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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
45
regional bloc of masseter
trigger point injection with local anesthetic
needling with acupuncture needles of trigger points in masseter
Erzincan Ağiz Ve Diş Sağlığı Egt Araş Hastanesi
Erzincan, Turkey (Türkiye)
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)
Time frame: 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)
Time frame: 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)
Time frame: 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)
Time frame: At 12th week (t3)
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.
Time frame: before the injections (T0, Baseline)
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.
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Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: At 12th week (t3)