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The aim of the present study was to compare the efficacy of three different treatment methods in the management of myofascial pain: masseteric nerve block (MN), trigger point injection(TrP) with local anesthetic (LA) and dry needling (DN).Study Design: 45 subjects aged 18-54 years were randomly assigned to the MN group (n= 15), LA group (n=15) and DN group (n=15).
The study sample consisted 45 patients with masseter muscle originated myofascial pain, were selected in accordance with the following criteria:
Patients were grouped according to the treatment they received: dry-needling (DN), TrP injections with local anesthetic (LA) and masseteric nerve block (MNB). Localization of the masseteric trigger points (MTPs) was based on clinician's sense and patients' expressions of pain. Local twitch response was not observable in all case. This procedure was completed by using digital palpation (1.5 Kg), and the clinical examiner's palpation was calibrated using a pressure algometer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MNB- masseteric nerve block | Active Comparator | masseteric nerve block with local anesthesia lidocaine single app. |
|
| LA -trigger point injection with local anesthetic | Active Comparator | local anesthetic injections on trigger points in masseter |
|
| DN-dry needling | Placebo Comparator | dren needling to masseter |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| masseteric nerve block | Procedure | regional bloc of masseter |
| |
| Measure | Description | Time Frame |
|---|---|---|
| The Rate of Pain on Function (PoF) assessed by Numerical pain Scale (NRS) | Patients rated their pain on function (pain during chewing or speaking etc.) on a Numeric Rating Scale (NRS) (0-10 where 0 is no pain and 10 is the worst pain imaginable) | before the injections (T0, Baseline) |
| The Rate of Pain on Function (PoF) assessed by Numerical pain Scale (NRS) | Patients rated their pain on function (pain during chewing or speaking etc.) on a Numeric Rating Scale (NRS) (0-10 where 0 is no pain and 10 is the worst pain imaginable) | At 1st week (t1) |
| The Rate of Pain on Function (PoF) assessed by Numerical pain Scale (NRS) | Patients rated their pain on function (pain during chewing or speaking etc.) on a Numeric Rating Scale (NRS) (0-10 where 0 is no pain and 10 is the worst pain imaginable) | At 4th week (t2) |
| The Rate of Pain on Function (PoF) assessed by Numerical pain Scale (NRS) | Patients rated their pain on function (pain during chewing or speaking etc.) on a Numeric Rating Scale (NRS) (0-10 where 0 is no pain and 10 is the worst pain imaginable) | At 12th week (t3) |
| Measure | Description | Time Frame |
|---|---|---|
| The Rate of Pain Intensity on Palpation (PoP) | Patients rated their pain intensity on masseter muscle by a 4-point Likert-type scale (0 = no pain, 3 = as worst pain imaginable) while a calibrated examiner palpating their masseter muscle. | before the injections (T0, Baseline) |
| The Rate of Pain Intensity on Palpation (PoP) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Erzincan Ağiz Ve Diş Sağlığı Egt Araş Hastanesi | Erzincan | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19241799 | Background | Venancio Rde A, Alencar FG Jr, Zamperini C. Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. Cranio. 2009 Jan;27(1):46-53. doi: 10.1179/crn.2009.008. | |
| 26715419 | Result | Quek SY, Subramanian G, Patel J, Ananthan S, Zagury JG, Khan J. Efficacy of regional nerve block in management of myofascial pain of masseteric origin. Cranio. 2015 Oct;33(4):285-90. doi: 10.1080/08869634.2015.1097300. Epub 2015 Dec 29. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 6, 2020 | Apr 6, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D013705 | Temporomandibular Joint Disorders |
| D009209 | Myofascial Pain Syndromes |
| D010146 | Pain |
| ID | Term |
|---|---|
| D017271 | Craniomandibular Disorders |
| D008336 | Mandibular Diseases |
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000079245 | Dry Needling |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
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randomized parallel controlled
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| trigger point injection |
| Procedure |
trigger point injection with local anesthetic |
|
| dry needling | Procedure | needling with acupuncture needles of trigger points in masseter |
|
Patients rated their pain intensity on masseter muscle by a 4-point Likert-type scale (0 = no pain, 3 = as worst pain imaginable) while a calibrated examiner palpating their masseter muscle. |
| At 1st week (t1) |
| The Rate of Pain Intensity on Palpation (PoP) | Patients rated their pain intensity on masseter muscle by a 4-point Likert-type scale (0 = no pain, 3 = as worst pain imaginable) while a calibrated examiner palpating their masseter muscle. | At 4th week (t2) |
| The Rate of Pain Intensity on Palpation (PoP) | Patients rated their pain intensity on masseter muscle by a 4-point Likert-type scale (0 = no pain, 3 = as worst pain imaginable) while a calibrated examiner palpating their masseter muscle. | At 12th week (t3) |
| The measurement of pain-free maximum mouth opening (MMO) in millimeters | Pain-free MMO was measured as the distance between the incisal edges of the upper and lower incisors while patient's mouth is open as possible without any assistance and without pain in masseter muscle. Three measurements were performed, and their average is recorded. | before the injections (T0, Baseline) |
| The measurement of pain-free maximum mouth opening (MMO) in millimeters | Pain-free MMO was measured as the distance between the incisal edges of the upper and lower incisors while patient's mouth is open as possible without any assistance and without pain in masseter muscle. Three measurements were performed, and their average is recorded. | At 1st week (t1) |
| The measurement of pain-free maximum mouth opening (MMO) in millimeters | Pain-free MMO was measured as the distance between the incisal edges of the upper and lower incisors while patient's mouth is open as possible without any assistance and without pain in masseter muscle. Three measurements were performed, and their average is recorded. | At 4th week (t2) |
| The measurement of pain-free maximum mouth opening (MMO) in millimeters | Pain-free MMO was measured as the distance between the incisal edges of the upper and lower incisors while patient's mouth is open as possible without any assistance and without pain in masseter muscle. Three measurements were performed, and their average is recorded. | At 12th week (t3) |
| D007592 |
| Joint Diseases |
| D009135 | Muscular Diseases |
| D009057 | Stomatognathic Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |