title: Effects of myofascial trigger point dry needling in patients with sleep bruxism and temporomandibular disorders: a prospective case series.
abstract: OBJECTIVE
  To investigate the effects of deep dry needling (DN) of myofascial trigger points (MTrPs) of the masseter and temporalis on pain, pressure pain threshold (PPT), pain-free maximal jaw opening and temporomandibular disorder (TMD)-related disability in patients with sleep bruxism (SB) and myofascial TMD.
  
  
  METHODS
  Seventeen subjects (11 women, 6 men) aged 39±13 years (range 23-66) diagnosed with SB and myofascial TMD were invited to participate in this prospective case series study. Each subject received a deep DN intervention in the masseter and temporalis MTrPs. Pain intensity, PPT, pain-free maximal jaw opening and TMD-related disability were assessed before treatment, immediately after treatment and at 1-week follow-up. Jaw disability was assessed using the jaw disability checklist (JDC) at baseline and 1 week post-treatment only.
  
  
  RESULTS
  One-way analyses of variance showed significant improvements in pain intensity, PPT and jaw opening (p<0.001). Post-hoc analysis revealed significant differences between baseline and post-intervention follow-up time points in pain (immediate: Cohen's d=1.72, p<0.001; 1 week: d=3.24, p<0.001), jaw opening (immediate: d=0.77, p<0.001; 1 week: d=1.02, p<0.001) and PPT in the masseter (immediate: d=1.02, p<0.001; 1 week: d=1.64, p<0.001) and temporalis (immediate: d=0.91, p=0.006; 1 week: d=1.8, p<0.001). A dependent t-test showed a significant improvement in jaw functioning, reflected by a large reduction in 1-week JDC scores relative to baseline (d=3.15, p<0.001).
  
  
  CONCLUSIONS
  Deep DN of active MTrPs in the masseter and temporalis in patients with myofascial TMD and SB was associated with immediate and 1-week improvements in pain, sensitivity, jaw opening and TMD-related disability.
  
  
  BACKGROUND
  NCT02587182; Results.
authors.affiliation: Private Practice, Physical Therapy, Valencia, Spain.
authors.forename: Paloma María
authors.initials: PM
authors.lastname: Blasco-Bonora
authors.affiliation: Department of Nursery and Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain.
authors.forename: Aitor
authors.initials: A
authors.lastname: Martín-Pintado-Zugasti
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008406:Masseter Muscle; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000628:therapy*; D009339:Needles; D010147:Pain Measurement; D017288:Pain Threshold; D011446:Prospective Studies; D020186:Sleep Bruxism / Q000628:therapy*; D013703:Temporal Muscle; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D016896:Treatment Outcome; D061028:Trigger Points; D055815:Young Adult