Effects of masseter muscle dry needling on temporo-mandibular myofascial pain: A scoping review
Abstract
Purpose: Myofascial pain is a common temporomandibular disorder that negatively affects quality of life. This study aims to assess the current evidence on the clinical response of dry needling (DN) applied to the masseter muscle as a therapeutic option for managing temporomandibular myofascial pain.
Material and Methods: A systematic electronic search of the literature was performed in PubMed, SCOPUS and Web of Science databases using tailored search strategies for each database. Articles published within the last five years were included if they evaluated DN of the masseter muscle in adults with myofascial pain, compared to placebo or other interventions. Pain intensity was assessed using the Visual Analogue Scale (VAS). Methodological quality was evaluated with the Critical Appraisal Skills Programme Spanish (CASPe) checklist for randomized controlled trials. Risk of bias assessment was not performed due to heterogeneity in study designs.
Results: Six studies met the inclusion criteria (four randomized clinical trials, one prospective study, one with unspecified design) involving 243 patients aged 18-65 years. Myofascial pain diagnosis was based on RDC/TMD or DC/TMD criteria. DN produced clinically meaningful reductions in pan intensity, with improvements maintained up to six months in some studies. Functional outcomes such as mouth opening and lateral movements also improved. The comparative efficacy of DN versus other treatments (botulinum toxin- A, platelet-rich plana, anesthetic nerve blocks) remains inconclusive due to variability in protocols and follow-up.
Conclusions: Dry needling of the masseter muscle shows potential as a therapeutic option for temporomandibular myofascial pain, particularly in reduction and functional improvement. However, heterogeneity across studies and lack of standardized protocols limit definitive conclusions. Further high-quality, standardized research is warranted.
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References
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6. Iturriaga V, Bornhardt T, Hermosilla L, Avila M. Prevalencia de Dolor Miofascial en Mús-culos de la Masticación y Cervicales en un Centro Especializado en Trastornos Tem-poromandibulares y Dolor Orofacial. Int J Odontostomat. 2014;8(3):413–7.
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8. Badil Güloğlu S, Tunç S. The assessment of affective temperament and life quality in myofascial pain syndrome patients. Int J Psychiatry Clin Pract. 2022;26(1):79-84. doi:10.1080/13651501.2020.1833039. PMID: 33084454.
9. Bilbeny N. DOLOR CRÓNICO EN CHILE. Rev médica Clín Las Condes. 2019;30(6):397–406.
10. Fricton J. Myofascial Pain: Mechanisms to Management. Oral Maxillofac Surg Clin North Am. 2016;28(3):289-311. doi:10.1016/j.coms.2016.03.010. PMID: 27475508.
11. Khan I, Ahmad A, Ahmed A, Sadiq S, Asim HM. Effects of dry needling in lower extremity myofascial trigger points. J Pak Med Assoc. 2021;71(11):2596-2603. doi:10.47391/JPMA.01398. PMID: 34783743.
12. Blasco-Bonora PM, Martín-Pintado-Zugasti A. Effects of myofascial trigger point dry ne-edling in patients with sleep bruxism and temporomandibular disorders: a prospective case series. Acupunct Med. 2017;35(1):69-74. doi: 10.1136/acupmed-2016-011102.PMID: 2769776 9.
13. Cao QW, Peng BG, Wang L, Huang YQ, Jia DL, Jiang H, et al. Expert consensus on the diagnosis and treatment of myofascial pain syndrome. World J Clin Cases. 2021 Mar 26;9(9):2077–89.
14. Anwar N, Wei X, Jie Y, Hongbo Z, Jin H, Zhu Z. Cur-rent advances in the treatment of myofascial pain syndrome with trigger point injections: A review. Medicine. 2024;103(40):e39885. doi: 10.1 097/MD.0000000000039885. PMID:39465697
15. Fernández-De-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buría JL, López-de-Uralde-Villanueva I, Navarro-Santana MJ. Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. Pain Res Manag. 2021 Feb 2;2021:8836427. doi: 10.1155/2021/8836427. PMID: 33603940; PMCID: PMC7872772.
16. Lew J, Kim J, Nair P. Comparison of dry ne-edling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29(3):136–46.
17. Fernández-De-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buría JL, López-de-Uralde-Villanueva I, Navarro-Santana MJ. Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. Pain Res Manag. 2021;2021:8836427. doi: 10.1155/2021/8836427. PMID: 33603940
18. CASP checklists. CASP - Critical Appraisal Skills Programme.
19. Dib-Zakkour J, Flores-Fraile J, Montero-Martin J, Dib-Zakkour S, Dib-Zaitun I. Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disor-ders. Medicina. 2022;58(2).
20. Özden MC PhD, Atalay B DDS, MSc, PhD, Özden AV DDS, PhD, Çankaya A DDS, PhD, Kolay E PhD, Yıldırım S DDS, PhD. Efficacy of dry needling in patients with myofascial temporomandibular disorders related to the masseter muscle. Cranio. 2020;38(5):305-311. doi: 10.1080/08869634.2018.1526848.
21. Sirikaku K, Watinaga GK, de Souza Moraes S, Guimarães TB, Onishi ET. Effect of Dry Needling on the Masseter Muscle in the Tin-nitus Perception of Patients with Temporo-mandibular Disorder. J Maxillofac Oral Surg. 2023;22(3):571–8.
22. Kütük SG, Özkan Y, Kütük M, Özdaş T. Comparison of the Efficacies of Dry Needling and Botox Methods in the Treatment of Myofascial Pain Syndrome Affecting the Temporomandibular Joint. J Craniofac Surg. 2019;30(5):1556–9.
23. Macedo CF de, Sonza A, Puel AN, Santos ARD. Trigger point dry needling increases mas-seter muscle oxygenation in patients with temporomandibular disorder. J Appl Oral Sci. 2023;31:e20230099.
24. Agarwal V, Gupta A, Singh H, Kamboj M, Popli H, Saroha S. Comparative Efficacy of Platelet-Rich Plasma and Dry Needling for Management of Trigger Points in Masseter Muscle in Myofascial Pain Syndrome Patients: A Randomized Con-trolled Trial. J Oral Facial Pain Headache. 2022; 36(3-4):253–262. doi: 10.11607/ofph.3188.
25. Taşkesen F, Cezairli B. The effectiveness of the masseteric nerve block compared with trigger point injections and dry needling in myofascial pain. CRANIO®. 2023 Mar 4;41(2):96–101.
26. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994 Jul-Aug;73(4):256–63.
27. Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge HY, et al. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. J Orofac Pain. 2010 Winter;24(1):106–12.
28. Tekin L, Akarsu S, Durmuş O, Cakar E, Dinçer U, Kıralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013 Mar;32(3):309–15.
29. Gattie E, Cleland JA, Snodgrass S. The Effec-tiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133–49.
30. Griswold D, Wilhelm M, Donaldson M, Learman K, Cleland J. The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis. J Man Manip Ther. 2019 Jul;27(3):128–40.
31. Hoseininejad Z, Kouhzad Mohammadi H, Azadeh H, Taheri N. Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points. J Bodyw Mov Ther. 2023 Jan;33:106–11.
32. Griswold D, Learman K, Ickert E, Clewley D, Donaldson MB, Wilhelm M, et al. Comparing dry needling or local acupuncture to various wet needling injection types for musculoskeletal pain and disability. A systematic review of randomized clinical trials. Disabil Rehabil. 2023 Jan 12;1–15.
33. Zha M, Chaffee K, Alsarraj J. Trigger point injections and dry needling can be effective in treating long COVID syndrome-related myalgia: a case report. J Med Case Rep. 2022 Jan 17;16(1):31.
34. Lewit K. The needle effect in the relief of myofascial pain. Pain. 1979 Feb;6(1):83–90.
35. Venancio R de A, Alencar FGP Jr, Zamperini C. Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. Cranio. 2009 Jan;27(1):46–53.
36. Boyce D, Wempe H, Campbell C, Fuehne S, Zylstra E, Smith G, Wingard C, Jones R. Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther. 2020;15(1):103-113. PMID: 32089962; PMCID: PMC7015026.
37. Kearns GA, Brismée JM, Riley SP, Wang-Price S, Denninger T, Vugrin M. Lack of standardization in dry needling dosage and adverse event documentation limits outcome and safety re-ports: a scoping review of randomized clinical trials. J Man Manip Ther. 2023;31(2):72–83.
38. Martín-Pintado-Zugasti A, Mayoral Del Moral O, Gerwin RD, Fernández-Carnero J. Post-needling soreness after myofascial trigger point dry needling: Current status and future research. J Bodyw Mov Ther. 2018;22(4):941–6.
39. McAphee D, Bagwell M, Falsone S. Dry needling: A clinical commentary. Int J Sports Phys Ther. 2022 Jun 1;17(4):551–5.
40. Castro Sánchez AM, García López H, Fernández Sánchez M, Pérez Mármol JM, Aguilar-Ferrándiz ME, Luque Suárez A, Matarán Peñarrocha GA. Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disabil Rehabil. 2019;41(19):2235-2246. doi: 10.1080/09638288.2018.1461259. Epub 2018 Apr 23. PMID: 29681188.
41. Rothman MG, Ortendahl M, Rosenblad A, Johansson AC. Improved quality of life, wor-king ability, and patient satisfaction after a pretreatment multimodal assessment method in patients with mixed chronic muscular pain: a randomized-controlled study: A randomized-controlled study. Clin J Pain. 2013;29(3):195–204.
42. He P, Fu W, Shao H, Zhang M, Xie Z, Xiao J, Li L, Liu Y, Cheng Y, Wang Q. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord. 2023;24(1):376. doi: 10.1186/s12891-023-06418-6. PMID: 37173661; PMCID: PMC10176871.
2. de Leeuw R, Klasser GD, editors. Orofacial pain: Guidelines for assessment, diagnosis, and management. STOMATOL EDU J. 2015;2(2):173.
3. Simons DG, Travell JG. Dolor y disfuncion miofascial V.1: El manual de los puntos gatillo, mitad superior del cuerpo. Ed. Médica Panamericana; 2002.
4. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27. https://doi.org/10.11607/jop.1151. PMID: 24482784; PMCID: PMC4478082.
5. Tantanatip A, Chang KV. Myofascial Pain Syndrome. StatPearls Publishing; 2023.
6. Iturriaga V, Bornhardt T, Hermosilla L, Avila M. Prevalencia de Dolor Miofascial en Mús-culos de la Masticación y Cervicales en un Centro Especializado en Trastornos Tem-poromandibulares y Dolor Orofacial. Int J Odontostomat. 2014;8(3):413–7.
7. Golanska P, Saczuk K, Domarecka M, Kuć J, Lukomska-Szymanska M. Temporomandibular Myofascial Pain Syndrome-Aetiology and Biop-sychosocial Modulation. A Narrative Review. Int J Environ Res Public Health. 2021; 18(15):7807. doi:10.3390/ijerph18157807.
8. Badil Güloğlu S, Tunç S. The assessment of affective temperament and life quality in myofascial pain syndrome patients. Int J Psychiatry Clin Pract. 2022;26(1):79-84. doi:10.1080/13651501.2020.1833039. PMID: 33084454.
9. Bilbeny N. DOLOR CRÓNICO EN CHILE. Rev médica Clín Las Condes. 2019;30(6):397–406.
10. Fricton J. Myofascial Pain: Mechanisms to Management. Oral Maxillofac Surg Clin North Am. 2016;28(3):289-311. doi:10.1016/j.coms.2016.03.010. PMID: 27475508.
11. Khan I, Ahmad A, Ahmed A, Sadiq S, Asim HM. Effects of dry needling in lower extremity myofascial trigger points. J Pak Med Assoc. 2021;71(11):2596-2603. doi:10.47391/JPMA.01398. PMID: 34783743.
12. Blasco-Bonora PM, Martín-Pintado-Zugasti A. Effects of myofascial trigger point dry ne-edling in patients with sleep bruxism and temporomandibular disorders: a prospective case series. Acupunct Med. 2017;35(1):69-74. doi: 10.1136/acupmed-2016-011102.PMID: 2769776 9.
13. Cao QW, Peng BG, Wang L, Huang YQ, Jia DL, Jiang H, et al. Expert consensus on the diagnosis and treatment of myofascial pain syndrome. World J Clin Cases. 2021 Mar 26;9(9):2077–89.
14. Anwar N, Wei X, Jie Y, Hongbo Z, Jin H, Zhu Z. Cur-rent advances in the treatment of myofascial pain syndrome with trigger point injections: A review. Medicine. 2024;103(40):e39885. doi: 10.1 097/MD.0000000000039885. PMID:39465697
15. Fernández-De-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buría JL, López-de-Uralde-Villanueva I, Navarro-Santana MJ. Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. Pain Res Manag. 2021 Feb 2;2021:8836427. doi: 10.1155/2021/8836427. PMID: 33603940; PMCID: PMC7872772.
16. Lew J, Kim J, Nair P. Comparison of dry ne-edling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29(3):136–46.
17. Fernández-De-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buría JL, López-de-Uralde-Villanueva I, Navarro-Santana MJ. Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. Pain Res Manag. 2021;2021:8836427. doi: 10.1155/2021/8836427. PMID: 33603940
18. CASP checklists. CASP - Critical Appraisal Skills Programme.
19. Dib-Zakkour J, Flores-Fraile J, Montero-Martin J, Dib-Zakkour S, Dib-Zaitun I. Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disor-ders. Medicina. 2022;58(2).
20. Özden MC PhD, Atalay B DDS, MSc, PhD, Özden AV DDS, PhD, Çankaya A DDS, PhD, Kolay E PhD, Yıldırım S DDS, PhD. Efficacy of dry needling in patients with myofascial temporomandibular disorders related to the masseter muscle. Cranio. 2020;38(5):305-311. doi: 10.1080/08869634.2018.1526848.
21. Sirikaku K, Watinaga GK, de Souza Moraes S, Guimarães TB, Onishi ET. Effect of Dry Needling on the Masseter Muscle in the Tin-nitus Perception of Patients with Temporo-mandibular Disorder. J Maxillofac Oral Surg. 2023;22(3):571–8.
22. Kütük SG, Özkan Y, Kütük M, Özdaş T. Comparison of the Efficacies of Dry Needling and Botox Methods in the Treatment of Myofascial Pain Syndrome Affecting the Temporomandibular Joint. J Craniofac Surg. 2019;30(5):1556–9.
23. Macedo CF de, Sonza A, Puel AN, Santos ARD. Trigger point dry needling increases mas-seter muscle oxygenation in patients with temporomandibular disorder. J Appl Oral Sci. 2023;31:e20230099.
24. Agarwal V, Gupta A, Singh H, Kamboj M, Popli H, Saroha S. Comparative Efficacy of Platelet-Rich Plasma and Dry Needling for Management of Trigger Points in Masseter Muscle in Myofascial Pain Syndrome Patients: A Randomized Con-trolled Trial. J Oral Facial Pain Headache. 2022; 36(3-4):253–262. doi: 10.11607/ofph.3188.
25. Taşkesen F, Cezairli B. The effectiveness of the masseteric nerve block compared with trigger point injections and dry needling in myofascial pain. CRANIO®. 2023 Mar 4;41(2):96–101.
26. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994 Jul-Aug;73(4):256–63.
27. Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge HY, et al. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. J Orofac Pain. 2010 Winter;24(1):106–12.
28. Tekin L, Akarsu S, Durmuş O, Cakar E, Dinçer U, Kıralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013 Mar;32(3):309–15.
29. Gattie E, Cleland JA, Snodgrass S. The Effec-tiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133–49.
30. Griswold D, Wilhelm M, Donaldson M, Learman K, Cleland J. The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis. J Man Manip Ther. 2019 Jul;27(3):128–40.
31. Hoseininejad Z, Kouhzad Mohammadi H, Azadeh H, Taheri N. Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points. J Bodyw Mov Ther. 2023 Jan;33:106–11.
32. Griswold D, Learman K, Ickert E, Clewley D, Donaldson MB, Wilhelm M, et al. Comparing dry needling or local acupuncture to various wet needling injection types for musculoskeletal pain and disability. A systematic review of randomized clinical trials. Disabil Rehabil. 2023 Jan 12;1–15.
33. Zha M, Chaffee K, Alsarraj J. Trigger point injections and dry needling can be effective in treating long COVID syndrome-related myalgia: a case report. J Med Case Rep. 2022 Jan 17;16(1):31.
34. Lewit K. The needle effect in the relief of myofascial pain. Pain. 1979 Feb;6(1):83–90.
35. Venancio R de A, Alencar FGP Jr, Zamperini C. Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. Cranio. 2009 Jan;27(1):46–53.
36. Boyce D, Wempe H, Campbell C, Fuehne S, Zylstra E, Smith G, Wingard C, Jones R. Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther. 2020;15(1):103-113. PMID: 32089962; PMCID: PMC7015026.
37. Kearns GA, Brismée JM, Riley SP, Wang-Price S, Denninger T, Vugrin M. Lack of standardization in dry needling dosage and adverse event documentation limits outcome and safety re-ports: a scoping review of randomized clinical trials. J Man Manip Ther. 2023;31(2):72–83.
38. Martín-Pintado-Zugasti A, Mayoral Del Moral O, Gerwin RD, Fernández-Carnero J. Post-needling soreness after myofascial trigger point dry needling: Current status and future research. J Bodyw Mov Ther. 2018;22(4):941–6.
39. McAphee D, Bagwell M, Falsone S. Dry needling: A clinical commentary. Int J Sports Phys Ther. 2022 Jun 1;17(4):551–5.
40. Castro Sánchez AM, García López H, Fernández Sánchez M, Pérez Mármol JM, Aguilar-Ferrándiz ME, Luque Suárez A, Matarán Peñarrocha GA. Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disabil Rehabil. 2019;41(19):2235-2246. doi: 10.1080/09638288.2018.1461259. Epub 2018 Apr 23. PMID: 29681188.
41. Rothman MG, Ortendahl M, Rosenblad A, Johansson AC. Improved quality of life, wor-king ability, and patient satisfaction after a pretreatment multimodal assessment method in patients with mixed chronic muscular pain: a randomized-controlled study: A randomized-controlled study. Clin J Pain. 2013;29(3):195–204.
42. He P, Fu W, Shao H, Zhang M, Xie Z, Xiao J, Li L, Liu Y, Cheng Y, Wang Q. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord. 2023;24(1):376. doi: 10.1186/s12891-023-06418-6. PMID: 37173661; PMCID: PMC10176871.
Published
2026-05-03
How to Cite
Bäumle, R., León-Morales, C., & Ossa, G. (2026). Effects of masseter muscle dry needling on temporo-mandibular myofascial pain: A scoping review. Journal of Oral Research, 15(1), 31-45. Retrieved from https://www.joralres.com/index.php/JOralRes/article/view/1700
Section
Reviews
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