Efficacy of acupuncture on craniomandibular myofascial pain in temporomandibular disorder patients: A systematic review.

Background: This systematic review aimed to answer the question, "What is the efficacy of acupuncture treatment in patients with temporomandibular disorder (TMD) with myofascial pain?". Data sources and study selection: This study followed PRISMA guidelines and was registered in PROSPERO. The electronic search strategy was applied to the Scopus, PubMed, Embase, and Science Direct databases. As inclusion criteria, were selected randomized clinical articles that evaluated patients with myofascial pain symptoms treated by acupuncture without the restriction of time and language. Results: The search in the databases resulted in 286 articles, after removing the duplicates 251 were analyzed by title and abstract. Twenty were selected for full reading and 10 were included in the systematic review. The studies evaluated acupuncture treatments by puncture and laser, auriculotherapy by puncture and laser, and an occlusal device for treating myofascial TMD. Conclusions: Comparing acupuncture with placebo acupuncture, it was observed that it is effective for subjective pain relief and palpation of orofacial structures with immediate results; it should be noted that there is still no specific protocol and that the duration of treatment must be personalized. When comparing it with the occlusal device, the associated treatment has enhanced the results. Future studies are suggested by the current literature gap that prevents the determination of clinical guidelines for effective acupuncture treatment in TMD patients with myofascial pain. Practical implications: Laser and needle puncture acupuncture treatment and laser and needle puncture auriculotherapy have shown favorable results in short-term myofascial pain relief. The need for long-term studies to assess benefits and reduce possible biases is highlighted. Clinical trial registry name: PROSPERO (CRD42021271505).