This randomized clinical trial will aim to compare the effectiveness of dry needling, lidocaine injection, and mepivacaine injection in the treatment of myofascial pain in the masticatory muscles. A total of 75 participants with bilateral active trigger points in the masseter and/or temporalis muscles will be enrolled and randomly assigned to three intervention groups. Each participant will receive weekly treatments for three weeks. Pain levels, depressive symptoms, and temporomandibular disorder severity will be assessed using the Visual Analog Scale, the Beck Depression Inventory, and the Fonseca Anamnestic Index. Outcome measures will be recorded at baseline and one week after the final treatment session. The primary objective of this study is to determine which intervention provides the greatest improvement in myofascial pain symptoms.
This study will be a randomized, controlled clinical trial designed to compare the effectiveness of dry needling, lidocaine, and mepivacaine injections in the treatment of myofascial pain in the masticatory muscles. Seventy-five participants with bilateral active myofascial trigger points in the masseter and/or temporalis muscles will be recruited. Participants will be randomly assigned to one of three intervention groups: dry needling, lidocaine (20 mg/mL), or mepivacaine (30 mg/mL). Injections will be administered once a week for three consecutive weeks to both sides of the face. Pain levels will be evaluated using the Visual Analog Scale, depressive symptoms with the Beck Depression Inventory and temporomandibular disorder severity with the Fonseca Anamnestic Index. Measurements will be performed at baseline (prior to first injection) and one week after the third and final injection. The study will be conducted at Istanbul Medipol University with ethics committee approval. Participants will be informed about the study procedures and informed consent will be obtained from all subjects. The primary objective of the study is to evaluate which intervention provides the most significant reduction in pain and associated symptoms of myofascial pain syndrome. Secondary outcomes will include improvements in depressive symptoms and temporomandibular disorder-related limitations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
75
Dry needling applied to bilateral active trigger points in the masseter and temporalis muscles once per week for three weeks.
Lidocaine (20 mg/mL) injected into each active trigger point in the masseter and temporalis muscles once per week for three weeks.
Mepivacaine (30 mg/mL) injected into each active trigger point in the masseter and temporalis muscles once per week for three weeks.
Istanbul Medipol University, Faculty of Dentistry
Istanbul, Turkey (Türkiye)
Change in pain intensity based on the Visual Analog Scale
Pain intensity will be assessed using a 10 cm Visual Analog Scale (VAS), where 0 indicates no pain and 10 indicates the worst possible pain. The change in VAS scores from baseline to post-treatment will be analyzed.
Time frame: Baseline and one week after the third injection
Change in depressive symptoms based on the Beck Depression Inventory
Change in depressive symptoms based on the Beck Depression Inventory (BDI). The BDI is a 21-item self-reported questionnaire that measures depressive symptoms. Scores range from 0 to 63, with higher scores indicating more severe depression.
Time frame: Baseline and one week after the third injection
Change in temporomandibular disorder severity based on the Fonseca Anamnestic Index
Change in temporomandibular disorder severity based on the Fonseca Anamnestic Index. The Fonseca Anamnestic Index consists of 10 items assessing TMD-related symptoms. Total scores range from 0 to 100, with higher scores indicating more severe temporomandibular dysfunction.
Time frame: Baseline and one week after the third injection
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.