Effect of acupuncture on headache measured by reduction in number of attacks and use of drugs.

The experiment was performed in order to study the effect of acupuncture on headache by comparing the number of attacks during a 2-month period after acupuncture with the number of attacks during a similar period before treatment. Twenty-nine students (age: 19-24 years) all suffering from headache filled out questionnaires noting the days with attacks of headache and the amount and type of drugs used for 60 consecutive days. After acupuncture this observation procedure was repeated. One group of 10 students, however, received a placebo treatment instead of acupuncture but followed the identical questionnaire procedure. After 120 days acupuncture was given to this second group without revealing that the first treatment was a placebo. This treatment was again followed by a 60-day observation period. Comparison of the questionnaires before and after acupuncture showed a significant reduction in the number of days with headache. The placebo treatment resulted in a nonsignificant reduction in attacks of headache. A reduction in the amount of drugs used, especially the acetylsalicylate type, was noted following the acupuncture treatment. It is concluded that acupuncture is a relevant therapy for headache with a definite symptomatic effect.     

Effect of acupuncture on myogenic headache

abstract – The purpose of the investigation was to study the effect of acupuncture on myogenic headache and to examine whether electromyographic recordings of jaw muscle activity would provide objective evidence of the effect of such treatment. In 21 dental students, 14 males and seven females, with a history of 2–10 years of headache, acupuncture was performed unilaterally in the foot between the 4th and 5th metatarsal bones (G 41). The needle was inserted to a depth of 10–15 mm and moved continuously by hand for 15–20 min. Electromyographic recordings of postural activity in the right and left anterior temporal and masseter muscles were obtained in the same sitting before, during and after acupuncture treatment. In clinical controls 24 h, 1 month and 4 months after the treatment, 12 subjects reported considerable improvement, two variable results, and seven no change. The electromyographic recordings showed an average decrease in postural activity during acupuncture, particularly of the temporalis muscles, and a further decrease after completed treatment. However, marked individual variations in muscular response were noted. The results indicate that acupuncture treatment can relieve headache, and that electromyographic recordings may provide objective evidence of the effect of acupuncture.     

Effect of acupuncture on tension headache and urinary catecholamine excretion

Abstract – Sixteen patients with tension headaches were treated with acupuncture, needles being inserted in the hand and foot and then electrostimulated. All patients were seen at four 2-h sessions with intervals of 1 week between each. The first two sessions were used for clinical examination only, thus serving as control, while acupuncture was administered during the last two sessions. Urine samples were collected immediately before and after each session and later analyzed for catecholamine content. During the 1-week intervals between sessions, records were kept of headache attacks and medicine intake. Following acupuncture two-thirds of the patients showed reduction in number of headache attacks, and about one half of the patients reduced their use of pain relieving drugs considerably. Urinary excretion of adrenaline and noradrenaline was always higher in samples collected before sessions than after sessions. However, this reduction in catecholamine excretion was significantly greater when acupuncture had been administered.     

Effect of acupuncture on myogenic headache.

The purpose of the investigation was to study the effect of acupuncture on myogenic headache and to examine whether electromyographic recordings of jaw muscle activity would provide objective evidence of the effect of such treatment. In 21 dental students, 14 males and seven females, with a history of 2--10 years of headache, acupuncture was performed unilaterally in the foot between the 4th and 5th metatarsal bones (G 41). The needle was inserted to a depth of 10--15 mm and moved continuously by hand for 15--20 min. Electromyographic recordings of postural activity in the right and left anterior temporal and masseter muscles were obtained in the same sitting before, during and after acupuncture treatment. In clinical controls 24 h, 1 month and 4 months after the treatment, 12 subjects reported considerable improvement, two variable results, and seven no change. The electromyographic recordings showed an average decrease in postural activity during acupuncture, particularly of the temporalis muscles, and a further decrease after completed treatment. However, marked individual variations in muscular response were noted. The results indicate that acupuncture treatment can relieve headache, and that electromyographic recordings may provide objective evidence of the effect of acupuncture.     

Effect of acupuncture on the pain perception thresholds of human teeth

abstract – The effect of acupuncture on the pain perception threshold of maxillary incisors and canines as determined by a Bofors Pulp Tester(r) was studied in 33 dental students 19–30 years of age. Test teeth were cleaned with pumice and 10 % alcohol, air-dried, and insulated at the approximal surfaces with strips of rubber dam. Based on a comparison of bipolar and monopolar stimulation the latter method was chosen, with the cathode placed on the incisal third of the facial surface, the indifferent electrode in the subject's hand. In separate groups of subjects thresholds were assessed four times at intervals of 15 min without acupuncture (1), with acupuncture performed manually (2) and electrically (3), and during electrical stimulation with surface electrodes over acupuncture points (4). On separate days acupuncture and surface stimulation was applied unilaterally at the points S2 (cheek), Li4 (hand), or S44 (foot). Compared with control threshold (8.44 μA) acupuncture was accompanied by a small increase, most pronounced after 45 min (1.51 μA, P < 0.0005). However, the hypalgesia observed was insufficient to justify acupuncture as a means of pain control in conservative dentistry.     

Practical recommendations for the use of acupuncture in the treatment of temporomandibular disorders based on the outcome of published controlled studies

OBJECTIVE: The objective is to analyse the treatment procedures used in the individual studies to identify any similarities of therapeutic approaches and subsequently present recommendations for a standard acupuncture procedure for the treatment of temporomandibular disorders (TMD). MATERIALS: Literature searches performed by the Royal Society of Medicine and the University Library, Copenhagen were able to identify 74 publications regarding the use of acupuncture in dentistry. Among them 14 papers concerned the use of acupuncture in the treatment of TMD. To ensure reasonable methodological soundness of the involved studies, only randomised and blinded studies were included, which reduced the number of papers to six. Among these six papers three concerns the same study and were counted as one. One paper was a follow-up of a previous study and for this purpose counted as one. METHODS: All publications were analysed for the following information: acupuncture points used, type of stimulation, number of treatments, duration of the individual treatment and the interval between the individual treatments. MAIN OUTCOME: Acupuncture has in three out of three randomised controlled trials (RCT) proved effective for the treatment of TMD. The following local acupuncture points are recommended for the treatment of TMD: ST-6, ST-7, SI-18, GV-20, GB-20, BL-10. As a distant point LI-4 is recommended. After inserting the needles they should be manipulated manually to achieve the De-qui sensation and left in situ for 30 min. Treatment should be given weekly and a total number of six treatments is recommended.     

针刺对口腔复发性溃疡患者Ｔ细胞亚群的影响

目的：研究针刺治疗对口腔复发性溃疡（ＲＡＳ）患者Ｔ细胞群的影响,方法：对ＲＡＳ病人进行针刺治疗,采用矫联免疫法（ＡＰＡＡＰ法）测定治疗前后外周血Ｔ淋巴细胞亚群ＣＤ^ 3,CD^ 4,CD^ 8。结论：治疗后患者ＣＤ^ 3无明显变化,ＣＤ^ 4有所增加（与治疗前及对照组相比较Ｐ＜０．０５）,而ＣＤ^ 8却相对下降（Ｐ＜０．０５）,ＣＤ^ 4/CD^ ８比值明显升高（Ｐ＜０．０５）,结论：针刺治疗能改善患者ＣＤ^ 4,CD^ 48的数量异常,使ＣＤ^ 4/CD^ 8的数量异常,使ＣＤ^ 4/CD^ 8比值恢复到正常。     

The use of acupuncture in dentistry: a review of the scientific validity of published papers

OBJECTIVE: To review the scientific validity of published papers on the efficacy of acupuncture in dentistry based on predefined methodological criteria. MATERIALS: A literature search performed by the Royal Society of Medicine and the University Library, Copenhagen, Denmark was able to identify 74 papers written in English, German, Danish, Swedish, Norwegian, Italian, French and Russian published between 1966 and 1996. The search words were: acupuncture and electro-acupuncture, randomised controlled trials (RCT), dental pain, postoperative dental pain, painrelieving in dentistry, and dental analgesia. Among the 74 listed papers, 48 papers were reviewed in the following languages: English, Danish, Swedish, Norwegian and German. Fifteen papers were excluded because they were written in French, Italian or Russian; 11 papers were excluded because the abstract clearly indicated the paper was not a RCT or the paper was of a general nature without relevance to acupuncture.
METHODS: To assess the methodological quality of the included papers, all papers were scored on the basis of predefined criteria. A total of 92 points could be achieved and on the basis of this scale papers were rated as: Excellent (85–100%), Good (70–84%), Fair (60–69%) and Bad (<60%).
MAIN OUTCOME: Fifteen out of 48 papers met the inclusion criteria.
RESULTS: Only one study met the criteria with more than 85%. Five studies met the criteria with 70–84%. Three studies met the criteria with 60–69%. Six studies did not meet the criteria. Acupuncture in 11 out of 15 studies proved effective in the treatment of tempero-mandibular dysfunction (TMD) and as analgesia. Four studies showed no effect of acupuncture.
CONCLUSION: The value of acupuncture as an analgesic must be questioned. The effect of acupunctutre in treating TMD and facial pain seems real and acupuncture could be a valuable alternative to orthodox treatment.     

肌筋膜疼痛功能紊乱综合征的手针治疗研究

目的应用红外热像与微循环技术研究手针治疗肌筋膜疼痛功能紊乱综合征（ｍｙｏｆａｓｃｉａｌｐａｉｎｄｙｓｆｕｎｃｔｉｏｎｓｙｎｄｒｏｍｅ，ＭＰＤ）疗效及制订疗效标准。方法应用红外热像与微循环观测手针合谷穴、面咽止痛穴与对照组比较治疗ＭＰＤ后患者颞下颌关节区温度变化、甲襞微循环变化、疼痛与开口度变化。结果手针组的ＴＭＪ升温效应、甲襞微循环的扩管增速效应、疼痛程度、开口度均优于对照组。评定本组手针治疗４７７例ＭＰＤ的总有效率为９３．１％。结论推荐手针合谷穴、面咽止痛穴为临床治疗ＭＰＤ较敏感的首选穴位     

Prevalence of recurrent headache and mandibular dysfunction in patients with unsatisfactory complete dentures

The prevalence of headache and mandibular dysfunction was studied in 43 patients with unsatisfactory complete dentures waiting for prosthodontic treatment at the Dental Clinic of the National Dental Service in Jokkmokk, Sweden. In addition to answering a questionnaire, all patients underwent a clinical-functional examination of the masticatory system. Seventeen patients (40%), 15 women and two men, reported recurrent headache. 63% of the men and 83% of the women showed marked clinical signs of mandibular dysfunction. A significant correlation between headache and mandibular dysfunction was found. The low representation of complete denture wearers in clinical series of patients referred for treatment of mandibular dysfunction may be due to a reduced propensity to seek help and a greater willingness to accept a certain degree of dysfunction compared with other people.     

Facial asymmetry in patients with cervicobrachial pain and headache

An increasing number of patients are visiting our hospital who have a chief complaint of neck and shoulder pain and/or headache but who do not have temporomandibular disorders (TMD). We carried out this study with a view to comparing the asymmetry of the facial skeleton or expression of such patients with those of healthy subjects. The incidence of such symptoms of patients and healthy subjects was examined by means of questionnaires. Asymmetry of the facial skeleton of patients was investigated by means of posterioanterior (PA) cephalograms. Facial asymmetry was analysed using the frontal view photographs of faces. We found that the patients had a higher incidence of various symptoms, including fatigability and irritability, in addition to neck and shoulder pain and headache, than the healthy subjects did. Both the healthy subjects and the patients had mandibular skeletal asymmetry to some degree, however, there was no significant difference between the two groups. On the other hand, the patients had a greater level of asymmetry of facial expression, chiefly of the lower face, than the healthy subjects did.     

Treatment outcome of short- and long-term appliance therapy in patients with TMD of myogenous origin and tension-type headache

The aim was to compare the short- and long-term effect of a stabilization appliance with a control appliance in myofascial pain patients suffering from episodic or chronic tension-type headache. Sixty patients (mean age 29 +/- 12 years) with temporomandibular disorders (TMD) of myogenous origin and headache were studied in this prospective controlled study. Seventy-seven per cent of the patients reported episodic and 23% chronic tension-type headache at the start of the study. The 60 patients were randomly assigned to a treatment group (stabilization appliance) or to a control group (control appliance). The patients were interviewed regarding symptoms of headache and myofascial pain and clinically examined for masticatory muscle tenderness. At the 10-week and the 6- and 12-month evaluations of appliance therapy, the treatment outcome of tension-type headache was studied. At the 10-week evaluation, 17 patients dropped-out from the control group by requesting another appliance and receiving a stabilization appliance. Another patient in the control group dropped out later during the trial. In an intent-to-treat analysis, significant differences in improvement of headache between treatment and control groups were found at the follow-ups. A 30% reduction of muscles tender to palpation correlated significantly to improvement of headache at all follow-ups. The stabilization appliance seems to have a positive effect on tension-type headache, both in a short- and in a long-term perspective in patients with TMD with pain of myogenous origin.     

Efficacy of sphenopalatine ganglion block in nasal mucosal headache presenting as facial pain

Abstract

Background: When intranasal contact points are the cause of headache and facial pain, opinions regarding whether to remove intranasal contact points when they are believed to be the cause of headache and facial pain are divided.

Clinical Presentation: A 46-year-old woman visited the authors’ pain clinic with complaints of right nasal pain accompanied by frontotemporal headache. She first met an Otorhinolaryngologist and a neurologist. Based on nasal endoscopy and pain pattern, they presumed that her pain was a nasal mucosal headache rather than migraine. A mild septal deviation to the right side with bony spur near the inferior turbinate was observed. The use of medication provided very insufficient relief. However, the sphenopalatine ganglion (SPG) block provided excellent pain relief, and the effect lasted for six months.

Conclusion: Considering the mechanism of pain in intranasal contact point headache, (SPG) block is a potentially effective therapeutic tool.     

Effect of restorations on pulpal blood flow in molars measured by laser Doppler flowmetry

Aim  To: (i) compare laser Doppler pulpal blood flow (PBF) signals from restored and unrestored first molar teeth, (ii) investigate PBF in teeth with large and small restorations, and (iii) to relate PBF to pulp chamber dimensions on radiographs.
Methodology  Bitewing radiographs of young adults with restored first molars were obtained and pulp chamber dimensions measured. Subjects were divided into 2 groups: group A with a restored tooth and an unrestored contralateral (43 subjects) and group B, those with a molar with a small (usually occlusal) restoration whilst the contralateral tooth had an extensive occlusal restoration (or restorations) or restored proximal surface(s) and/or cuspal overlay (31 subjects). The 148 teeth responded to electric pulp testing, and their PBF was recorded using a laser Doppler flowmeter. Data were analysed using Student's t -test.
Results  In group A the PBF in the restored teeth was significantly lower than in unrestored contralaterals ( P  =   0.028) and the total pulp chamber area and that in the clinical crown were smaller ( P  =   0.039 and 0.021 respectively). The group B molars with large restorations had significantly lower PBF than contralaterals with small restorations ( P  =   0.001), and their total pulp chamber area and pulp chamber width at cervix were reduced significantly ( P  =   0.003 and 0.032 respectively).
Conclusions  In molars the size of the pulp chamber was influenced by the presence of restorations and the PBF was reduced when restorations were present. Size and extent of restorations had a significant effect on PBF.     

Effect of periodontal therapy on alveolar bone as measured by subtraction radiography

Changes in the periodontal alveolar bone are often evaluated by comparing a series of radiographs taken over time. This investigation used a technique that allowed the image registration to be geometrically standardized each time a radiograph was taken. Radiographs of 24 patients from an ongoing double-blind, clinical study using metronidazole were obtained: (1) before any treatment, (2) at the completion of scaling and root planing and surgery (when performed) and (3) during the maintenance phase. One hundred six (106) paired comparisons were analyzed by subtraction radiography using a computerized system. Of these, 95 (89%) exhibited a minimal degree of geometric distortion and could be successfully substracted. Most areas (67%) showed no change in bone structure following periodontal treatment. Bone gain was noted in 12% of the sites examined, while bone loss was seen in 21% of the sites. This bone loss was statistically associated with sites that had received some form of surgical treatment.