Effectiveness of Dry Needling vs Manual Therapy in Patients With Temporomandibular Joint Disorders.
Condition: Temporomandibular Joint Disorders; Dry Needling; Musculoskeletal Manipulations
MeSH terms: Joint Diseases; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
Study type: Interventional

Summary: 
      Temporomandibular Joint Disorders (TJD) represent a set of conditions that involve pain and
      dysfunction of the temporomandibular joint. TJD are a frequent disability affection in the
      worldwide population and the 35% of affected present at least a symptom such as orofacial
      pain, mouth movement limitations and snapping or crying temporo-mandibular. Due to the
      increase of the incidence of the TJD the investigators propose to complete this study.

      A randomized controlled trial with parallel groups have been designed and blind evaluation of
      the response variable.

      The hypothesis is that dry needling produces a positive effect in the involved variables of
      this study in comparison with manual therapy.

      The aim of this RCT is to compare the effectiviness of the application of manual therapy in
      comparison with dry needling in the perceived pain, mouth opening, the degree of cervical
      disability and the pressure-pain threshold (PPT) of myofascial trigger points (MTrP) in
      patiens with TJD.
    


Intervention name(s): Dry needling; Manual Therapy Treatment
Intervention type(s): Other; Other
Intervention description(s): Twenty-three patients with TJD will be allocated in Dry Needling Group. They will receive 3 sessions of dry needling separated for 4 days. This treatment will consist of puncturing the active myofascial trigger points (PGM) of the aforementioned muscles. Sterile acupuncture needles of 0.26 mm in diameter by 40 mm in length, guided with a plastic cannula of the Ener-qi brand, will be used. The area will be cleaned with alcohol and a deep puncture of the PGM will be performed, triggering local spasm responses. Needle through the muscle following the technique described by Hong (Hong et al. 1994). After the procedure, the area is compressed with cotton for 90 seconds.; Twenty-three patients will be allocated in Manual Therapy (MT) Group for three sessions during 30 minutes. MT treatment will consist in the application of neuromuscular techniques of the temporal, masseter and sternocleidomastoid muscles and Jones techniques in the external pterygoid muscle. Neuromuscular techniques are performed with the index and major fingers to apply a transverse friction with enough pressure to feel vertical fibers of each muscle or produce a medium discomfort level. To perform the Jones technique on the external pterygoid muscle, the patient will be asked to open the mouth and deviate the jaw slightly towards the treated side in order to make room for the finger to be located between the upper jaw and the coronoid process. Once the trigger point is located, we press to trigger the pain and we look for neurological silence and we maintain the pressure for 90 seconds. Over time, we slowly withdraw the pressure and return to the position passively.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Temporomandibular joint disorders; Dry Needling; Manual Therapy; Orofacial disability; Neck Pain