Comparative Efficacy of Low-Level Laser Acupuncture and Cupping for Treatment of Patients with Myofascial Pain Dysfunction Syndrome: A Double-blinded, Randomized Clinical Trial: Comparison of the Effects of LLL Acupuncture and Cupping

In Vitro Effects of Photobiomodulation with 660 Nm Laser and Vitamin D on Osteoblastic Differentiation of Human Periodontal Ligament Stem Cells

BACKGROUND

Mesenchymal stem cells (MSCs) can be found inside the human periodontal ligament. Application of vitamin D and photobiomodulation for regulation of the proliferation of MSCs and bone differentiation have been recently considered in cell engineering. This study is performed to evaluate the effects of photobiomodulation with 660 nm laser exposure and vitamin D on human periodontal ligament stem cells (HPDLSCs) and their osteoblastic differentiation properties.

MATERIALS AND METHODS

This study, was an in vitro experimental study performed on HPDLSCs in six groups of (I) control cells in the culture medium with no intervention, (II) addition of 10-7 mol vitamin D to the medium, (III) 660 nm diode laser exposure in 3 J/cm2 density of energy, (IV) 660 nm diode laser exposure in 3 J/cm2 density of energy + addition of 10-7 mol vitamin D to the medium, (V) 660 nm diode laser exposure in 5 J/cm2 density of energy, and (VI) 660 nm diode laser exposure in 5 J/cm2 density of energy + addition of 10-7 mol vitamin D to the medium. after 24 hours of the last exposure, cell viability had been assessed by methyl thiazolyl tetrazolium assay. The expression of Runt-related transcription factor 2 (RUNX2), osteopontin (OPN), alkaline phosphatase (ALP), and osteocalcin (OCN) genes was also assessed by reverse transcription-polymerase chain reaction, then Alizarin red staining was used to assess calcification.

RESULTS

Combined use of 660 nm laser with 3 and 5 J/cm2 density of energy and 10-7 mol vitamin D significantly increased cell viability, osteoblastic differentiation by upregulation of RUNX2, ALP, OPN, and OCN, and calcification (P0.05).

CONCLUSION

The results showed that combined use of vitamin D3 and irradiation of 660 nm laser with 3 J/cm2 and particularly 5 J/cm2 energy density increased the viability of HPDLSCs and enhanced their osteoblastic differentiation.

The effectiveness of different types of acupuncture to reduce symptoms and disability for patients with orofacial pain. A systematic review and meta-analysis

PURPOSE

To determine the effectiveness of different types of acupuncture in reducing pain, improving maximum mouth opening and jaw functions in adults with orofacial pain.

METHODS

Six databases were searched until 15 June 2023. The Cochrane risk of bias tool and GRADE were employed to evaluate bias and overall evidence certainty.

RESULTS

Among 52 studies, 86.5% (n = 45) exhibited high risk of bias. Common acupoints, including Hegu LI 4, Jiache ST 6, and Xiaguan ST 7, were used primarily for patients with temporomandibular disorder [TMDs]. Meta-analyses indicated that acupuncture significantly reduced pain intensity in individuals with myogenous TMD (MD = 26.02 mm, I2=89%, p = 0.05), reduced tenderness in the medial pterygoid muscle (standardised mean differences [SMD] = 1.72, I2 = 0%, p < 0.00001) and jaw dysfunction (SMD = 1.62, I2 = 88%, p = 0.010) in mixed TMD when compared to sham/no treatment. However, the overall certainty of the evidence was very low for all outcomes as evaluated by GRADE.

CONCLUSION

The overall results in this review should be interpreted with caution as there was a high risk of bias across the majority of randomized controlled trial (RCTs), and the overall certainty of the evidence was very low. Therefore, future studies with high-quality RCTs are warranted evaluating the use of acupuncture in patients with orofacial pain.

Effectiveness of Manual Trigger Point Therapy in Patients with Myofascial Trigger Points in the Orofacial Region-A Systematic Review

The objective was to compile, synthetize, and evaluate the quality of the evidence from randomized controlled trials (RCTs) regarding the effectiveness of manual trigger point therapy in the orofacial area in patients with or without orofacial pain. This project was registered in PROSPERO and follows the PRISMA guidelines. Searches (20 April 2021) were conducted in six databases for RCTs involving adults with active or latent myofascial trigger points (mTrPs) in the orofacial area. The data were extracted by two independent assessors. Four studies were included. According to the GRADE approach, the overall quality/certainty of the evidence was very low due to the high risk of bias of the studies included. Manual trigger point therapy showed no clear advantage over other conservative treatments. However, it was found to be an equally effective and safe therapy for individuals with myofascial trigger points in the orofacial region and better than control groups. This systematic review revealed a limited number of RCTs conducted with patients with mTrPs in the orofacial area and the methodological limitations of those RCTs. Rigorous, well-designed RCTs are still needed in this field.