Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
The aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs).


METHODS
By using electronic databases, the goal was to search and evaluate all the randomized controlled trials (RCTs) in which acupuncture was used in the management of pain attributed to these clinical entities. For the meta-analysis, an adequate description of the results' statistical data was required along with a comparison of the treatment with a control group using a placebo or sham. Two independent reviewers evaluated the quality of the studies using the Jadad scale.


RESULTS
A total of 8 RCTs were selected, and the quality of only 4 was considered acceptable. These 4 studies showed positive results such as reducing pain, improving masticatory function, and increasing maximum interincisal opening. By combining the studies (n=96) and analyzing the results, it was concluded that acupuncture is more effective than placebo in reducing pain intensity in TMD (standardized mean difference 0.83; 95% confidence interval, 0.41-1.25; P=0.00012).


CONCLUSIONS
The results of this meta-analysis suggest that acupuncture is a reasonable adjunctive treatment for producing a short-term analgesic effect in patients with painful TMD symptoms. Although the results described are positive, the relevance of these results was limited by the fact that substantial bias was present. These findings must be confirmed by future RCTs that improve the methodologic deficiencies of the studies evaluated in this meta-analysis.
La Touche
Roy
R
Faculty of Health Science, Department of Physical Therapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain. roylatouche@yahoo.es
Goddard
Greg
G
De-la-Hoz
José Luis
JL
Wang
Kelun
K
Paris-Alemany
Alba
A
Angulo-Díaz-Parreño
Santiago
S
Mesa
Juan
J
Hernández
Mar
M
D015670:Acupuncture Therapy / Q000379:methods*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D015201:Meta-Analysis as Topic; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010147:Pain Measurement; D016032:Randomized Controlled Trials as Topic; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D016896:Treatment Outcome