Foram incluídos 641 CD que responderam a um formulário eletrônico contendo: Questionário de triagem de dor para Disfunções Temporomandibulares, Índice de Qualidade do Sono de Pittsburgh, Escala de Depressão, Ansiedade e Estresse e questões sobre as características da cefaleia durante a pandemia. Para análise estatística o método de regressão logística foi utilizado considerando um nível de significância de 5%. Foi observado que 40,38% dos pacientes possuíram algum tipo de cefaleia possivelmente relacionada ao uso do EPI. Desses, 51,18% relataram dor na região temporal e parietal, 41,76% na região frontal, 21,18% na occipital, 15,88% orbital, 14,12% no topo da cabeça e 9,41 em toda a cabeça. Em 82,35% dos pacientes a cefaleia foi bilateral e as características mais comuns foram dor em pressão (67,06%) e latejante/pulsátil (30%). Em relação a intensidade, 41,17% apresentaram uma cefaleia leve, 57,65% moderada e 0,59% severa. Houve uma associação da ocorrência de cefaleia devido ao uso de EPI com as variáveis: sexo, idade, ansiedade e sintomas de DTM. Também foi verificado que profissionais do gênero feminino possuíram uma chance 4,2 maior de apresentar cefaleia. Além disso, a chance do profissional com idade até 40 anos, apresentar cefaleia foi 1,7 vezes maior em comparação aos profissionais com idade superior. Em contrapartida, em profissionais sem sintomas de ansiedade, a chance de apresentar cefaleia diminui 53% e a chance do profissional sem sintomas de DTM apresentar cefaleia, diminui em 53%. Uma possível cefaleia pelo uso de EPI é fenotipicamente semelhante à cefaleia do tipo tensional.

Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

BACKGROUND

Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism.

OBJECTIVE

to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic.

METHODOLOGY

The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p<0.016) and a 95% confidence level.

RESULTS

Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively.

CONCLUSION

The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed.

Short-Term Effect of Scalp Acupuncture on Pain, Sleep Disorders, and Quality of Life in Patients with Temporomandibular Disorders: A A Randomized Clinical Trial

OBJETIVE

To evaluate the effects of Chinese scalp acupuncture in patients diagnosed with temporomandibular disorders (TMD) on pain, sleep, and quality of life (QOL), and compare these results with the results from traditional therapies.

METHODS

Sixty patients diagnosed with TMD using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) were allocated into four treatment groups: counseling (C = 15), occlusal splint (OS = 15), scalp acupuncture (SA = 15), and manual therapy (MT = 15). Participants were re-evaluated within 1 month. Three questionnaires were used to access sleep disorders, QOL, and pain: The Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-bref), and the Visual Analogue Scale (VAS), respectively. The data obtained were analyzed using the Statistical Package for the Social Science program (SPSS 22.0).

RESULTS

The SA group significantly improved pain (P = .015), as well as the OS (P = .01) and MT groups (P = .014). Only the OS (P = .002) and MT (P = .029) groups improved sleep. MT group significantly improved QOL in terms of the physical domain of the WHOQOL-bref (P = .011) and the OS group in the psychological domain (P = .012).

CONCLUSIONS

The scalp acupuncture proved to be another alternative for pain relief in patients with TMD, demonstrating positive results in the short term. However, it was not as effective in improving quality of life and sleep.