Efficacy of dry needling in TMD treatment: clinical case report





Temporomandibular disorder; Dry needling; Orofacial pain.


The purpose of this article is to report a clinical case of a patient with TMD, evaluating the efficacy of dry needling as a treatment. The study was carried out in a dental clinic of higher education, where the evaluation of the patient was performed in order to conclude a correct diagnosis complementing with the use of dry needling. Patient, female, 38 years old, reported pain throughout the muscular region of the face, where it was more pronounced in the parotid-massometric region, with spreading to the temporal region. After performing the evaluation in addition to the percussion and palpation tests, the patient was diagnosed with spreading myofascial pain, in addition to headache attributed to TMD bilaterally. As a therapeutic approach, the dry needling technique was performed, in addition to the orientation of Cognitive Behavioral Therapy, since the patient reported having parafunctional habits. The techniques used produced an effective improvement to the patient, where the patient reports a relief of the muscular pains when performing the dry needling.


Alamoudi, N., Farsi, N., Salako, N. O., & Feteih, R. (1998). Temporomandibular disorders among school children. The Journal of clinical pediatric dentistry, 22(4), 323–328.

Alencar, J. F. G. (2005). Occlusion, orofacial pain and headache. Sao Paulo: Santos

Alencar, F., Jr, & Becker, A. (2009). Evaluation of different occlusal splints and counselling in the management of myofascial pain dysfunction. Journal of oral rehabilitation, 36(2), 79–85. https://doi.org/10.1111/j.1365-2842.2008.01913.x

Almeida, L. H. M., Farias, A. B. L., Soares, M. S. M., Cruz, J. S. A., Cruz, R. E. S., Lima, M. G. (2008). Temporomandibular disorder in the elderly. Journal of the Faculty of Dentistry –UPF, 13 (1): 35-8

Anderson, G. C., John, M. T., Ohrbach, R., Nixdorf, D. R., Schiffman, E. L., Truelove, E. S., & List, T. (2011). Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain. Pain, 152(4), 765–771. https://doi.org/10.1016/j.pain.2010.11.007

Battistella, C. B., Guimarães, T, B., Quaglio, C. L. et al. (2016). Axis II biopsychosocial factors of the Diagnostic Criteria for Researching Temporomandibular Disorders in individuals with muscle and migraine temporomandibular disorders. Rev. Pain, São Paulo, v. 17, n. 1, p. 19-23

Bendtsen L. Central sensitization in tension-type headache--possible pathophysiological mechanisms. Cephalalgia. 2000 Jun;20(5):486-508. doi: 10.1046/j.1468-2982.2000.00070.x. PMID: 11037746.

Bevilaqua-Grossi, D., Lipton, R. B., Napchan, U., Grosberg, B., Ashina, S., & Bigal, M. E. (2010). Temporomandibular disorders and cutaneous allodynia are associated in individuals with migraine. Cephalalgia : an international journal of headache, 30(4), 425–432. https://doi.org/10.1111/j.1468-2982.2009.01928.x

Biasotto-Gonzalez, D. A. (2005). Interdisciplinary approach to temporomandibular disorders. Sao Paulo: Manole

Buchgreitz, L., Lyngberg, A. C., Bendtsen, L., & Jensen, R. (2006). Frequency of headache is related to sensitization: a population study. Pain, 123(1-2), 19–27. https://doi.org/10.1016/j.pain.2006.01.040

Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R. Increased pain sensitivity is not a risk factor but a consequence of frequent headache: a population-based follow-up study. Pain. 2008 Jul 31;137(3):623-630. doi: 10.1016/j.pain.2007.10.023. Epub 2007 Dec 3. PMID: 18061350.

Carlsson, G., Le Reseche, L., (1995). Epidemiology of temporomandibular disorders. In: Sessle B, Bryant P, Dionne R. Progress in pain research and management. IASP Press 1995; 211-226.

Ciancaglini, R., & Radaelli, G. (2001). The relationship between headache and symptoms of temporomandibular disorder in the general population. Journal of dentistry, 29(2), 93–98. https://doi.org/10.1016/s0300-5712(00)00042-7

Correia, F. A. S. (1991). Prevalence of symptomatology in temporomandibular joint disorders and its relationship with age, sex and tooth loss. Sao Paulo: University of Sao Paulo

Machado, E., Machado, P., Wandscher, V. F., Marchionatti, A., Zanatta, F. B., & Kaizer, O. B. (2018). A systematic review of different substance injection and dry needling for treatment of temporomandibular myofascial pain. International journal of oral and maxillofacial surgery, 47(11), 1420–1432. https://doi.org/10.1016/j.ijom.2018.05.003

Felício, C. M., Mazzetto, M. O., Bataglion, C., Silva, M. A. M. R., Hotta, T. H. (2003). Temporomandibular disorder: analysis of the frequency and severity of signs and symptoms before and after the occlusion plaque. J. Bras. Ortodont. Ortop. Facial, v. 8, n.43, p.48-57

Gonçalves DA, Camparis CM, Speciali JG, Franco AL, Castanharo SM, Bigal ME. Temporomandibular disorders are differentially associated with headache diagnoses: a controlled study. Clin J Pain. 2011 Sep;27(7):611-5. doi: 10.1097/AJP.0b013e31820e12f5. PMID: 21368664.

Graff-Radford S. B. (2007). Temporomandibular disorders and headache. Dental clinics of North America, 51(1), 129–vii. https://doi.org/10.1016/j.cden.2006.09.005

Greene, C. S., Klasser, G. D., Epstein, J. B. (2010) Revision of the American Association of Dental Research’s Science information statement about temporomandibular disorders. J Can Dent Assoc, Ottawa, v. 76, a115

Haley, D., Schiffman, E., Baker, C., & Belgrade, M. (1993). The comparison of patients suffering from temporomandibular disorders and a general headache population. Headache, 33(4), 210–213. https://doi.org/10.1111/j.1526-4610.1993.hed33040210.x

LeResche, L., Saunders, K., Von Korff, M. R., Barlow, W., & Dworkin, S. F. (1997). Use of exogenous hormones and risk of temporomandibular disorder pain. Pain, 69(1-2), 153–160. https://doi.org/10.1016/s0304-3959(96)03230-7

LeResche, L., Mancl, L., Sherman, J. J., Gandara, B., & Dworkin, S. F. (2003). Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain, 106(3), 253–261. https://doi.org/10.1016/j.pain.2003.06.001 .

Liljeström, M. R., Jämsä, A., Le Bell, Y., Alanen, P., Anttila, P., Metsähonkala, L., Aromaa, M., & Sillanpää, N. (2001). Signs and symptoms of temporomandibular disorders in children with different types of headache. Acta odontologica Scandinavica, 59(6), 413–417. https://doi.org/10.1080/000163501317153284.

Lupoli, T. A., & Lockey, R. F. (2007). Temporomandibular dysfunction: an often overlooked cause of chronic headaches. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 99(4), 314–318. https://doi.org/10.1016/S1081-1206(10)60546-7

Mor, N., Tang, C., & Blitzer, A. (2015). Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection. Toxins, 7(8), 2791–2800. https://doi.org/10.3390/toxins7082791 .

Pettengill, C. A., Growney, M. R., Jr, Schoff, R., & Kenworthy, C. R. (1998). A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. The Journal of prosthetic dentistry, 79(2), 165–168. https://doi.org/10.1016/s0022-3913(98)70211-2

Portero, P. P., Kern, R., Kusma, S. Z., Grau-Grullón, P. (2009). Occlusal plaques in the treatment of temporomandibular disorders (TMD). Gestão & Saúde Magazine, Curitiba, v. 1, n. 1, p. 36-40

Ramjord, S. I., Ash, M. (1984). Occlusion. Rio de Janeiro: Inter-American

Ramos, H. A. D. (1992). Signs and symptoms of painful temporomandibular joint disorders. Dental Cad Doc, 34(2), 252-255.

Schiffman, E., Haley, D., Baker, C., & Lindgren, B. (1995). Diagnostic criteria for screening headache patients for temporomandibular disorders. Headache, 35(3), 121–124. https://doi.org/10.1111/j.1526-4610.1995.hed3503121.x

Svensson P. (2007). Muscle pain in the head: overlap between temporomandibular disorders and tension-type headaches. Current opinion in neurology, 20(3), 320–325. https://doi.org/10.1097/WCO.0b013e328136c1f9

Tesch, R. S., Macedo, L., Fernandes, F. S., Goffredo Filho, G. S., & Goes, C. (2019). Effectiveness of dry needling on the local pressure pain threshold in patients with masticatory myofascial pain. Systematic review and preliminary clinical trial. Cranio : the journal of craniomandibular practice, 1–9. Advance online publication. https://doi.org/10.1080/08869634.2019.1588518

Thilander, B., Rubio, G., Pena, L., Mayorga, C. (2002) Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod, 72(2): 146-154.

Winocur, E., Emodi-Perlman, A., Finkelstein, T., Sharabi-Ventura, Y., & Gavish, A. (2003). Refu'at ha-peh veha-shinayim (1993), 20(1), 62–82.4

Yap, A. U., Tan, K. B., Chua, E. K., & Tan, H. H. (2002). Depression and somatization in patients with temporomandibular disorders. The Journal of prosthetic dentistry, 88(5), 479–484. https://doi.org/10.1067/mpr.2002.129375




How to Cite

OLIVEIRA, A. S. de .; MAIA , I. H. T. .; RIFANE , T. O. .; SILVESTRE , F. A. .; FREITAS , B. de F. B. de .; PICANÇO, P. R. B. .; FEITOSA , V. P. .; LEITÃO, A. K. A. . Efficacy of dry needling in TMD treatment: clinical case report. Research, Society and Development, [S. l.], v. 10, n. 3, p. e16810313131, 2021. DOI: 10.33448/rsd-v10i3.13131. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/13131. Acesso em: 3 feb. 2023.



Health Sciences