Acupuncture treatment for idiopathic trigeminal neuralgia: A longitudinal case-control double blinded study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia (ITN) by case-control longitudinal blinded study.</p><p><b>METHODS</b>Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group (15 cases), sham-acupuncture group (15 cases) and carbamazepine group (30 cases), respectively. Clinical orofacial evaluation (including pain intensity and medication doses), research diagnostic criteria for temporomandibular disorders (RDC/TMD) and Helkimo indexes (for functional evaluation of the masticatory system), and quantitative sensory testing for sensory thresholds (gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain) were evaluated before treatment, immediately after treatment, and 6 months after treatment.</p><p><b>RESULTS</b>The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation (P=0.012). Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions (P<0.01). There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months (P<0.01, P=0.023). There was a decrease in mechanical thresholds in the acupuncture group (tactile, P<0.01; vibration, P=0.027) and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups (P=0.013).</p><p><b>CONCLUSIONS</b>Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.</p>

Implantes osseointegrados na reabilitação de desdentado total com dor orofacial por disfunção temporomandibular: importância do tratamento sintomático. Caso clínico / Osseointegrated implants and rehabilitation of patients with temporomandibular disorders: the need of a symptomatic treatment. A clinical report

É discutido o caso de uma paciente com dor craniofacial por disfunção temporomandibular e cefaléia crônica. Ela recebera um tratamento oclusal reabilitador através de implantes osteointegrados. Embora os implantes para osteointegração sejam fatores importantes para estabilidade oclusal, principalmente em pacientes disfuncionados, eles devem ser utilizados na reabilitação final, após diagnóstico e tratamento sintomático da dor, quando esta é comprovadamente devido à disfunção. A presença de outras fontes de dor no segmento cefálico e o seu diagnóstico diferencial devem ser compreendidos, evitando-se a indicação incorreta dessa excelente terapia reabilitadora oral.