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Objective: The aim of the present study was to analyze the results of randomized clinical trials on the efficacy of acupuncture in the treatment of painful dysfunction of the temporomandibular joint., Materials and Methods: A literature search of 3 electronic databases was performed, and only randomized studies comparing acupuncture-treated patients with either untreated or conservatively treated control groups were included. For this purpose, results were compared in narrative and tabular form., Results: To date, only 8 publications representing 6 randomized clinical trials have looked into the efficacy of acupuncture in the treatment of craniomandibular dysfunction. With the exception of one, all studies were published in Sweden, between 1985 and 1992. A more recent US study was the only one to apply sham acupuncture to test the efficacy of acupuncture. All studies share methodological shortcomings, including a lack of detailed descriptions of the randomization procedures, point selection, possible dropouts and undesirable events as well as attempts to identify a possible placebo effect of the acupuncture. Only 1 study investigated long-term results. Although based on the improvement of subjective and objective criteria, all studies consider acupuncture as an effective treatment for painful dysfunction of the temporomandibular joint, the good results achieved must be interpreted with caution because of the methodological shortcomings identified., Conclusion: Acupuncture appears to be a suitable complementary treatment method in the management of craniomandibular dysfunction. However, its significance has to be further evaluated in future studies.

We studied the influence of the glucocorticosteroids dexamethasone and prednisolone on epidermal Langerhans cells (ELC) in the ear skin of BALB/c mice. ELC were detected by HLA II-antigen-expression and ATPase staining. The number of ELC was counted by normal light and immunofluorescence microscopy. Both, dexamethasone and prednisolone decreased the number of ELC and the intensity of the reaction for HLA II and ATPase significantly. In the electron microscope, ELC were identified by their light cytoplasm, the lobulated nucleus and typical Birbeck Granula (BG). After systemic application of dexamethasone or prednisolone the ultrastructure was changed with respect to a loss of typical BG and occurrence of numerous small vacuoles without electron dense content instead of BG.