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Alam M, Karami S, Mohammadikhah M, Badkoobeh A, Golkar M, Abbasi K, Soufdoost RS, Hakim LK, Talebi S, Namanloo RA, Hussain A, Heboyan A, Tebyaniyan H. The effect of photobiomodulation therapy in common maxillofacial injuries: Current status. Cell Biochem Funct 2024; 42:e3951. [PMID: 38349051 DOI: 10.1002/cbf.3951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.
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Affiliation(s)
- Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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Shousha T, Alayat M, Moustafa I. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: A randomized-controlled study. PLoS One 2021; 16:e0258063. [PMID: 34597318 PMCID: PMC8486092 DOI: 10.1371/journal.pone.0258063] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022] Open
Abstract
Background Low level lasers have been used as an alternative pain relief therapy for muscle and joint pain, since it induces analgesic, anti-inflammatory, and biomodulation effects of the physiological cell functions. The effectiveness of low-level laser therapy in temporomandibular joint dysfunction (TMD) treatment, however, is not well established. Although Surface electromyography (sEMG) has been suggested as a complementary means in TMD diagnosis, the effect of conservative treatments on muscle activity has not yet been thoroughly correlated with (sEMG) findings. Purpose To assess the efficacy of low-level laser therapy (LLLT) as compared to occlusive splint therapy (OST) on the TMJ opening index (TOI) and sEMG of masticatory muscles. Materials and methods 112 female subjects suffering from unilateral myogenous TMD, aged 21–30 years-old, were recruited and divided into three groups: LLLT; soft occlusive splint therapy OST and a waitlist group as controls. Outcome measures TMJ opening index (TOI), Visual analogue scale (VAS), surface electromyography (sEMG). Results A significant reduction was reported in TOI, VAS and the sEMG within the LLLT and OST groups as well as significant decrease in all outcomes between groups in favor of the LLLT group (P< 0.0001). Meanwhile, there was a weak significant difference within the control group probably attributed to the analgesic. Post-hoc pairwise comparisons between groups [control vs occlusive splints, control vs low-level laser and low-level laser vs occlusive splints] revealed significant differences in the VAS and TOI [P = 0.0001; 95% CI: 0.9–2.2, 1.61–4.01, 0.65–1.96]. Conclusions Findings support an evident short term therapeutic effect of the LLLT on improving VAS, TOI and sEMG in females suffering from myogenous TMD.
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Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- * E-mail:
| | - Mohamed Alayat
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, KSA
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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NEGUCIOIU M, KUI A, MITARIU M, MANZIUC M, CONDOR D, MITARIU L, BUDURU S. The outcomes of ultrasonic and laser therapy in case of temporomandibular disorders – an evidence based update. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Temporomandibular disorders (TMDs) are considered multifactorial conditions, thereby with different therapy options, from occlusal equilibration, splint therapy, pharmacotherapy or physical therapy. Among the physical therapies, over the last years, laser therapy and ultrasound therapy have gained attention, as different experimental or clinical studies suggest their efficacy in case of TMDs. The aim of our literature review is to evaluate the available evidence on the effectiveness of laser and ultrasound therapy in the treatment of temporomandibular disorders. Material and method. A research of literature has been performed - articles published over the last 5 years (January 2016 until June 2021) were searched by introducing a combination of different terms, using the Pubmed, Scopus and Google Scholar databases. Results and discussions. A total number of 332 articles was found. For multiple publications regarding the same group of patients, the most recent studies were included. Initial analysis of titles and abstracts eliminated 232 articles, leaving 35 articles whose full text was examined. 20 articles met the inclusion criteria Conclusions. According to the findings of this literature update we can conclude that low level laser therapy, ultrasound therapy, and photobiomodulation may effectively reduce pain for patients suffering of muscular and joint TMDs. However, their effects appear to be only shortly maintained, and only for less complex cases. In addition, it was difficult to compare the studies included, as they do not offer an optimal usage (program, duration of sessions, or number of sessions) of each technique. In this context, we consider that further randomized clinical studies are necessarily to compare each physical technique as well as their synergic effect on the symptoms in case of temporomandibular disorders.
Keywords: temporomandibular disorders, low level laser therapy, ultrasound therapy, photobiomodulation, TMD, LLLT
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Affiliation(s)
- Marius NEGUCIOIU
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
| | - Andreea KUI
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania 2.“Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Mihai MITARIU
- “Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Manuela MANZIUC
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
| | - Daniela CONDOR
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Periodontics, Cluj Napoca, Romania
| | - Loredana MITARIU
- “Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Smaranda BUDURU
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
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Vrbanović E, Dešković K, Zlendić M, Alajbeg IZ. Profiling of Patients with Temporomandibular Disorders: Experience of One Tertiary Care Center. Acta Stomatol Croat 2021; 55:147-158. [PMID: 34248148 PMCID: PMC8255039 DOI: 10.15644/asc55/2/4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/14/2021] [Indexed: 10/31/2022] Open
Abstract
Objectives The aim of this study was to assess typical and most prevalent characteristics of patients suffering from temporomandibular disorders (TMD) by a retrospective assessment of their medical records. Material and Methods Demographic data and data on the characteristics of TMD were collected from the existing medical documentation of 304 TMD patients (250 females and 54 males) who had been referred to the Department of Dentistry, Clinical Hospital Center Zagreb from October 2016 to October 2020 due to temporomandibular pain. For the purpose of analysis, three age groups were formed: i) "children and adolescents" (up to 19 years of age); ii) "middle age" (from 20 to 50 years of age); iii) "older age" (>50 year- olds). A two-step cluster analysis was performed with the aim of classifying TMD patients into homogenous groups. Results The mean age of patients whose data were included in the study was 33.8 ± 16.66, with a significantly higher age in the group of women (p<0.001). Most of the patients had chronic pain (67.4%), with the ratio in favor of chronic patients being significantly higher in women than in men (p=0.001). Data on parafunctional behavior were confirmed in 14.5% of patients. Data on the onset of symptoms during/just after orthodontic treatment were present in 14.5% of patients. Data on spontaneous pain, assessed with a visual analogue scale, were recorded in 87 patients, with a mean of 6.14 ± 1.79 and with the highest pain in the "older age" group. Physical therapy was the most common therapeutic modality (56.3%) followed by an occlusal splint (40.5%). The analysis revealed 5 different clusters in the TMD patient data set. Conclusions Our results are largely in line with current epidemiological knowledge on TMD. Women predominated in all age groups and most of the patients experienced chronic pain. Classifying patients into homogeneous groups using the clustering method could provide better identification of subgroups of conditions that mainly occur together in these patients, thus providing the basis for more specific management.
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Affiliation(s)
- Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb
| | | | - Marko Zlendić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb.,Department of Dentistry, Clinical Hospital Center Zagreb, Croatia
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Effect of photobiomodulation therapy on painful temporomandibular disorders. Sci Rep 2021; 11:9049. [PMID: 33907210 PMCID: PMC8079391 DOI: 10.1038/s41598-021-87265-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm2, 3 regions, 60 s) or TMJ region (6 J/cm2, 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0–10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P < 0.001) for both types of interventions, however, PBMT caused greater reduction in pain scores than placebo (P = 0.014). For myalgia patients, pain intensity decreased over time (P < 0.001) but without difference between interventions (P = 0.074). PPTs increased in both myalgia (P < 0.001) and TMJ arthralgia patients over time (P < 0.001) but without difference between interventions (P ≥ 0.614). Overall, PBMT was associated with marginally better improvements in range of motion compared to placebo in both myalgia and arthralgia patients. Pain intensity, sensory function and jaw movements improve after both PBMT and placebo treatments in myalgia and arthralgia patients indicating a substantial non-specific effect of PBMT.
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Lin YP, Su YH, Chin SF, Chou YC, Chia WT. Light-emitting diode photobiomodulation therapy for non-specific low back pain in working nurses: A single-center, double-blind, prospective, randomized controlled trial. Medicine (Baltimore) 2020; 99:e21611. [PMID: 32769919 PMCID: PMC7592994 DOI: 10.1097/md.0000000000021611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Low back pain (LBP) affects approximately 51% to 57% of hospital nurses and nurses' aides in Europe. New high-risk groups include home- and long-term-care nurses and physiotherapists. A number of European countries are experiencing a shortage of healthcare workers. Light therapy has been shown to be an effective treatment for various musculoskeletal disorders, including lateral epicondylitis, temporomandibular joint pain, carpal tunnel syndrome, and delayed-onset muscle soreness. A systematic review and meta-analysis demonstrated that low-level laser therapy is an effective method for relieving non-specific chronic low back pain (NSCLBP). However, the efficacy of light-emitting diode (LED) therapy for NSCLBP is disputed. This study aims to evaluate the effect of LED therapy on NSCLBP. METHODS AND ANALYSIS We conducted a prospective, double-blind, randomized placebo-controlled trial of 148 patients with NSCLBP. The patients were randomly assigned to 2 groups: intervention group, where patients received LED photobiomodulation therapy 3 times a week for 2 weeks, and the sham group, where patients had sham therapy 3 times a week for 2 weeks. Primary outcome measures included the visual analog scale for pain, lumbar active range of motion assessments, and chair-rising times. Secondary outcome measures included a multidimensional fatigue inventory, fear-avoidance beliefs questionnaire, and the Oswestry disability index. The outcome measures were assessed before therapy and 2weeks, 4 weeks, 8 weeks, 12 weeks, and 6 months after the first interventions were completed. DISCUSSION This study is a prospective, single-center, double-blind, randomized, controlled study. This study aims to research the efficacy of a 2-week LED program for NSCLBP working nurse. Our results will be useful for patients, working nurses, nurses' aides, and other healthcare workers with chronic low back pain. TRIAL REGISTRATION NUMBER NCT04424823.
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Affiliation(s)
- Yen-Po Lin
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City
| | - Ying-Hao Su
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City
| | - Shih-Fang Chin
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (R.O.C.)
| | - Wei-Tso Chia
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City
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Nascimento GC, Malzone BL, Iyomasa DM, Pereira YCL, Issa JPM, Leite-Panissi CRA, Watanabe IS, Iyomasa MM, Fuentes R, Del Bel E, Dias FJ. Beneficial effects of benzodiazepine on masticatory muscle dysfunction induced by chronic stress and occlusal instability in an experimental animal study. Sci Rep 2020; 10:8787. [PMID: 32472004 PMCID: PMC7260241 DOI: 10.1038/s41598-020-65524-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/07/2020] [Indexed: 11/09/2022] Open
Abstract
Psychological stress and occlusal alteration are important etiologic factors for temporomandibular/masticatory muscular disorders. In particular, the exact physiologic mechanism underlying the relation by occlusal alteration and temporomandibular disorders remains unclear. Our purpose was to test the hypothesis that benzodiazepine therapy is able to prevent metabolic and vascular changes in the medial pterygoid muscle of rats under chronic stress after 14 days of unilateral exodontia. Adult Wistar rats were submitted to unpredictable chronic mild stress (10 days) and/or unilateral exodontia and their plasma and medial pterygoid muscles were removed for analysis. A pre-treatment with diazepam was used to verify its effect on stress. The parameters evaluated included anxiety behavior, plasma levels of corticosterone, metabolic activity by succinate dehydrogenase, capillary density by laminin staining and ultrastructural findings by transmission electron microscopy. Occlusal instability induced anxiety-like behavior on elevated plus-maze test and diazepam administration blocked the appearance of this behavior. Unilateral exodontia promoted in the contralateral muscle an increase of oxidative fibers and capillaries and modification of sarcoplasmic reticulum. Chronic stress caused increased glycolytic metabolism, reduced capillary density and morphological changes in mitochondria on both sides. Association of both factors induced a glycolytic pattern in muscle and hemodynamic changes. Pharmacological manipulation with diazepam inhibited the changes in the medial pterygoid muscle after stress. Our results reveal a preventive benzodiazepine treatment for stress and occlusal instability conditions affecting masticatory muscle disorders. In addition, provide insights into the mechanisms by which chronic stress and exodontia might be involved in the pathophysiology of masticatory muscular dysfunctions.
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Affiliation(s)
- Glauce C Nascimento
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Bruno L Malzone
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela M Iyomasa
- Department of Morphology, Presidente Prudente Medical School, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Yamba C L Pereira
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - João Paulo M Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Christie R A Leite-Panissi
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Ii-Sei Watanabe
- Department of Anatomy, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mamie M Iyomasa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Ramon Fuentes
- Department of Integral Dentistry, Research Centre for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile
| | - Elaine Del Bel
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Fernando J Dias
- Department of Integral Dentistry, Research Centre for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile.
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Salgueiro MDCC, Silva T, Motta LJ, Horliana ACRT, Gonçalves MLL, Gomes AO, Pinto MM, Bortoletto CC, Altavista OM, Deana AM, Silva DDFTD, Santos EM, Castelo PM, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. Effects of Photobiomodulation in Children with Down Syndrome and Possible Sleep Bruxism: Protocol For A Randomized, Controlled, Blind, Clinical Trial: Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore) 2020; 99:e19904. [PMID: 32332670 PMCID: PMC7440284 DOI: 10.1097/md.0000000000019904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Hypotonia, particularly of the masticatory and oropharyngeal muscles, is 1 of the main characteristics of Down Syndrome (DS), resulting in impaired speech, chewing and swallowing. Moreover, the complete or partial obstruction of the airways during sleep may occur due to hypotonia of the tongue, leading to snoring and sleep disorders, such as obstructive apnea and sleep bruxism. OBJECTIVE:: Analyze salivary levels of dopamine and cortisol and muscle activity before and after treatment with low-level laser therapy administered to acupoints in children with DS. METHODS:: A randomized, controlled, clinical trial will be conducted. Individuals 4 to 17 years of age with a diagnosis of DS and possible sleep bruxism will be screened at the Integrated Health Clinic of Nove de Julho University. We will evaluate orofacial dysfunction (Nordic Orofacial Test - Screening questionnaire), Masseter muscle activity during sleep will be assessed by BiteStrip and the masticatory muscles will be evaluated by electromyography (BTS TMJOINT) head posture as well as salivary cortisol and dopamine. After the evaluations, the participants will be randomized into 2 groups: Grupo 1 - treatment with low-level laser therapy at a wavelength of 808 nm; Group 2 - sham treatment (simulated laser therapy). Treatment will be conducted twice per week for a total of 12 sessions. The data will be tabulated and treated using GraphPad Prism version 7.0. The Kolmogorov-Smirnov test will be used to determine the normality of the data. Variables that fit the Gaussian curve will be expressed as mean and standard deviation. The ANOVA 2-way will be used for comparisons between the groups, with the significance level set to 5% (P < .05).ClinicalTrials registration number: NCT04211870.
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Evaluation the effects of low-level laser therapy on disc displacement with reduction. Turk J Phys Med Rehabil 2020; 66:24-30. [PMID: 32318671 DOI: 10.5606/tftrd.2020.3355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/04/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the effects of additional low-level laser therapy (940 nm GaAlAs) to the routine occlusal splint therapy on maximal mouth opening (MMO), visual analog scale (VAS) scores, and passive mouth opening (PMO). Patients and methods Between January 2016 and March 2018, a total of 40 patients (10 males, 30 females; mean age 22.35 years; range, 18 to 60 years) with disc displacement with reduction of the temporomandibular joint were included. The patients were divided into two groups. Group 1 (control group, n=20) received routine non-steroidal anti-inflammatory drug (NSAID) therapy and occlusal splint therapy for eight hours per day for a total of three months. Group 2 (laser group, n=20) received NSAID, occlusal splint therapy and 940 nm wavelength diode laser therapy for two sessions per week for a total of four weeks. The MMO, PMO, and VAS scores were recorded before and at one, two, three, four, and 12 weeks after treatment. The joint and muscle examinations were performed. Results A constant decrease was found in the VAS scores in both groups. At four (p=0.008) and 12 weeks (p=0.003), a statistically significant difference in the VAS scores was observed. At all time points, PMO and MMO scores increased in both groups. The MMO scores were statistically higher in the laser group at all time points (p<0.005). Conclusion Our study results suggest that short-term low-level laser therapy additional to conventional treatment may yield satisfactory outcomes.
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Dantas CMG, Vivan CL, de Fantini SM, de Freitas Costa e Silva PM, Pannuti CM, Witzel AL, Dominguez GC. The influence of educational measures and low-level laser phototherapy on temporomandibular disorders: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore) 2020; 99:e19005. [PMID: 32150048 PMCID: PMC7478391 DOI: 10.1097/md.0000000000019005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Photobiomodulation therapy (PBMT) with low-power laser is used for pain relief in several clinical conditions, including temporomandibular disorders (TMD). As musculoskeletal pain often produces changes in motor behavior, it is common for patients with TMD to present limited mandibular movements. To the date, there is no consensus about the optimal dosimetric parameters of PMBT for TMD. This randomized, controlled, double-blind clinical trial aims to evaluate pain relief and mandibular mobility in patients with TMD following treatments with 2 laser wavelengths, red (660 nm) and infrared (808 nm) individually and in combination as compared to a placebo treatment. One-hundred participants presenting myalgia and arthralgia, with disk displacement or not, will be selected based on the Research Diagnostic Criteria for Temporomandibular Disorders. All participants will be instructed about the etiology, prognosis, and self-care techniques for pain control on TMD, and followed up for 2 weeks. After this period, those who still present pain score over 4 in a visual analog scale (VAS) will be included in the study. Participants will be randomly assigned to 4 treatment groups: G1 = placebo (SHAM); G2 = PBMT with red laser (660 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); G3 = PBMT with infrared laser (808 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); and G4 = PBMT with red and infrared laser alternated between sessions. The treatment consists of 8 sessions, 2 times a week. The effect of the proposed therapies will be measured by: pain reduction in VAS; pressure pain threshold on TMJ, masseter and temporal muscles; and the amplitude of mandibular movements (opening, protrusion, and right and left lateral movements). The data will be collected at the following times: initial (T1), after the 1st treatment session (T2), at the end of treatment (T3), and 30 days after the last PBMT session (T4). For statistical analysis will be used 2-way repeated measures analysis of variance test, complemented by a post hoc Tukey test (P < .05).
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Affiliation(s)
| | | | | | | | - Claudio Mendes Pannuti
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
| | - Andrea Lusvarghi Witzel
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
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Nadhreen AA, Alamoudi NM, Elkhodary HM. Low-level laser therapy in dentistry: Extra-oral applications. Niger J Clin Pract 2019; 22:1313-1318. [PMID: 31607717 DOI: 10.4103/njcp.njcp_53_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Low-level laser therapy (LLLT) is considered as a recent technique in the dental field. Nowadays, it is used by many clinicians in dentistry. The stimulation of the healing process and pain relief are among its most popular uses. The purpose of this paper is to discuss and review the latest extra-oral applications of LLLT in the dental field. An electronic search of English scientific papers from 2000 to 2018 was accomplished using PubMed and Google Scholar search engines. The following key words were used extra-oral, applications, LLLT, and dental field. This review demonstrates the marked effectiveness of LLLT in the management of many conditions and how it could improve the quality of life of many patients. However, LLLT is still considered a recent alternative and requires more understanding of its mechanism of action by conducting more high-quality randomized clinical trials with larger sample sizes and longer follow-up periods.
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Affiliation(s)
- A A Nadhreen
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - N M Alamoudi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - H M Elkhodary
- Department of Pediatric Dentistry, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
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Abbasgholizadeh ZS, Evren B, Ozkan Y. Evaluation of the efficacy of different treatment modalities for painful temporomandibular disorders. Int J Oral Maxillofac Surg 2019; 49:628-635. [PMID: 31547949 DOI: 10.1016/j.ijom.2019.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 06/12/2019] [Accepted: 08/19/2019] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to clinically evaluate the efficacies of three treatment methods and to compare their outcomes in patients with painful disc displacement. The study group comprised 45 patients with unilateral temporomandibular disorders who fell into Axis I group II (with limited mouth opening) of the Research Diagnostic Criteria for Temporomandibular Disorders. Magnetic resonance imaging was used for definitive diagnosis. The patients were divided randomly into three groups according to the treatment method: splint therapy, splint therapy with ultrasound-guided arthrocentesis, and splint therapy with low-level laser therapy. Patients were followed up after treatment for 6 months. The groups were compared in terms of pain and functional jaw movements (unassisted mouth opening without pain, maximum unassisted mouth opening, and contralateral movements). At the end of treatment, functional jaw movements were significantly increased while pain values were significantly decreased in all groups (P<0.05). Group 2 had a quicker improvement in terms of mouth opening scores at the end of the first month, and unassisted mouth opening without pain was found to be more than 35 millimetres in all groups at the end of 6 months. All treatment modalities showed effective results on pain and functional jaw movements in the treatment of temporomandibular disorders.
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Affiliation(s)
- Z S Abbasgholizadeh
- Department of Prosthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - B Evren
- Department of Prosthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Y Ozkan
- Department of Prosthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Efficacy of the LED Red Light Therapy in the Treatment of Temporomandibular Disorders: Double Blind Randomized Controlled Trial. PAIN RESEARCH AND TREATMENT 2019; 2019:8578703. [PMID: 31205787 PMCID: PMC6530159 DOI: 10.1155/2019/8578703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/02/2019] [Accepted: 04/08/2019] [Indexed: 11/18/2022]
Abstract
Background Temporomandibular dysfunction syndrome (TMD) is a common disease among dental patients. It occurs as a consequence of malfunction of the tempromandibular and/or surrounding facial muscles. LED red light therapy is not been well established, and it is important to find out the role of this technique in the treatment of temporomandibular disorders. Aim of the Study To evaluate the efficacy of the LED red light in the treatment of the tempromandibular dysfunction syndrome. Material and Methods Fifty students of the College of Dentistry/University of Baghdad with myofacial pain associated with Tempromandibular Disorder volunteered to participate in this study and be evaluated during both treatment and follow-up periods. They were 40 (80%) females and 10 (20%) males. Patients were divided into 2 groups: Group A treated by TenDlite® Medical Device model 204 with a LED's of wavelength 660 nm (red light) and Group B given placebo (no treatment at all) by just putting the TenDlite device near the tender points without battery and turning ON the device. Results The changes in the pain value and number of the tender muscles in both groups were highly significant, only placebo group less but with no significant differences. Conclusions This study showed that red LED therapy could be useful in improving patient's symptoms regarding pain, clicking, and number of tender muscles. In addition, this study showed the importance of the psychological part of treatment of those patients. This trial is registered with TCTR20190406002.
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Del Vecchio A, Floravanti M, Boccassini A, Gaimari G, Vestri A, Di Paolo C, Romeo U. Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related pain: A randomized, double-blind, placebo-controlled clinical trial. Cranio 2019; 39:141-150. [PMID: 30999823 DOI: 10.1080/08869634.2019.1599174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: This study analyzed a home, low-level laser therapy (LLLT) protocol to manage temporomandibular joint disorders (TMJDs)-related pain.Methods: Ninety TMJD patients (12M, 78F) between 18 and 73 years were randomly subdivided into three groups. Study group (SG) received 1-week home protocol LLLT by B-cure Dental Pro: 808 nm, 5 J/min, 250 mW, 15 KHz for 8', 40 J each, over pain area, twice daily. Placebo group (PG) followed the same protocol using sham devices. Drugs group (DG) received conventional drugs. Pain was evaluated by visual analog scale (VAS) before and after therapy.Results: Statistical analysis showed that treatment was effective (F(2,83) = 4.882; p = .010). Bonferroni post-hoc analysis indicated a lower pain decrease in PG. SG registered a 34-point decrease per patient, while in PG and DG, the reduction was 25.6 and 35.3, respectively.Conclusion: The study supports the efficacy of home LLLT management of TMJD related pain.
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Affiliation(s)
- Alessandro Del Vecchio
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Miriam Floravanti
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Armando Boccassini
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Gianfranco Gaimari
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Policlinic Umberto I Rome, Rome, Italy
| | - Carlo Di Paolo
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Umberto Romeo
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
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Carvalho FR, Barros RQ, Gonçalves AS, Freitas PM. Photobiomodulation therapy on the palliative care of temporomandibular disorder and orofacial/cervical skull pain: study protocol for a randomized controlled clinical trial. Trials 2019; 20:200. [PMID: 30954086 PMCID: PMC6451204 DOI: 10.1186/s13063-019-3294-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Temporomandibular disorder (TMD) is the most common cause of orofacial and cervical skull pain and is considered to be a public health problem, affecting 5% to 12% of the world population. TMD is multifactorial and there are several types of treatment, with the conservative types being indicated more often as they are less aggressive and reversible. The main aim of these treatments is to relieve symptoms, reduce of pain, and restore orofacial and cervical skull functions. Photobiomodulation therapy (PBMT), a noninvasive therapy, is an option for the management of musculoskeletal disorders due to its analgesic, anti-inflammatory, and regenerative effects. Methods The aim of the proposed study is to verify whether PBMT is effective for use in palliative care of TMD and orofacial and cervical skull pain. A randomized, triple-blinded, placebo-controlled clinical trial is proposed. This study will involve 200 adult participants (over 18 years of age) who will be randomly divided into two groups (n = 100): Group 1, active treatment (PBMT); and Group 2, placebo. Participants will be subjected to three sessions of PBMT or placebo and will be evaluated using the research diagnostic criteria (RDC) for TMD. Pain level (measured by a visual analog scale (VAS)), mandibular movements (measured by ruler and caliper), quality of life (measured by the Oral Health Impact Profile (OHIP)-14), and quality of sleep (measured by the Epworth scale) will be recorded. This study is being conducted at the Special Laboratory of Lasers in Dentistry (LELO) of the School of Dentistry of the University of Sao Paulo (USP). Discussion This study will verify whether PBMT is effective in reducing TMD and orofacial and cervical skull pain. PBMT may be an option for the management of musculoskeletal disorders due to its analgesic, anti-inflammatory, and regenerative effects, in addition to being a noninvasive technique. Trial registration Registro Brasileiro de Ensaios Clínicos, RBR-9b6mnj. Registered on 27 March 2018. Trial registry name: Laser de baixa potência no cuidado paliativo da disfunção temporomandibular e dor crânio orofacial e cervical. Ethics committee: #1774930 approved on 14 October 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3294-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fernando Rodrigues Carvalho
- Special Laboratory of Lasers in Dentistry (LELO), School of Dentistry of the University of São Paulo (USP), São Paulo, Brazil
| | - Rafael Queiroz Barros
- Special Laboratory of Lasers in Dentistry (LELO), School of Dentistry of the University of São Paulo (USP), São Paulo, Brazil
| | - Alyne Simões Gonçalves
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Patrícia Moreira Freitas
- Department of Restorative Dentistry, Special Laboratory of Lasers in Dentistry, School of Dentistry, University of São Paulo (USP), Avenida Professor Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.
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Brochado FT, Jesus LHD, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018; 32:e50. [PMID: 29995062 DOI: 10.1590/1807-3107bor-2018.vol32.0050] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/25/2018] [Indexed: 12/22/2022] Open
Abstract
The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
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Affiliation(s)
- Fernanda Thomé Brochado
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Luciano Henrique de Jesus
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Vinicius Coelho Carrard
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Angelo Luiz Freddo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Buco Maxillofacial Surgery and Traumatology, Porto Alegre, RS, Brazil
| | - Karen Dantur Chaves
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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17
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Sobral APT, Godoy CLHD, Fernandes KPS, Bussadori SK, Ferrari RAM, Horliana ACRT, Monken SF, Motta LJ. Photomodulation in the treatment of chronic pain in patients with temporomandibular disorder: protocol for cost-effectiveness analysis. BMJ Open 2018; 8:e018326. [PMID: 29730613 PMCID: PMC5942461 DOI: 10.1136/bmjopen-2017-018326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Epidemiological data show that the signs and symptoms of temporomandibular disorder (TMD) start becoming apparent from 6 years of age, and during adolescence these signs and symptoms are similar to those of adults. The present study aims to estimate the direct costs for treatment of chronic muscle pain with photobiomodulation therapy, occlusal splint and placebo in patients with TMD; to evaluate the effectiveness of photobiomodulation therapy and occlusal splint for treatment of muscle pain in patients with TMD; to analyse the cost-effectiveness of the two proposed treatments for pain; and to describe and compare the results of the analyses of these treatments. METHODS AND ANALYSIS This is a prospective trial of clinical and economic analyses that will include 135 patientswith TMD aged between 15 years and 25 years, randomly assigned to a treatment group: G1 (photobiomodulation), G2 (occlusal splint) and G3 (placebo). The analyses will be based on the cost of each treatment during the 12-month period. The outcome of the analysis of effectiveness will be pain, measured periodically by means of clinical examination of Research Diagnostic Criteria for Temporomandibular Disorders. The cost-effectiveness ratio will be calculated using, as end points, pain and the ratio of the differences in costs between the groups studied. The evaluation of the impact of the treatment on quality of life will be determined by applying the adapted EuroQol-5D. ETHICS AND DISSEMINATION This protocol has been ethically approved by the local medical ethical committee, protocol number 2.014.339. Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT03096301.
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Affiliation(s)
- Ana Paula Taboada Sobral
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Camila Leal H de Godoy
- Dentistry School from Universidade Nove de Julho - UNINOVE, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Kristianne P Santos Fernandes
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | | | | | - Sonia F Monken
- Professional Master Health Administration Program, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Lara J Motta
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
- Professional Master Health Administration Program, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
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18
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Leal de Godoy CH, Motta LJ, Garcia EJ, Fernandes KPS, Mesquita-Ferrari RA, Sfalcin RA, Motta PDB, Politti F, Bussadori SK. Electromyographic evaluation of a low-level laser protocol for the treatment of temporomandibular disorder: a randomized, controlled, blind trial. J Phys Ther Sci 2017; 29:2107-2111. [PMID: 29643585 PMCID: PMC5890211 DOI: 10.1589/jpts.29.2107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Problems involving the temporomandibular joint and associated structures can
lead to temporomandibular disorder (TMD). The aim of the present study was to evaluate
muscle activity in individuals with a diagnosis of TMD before and after treatment with
low-level laser therapy (LLLT) through the use of electromyography (EMG). [Subjects and
Methods] Male and female individuals aged 14 to 23 years were evaluated. TMD was
determined by a clinical examination and the administration of the Research Diagnostic
Criteria for Temporomandibular Disorders, followed by the evaluation of sensitivity to
palpation of the masseter and anterior temporal muscles as well as the EMG determination
of muscle activity. The participants were randomly allocated to an active LLLT group (n=9)
and sham group (n=7). Twelve sessions of LLLT were conducted using a wavelength of 780 nm,
energy density of 25 J/cm2, power of 50 mW, power density of
1.25 W/cm2 and a 20-second exposure time or sham LLLT. Muscle activity was
determined prior to treatment and after the last session. [Results] During the isometric
evaluation of the masseter and anterior temporal muscles, an increase in the mean EMG
signal was found in the group submitted to active LLLT. When evaluated individually, some
participants in the active LLLT group demonstrated a reduction in muscle activity, but no
significant differences were found in the mean EMG signal between the initial and final
evaluations. [Conclusion] Further studies with a larger sample size are needed to confirm
the present findings.
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Lauriti L, de Cerqueira Luz JG, Agnelli Mesquita-Ferrari R, Fernandes KPS, Deana AM, Tempestini Horliana ACR, Costa-Santos L, Brugnera Junior A, Bussadori SK. Evaluation of the Effect of Phototherapy in Patients with Mandibular Fracture on Mandibular Dynamics, Pain, Edema, and Bite Force: A Pilot Study. Photomed Laser Surg 2017; 36:24-30. [PMID: 29023221 DOI: 10.1089/pho.2017.4334] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of phototherapy on bite force, facial swelling, mandibular movements, and pain in patients having undergone surgical treatment for mandibular fractures. BACKGROUND These are among the predominant types of facial fractures, and treatment involving surgical fixation with titanium plates is one of the most common procedures in oral-maxillofacial surgery. Phototherapy has been used to accelerate the muscle healing process and significantly improves muscle regeneration by inducing the formation of new muscle fibers. METHODS The patients were divided into two groups: Group 1-active phototherapy, and Group 2-sham phototherapy. Both groups underwent the surgical procedure by the same surgeon using the same surgical technique. Dosimetric parameters are wavelength, 660 nm; power, 108 mW; radiant energy, 21.6 J; fluency, 21.6 J/cm2; radiance, 38197 mW/cm2; exposure time, 200 sec per point, 10 points bilaterally. Photobiomodulation was performed in 15 sessions. RESULTS The primary variable was bite force measured with a gnathodynamometer and the secondary variables were facial swelling, mandibular movements (measured with digital calipers), and pain. The Student's t-test was used to determine intergroup differences. CONCLUSIONS The findings suggest improvements in the laser group in comparison with the sham group with regard to mandibular dynamics, a reduction in postoperative facial swelling, a reduction in pain, and an increase in bite force.
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Affiliation(s)
- Leandro Lauriti
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Raquel Agnelli Mesquita-Ferrari
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Alessandro Melo Deana
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Larissa Costa-Santos
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | - Aldo Brugnera Junior
- 4 National Institute of Science and Technology-INCT, IFSC, University of São Paulo , São Carlos, Brazil
| | - Sandra Kalil Bussadori
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
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20
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Seifi M, Ebadifar A, Kabiri S, Badiee MR, Abdolazimi Z, Amdjadi P. Comparative effectiveness of Low Level Laser therapy and Transcutaneous Electric Nerve Stimulation on Temporomandibular Joint Disorders. J Lasers Med Sci 2017; 8:S27-S31. [PMID: 29071032 DOI: 10.15171/jlms.2017.s6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Temporomandibular joint disorders (TMDs) are the most common source of pain on the face. There are multiple etiologies, and several types of treatment have been reported. The use of non-invasive and reversible therapies in the treatment of such problems is recommended. The present study evaluated the effect of low-level laser (LLL) therapy and transcutaneous electric nerve stimulation (TENS) on TMDs. Methods: In this single-blind study, 40 patients with temporomandibular disorders were randomly divided into four groups: TENS (TENSTem dental), LLL (diode 810 nm CW), shamTENS, and sham-LLL. All subjects were examined and data on pain and tenderness in the temporomandibular joint (TMJ) and masticatory muscles (using the visual analogue scale) and mouth-opening (distance between incisal edges before feeling pain; mm) were collected before baseline (T1), after each session (T2-T5) and one month after the end of the sessions (T6)), and analyzed using repeated measure analysis of variance (ANOVA) and Bonferroni statistical tests. A P value < 0.05 was considered significant. Results: The decrease in pain (P=0.000), tenderness (P=0.000) and increase in mouth-opening ability (P=0.002) was greater in the TENS and LLL groups than in the placebo groups. At the one-month follow-up, significant decrease in pain and tenderness was recorded in the TENS and LLL groups (P=0.000). There was no significant differences between TENS and LLL and the placebo groups for maximum mouth-opening at the end of the study (P=0.692). Conclusion: Using TENS or LLL therapy can improve TMD symptoms at least for the short term. Although the effects of the placebo played a role in improving symptoms, their effects were less important.
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Affiliation(s)
- Massoud Seifi
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ebadifar
- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Sattar Kabiri
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Badiee
- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Zahra Abdolazimi
- Pediatric Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amdjadi
- Department of Dental Materials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Salgueiro MDCC, Bortoletto CC, Horliana ACR, Mota ACC, Motta LJ, Motta PDB, MesquitaFerrari RA, Fernandes KPS, Bussadori SK. Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:391. [PMID: 28789647 PMCID: PMC5549372 DOI: 10.1186/s12906-017-1905-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022]
Abstract
BACKGROUND Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. METHODS The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. DISCUSSION Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. TRIAL REGISTRATION NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).
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Affiliation(s)
- Mônica da Consolação Canuto Salgueiro
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | | | - Anna Carolina RattoTempestini Horliana
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Ana Carolina Costa Mota
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Lara Jansiski Motta
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Management in Health Systems, Nove de Julho University, São Paulo, Brazil
| | | | - Raquel Agnelli MesquitaFerrari
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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Antonić R, Brumini M, Vidović I, Muhvić Urek M, Glažar I, Pezelj-Ribarić S. he effects of low level laser therapy on the management of chronic idiopathic orofacial pain: trigeminal neuralgia, temporomandibular disorders and burning mouth syndrome. ACTA ACUST UNITED AC 2017. [DOI: 10.21860/medflum2017_173373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sattayut S. Low intensity laser for reducing pain from anesthetic palatal injection. Photomed Laser Surg 2016; 32:658-62. [PMID: 25372219 DOI: 10.1089/pho.2014.3770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of pain reduction techniques for palatal injection, namely, low intensity laser therapy (LILT), topical anesthesia, pressure, and light touch. BACKGROUND DATA Previous evidence indicates that LILT may prevent pain from palatal injection. However, no clinical trials evaluating this clinical question have been performed. METHODS A double-blind clinical trial was conducted using 80 healthy volunteers, 18-25 years of age. The subjects were randomly allocated into four groups with 10 females and 10 males each group. Pain reduction techniques were administered at an injection point that was 10 mm from the margin of the palatal gingiva of the upper left first molar according to the following groups: (1) a 790 nm 30 mW continuous wave with a 0.13 cm2 focal spot at an applied energy of 3.6 J and fluence of 27.69 J/cm2, (2) 20% benzocaine, (3) pressure, and (4) light touch as the control. Then, 2% lidocaine with 1:100,000 epinephrine was injected using a 27-gauge needle with a pressure and volume control intraligamentary syringe. All subjects recorded pain on a 10 cm visual analog scale (VAS). RESULTS The pain score in the LILT group was <50 mm. The median of pain scores of the LILT, 20% benzocaine, pressure, and light touch groups were 11, 23, 27, and 31 mm, respectively. There was no statistically significant difference in VAS among the groups, using Kruskal-Wallis test (p=0.385). CONCLUSIONS No statistically significant differences in pain scores were noted among low intensity laser, 20% benzocaine, pressure, and light touch.
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Affiliation(s)
- Sajee Sattayut
- Oral Surgery Department, Faculty of Dentistry and Lasers in Dentistry Research Group, Khon Kaen University , Khon Kaen, Thailand
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Evaluation of Low-Level Laser Therapy in TMD Patients. Case Rep Dent 2015; 2015:424213. [PMID: 26587294 PMCID: PMC4637444 DOI: 10.1155/2015/424213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 02/07/2023] Open
Abstract
Light amplification by stimulated emission of radiation (laser) is one of the most recent treatment modalities in dentistry. Low-level laser therapy (LLLT) is suggested to have biostimulating and analgesic effects through direct irradiation without causing thermal response. There are few studies that have investigated the efficacy of laser therapy in temporomandibular disorders (TMD), especially in reduced mouth opening. The case report here evaluates performance of LLLT with a diode laser for temporomandibular clicking and postoperative findings were evaluated in two cases of TMD patients. First patient had a history of limited mouth opening and pain in temporomandibular joint (TMJ) region since nine months. Second patient's main complaint was his restricted mouth opening, which was progressed in one year. LLLT was performed with a 685 nm red probed diode laser that has an energy density of 6.2 J/cm(2), three times a week for one month, and application time was 30 seconds (685 nm, 25 mW, 30 s, 0.02 Hz, and 6.2 J/cm(2)) (BTL-2000, Portative Laser Therapy Device). The treatment protocol was decided according to the literature. One year later patients were evaluated and there were no changes. This application suggested that LLLT is an appropriate treatment for TMD related pain and limited mouth opening and should be considered as an alternative to other methods.
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Leal de Godoy CH, Motta LJ, Santos Fernandes KP, Mesquita-Ferrari RA, Deana AM, Bussadori SK. Effect of Low-Level Laser Therapy on Adolescents With Temporomandibular Disorder: A Blind Randomized Controlled Pilot Study. J Oral Maxillofac Surg 2015; 73:622-9. [DOI: 10.1016/j.joms.2014.09.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 09/16/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
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Herpich CM, Amaral AP, Leal-Junior ECP, Tosato JDP, Gomes CAFDP, Arruda ÉEC, Glória IPDS, Garcia MBS, Barbosa BRB, Rodrigues MS, Silva KL, El Hage Y, Politti F, Gonzalez TDO, Bussadori SK, Biasotto-Gonzalez DA. Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature. J Phys Ther Sci 2015; 27:295-301. [PMID: 25642095 PMCID: PMC4305586 DOI: 10.1589/jpts.27.295] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/18/2014] [Indexed: 12/02/2022] Open
Abstract
The aim of the present study was to perform a systematic review of the literature on the
effects of low-level laser therapy in the treatment of TMD, and to analyze the use of
different assessment tools. [Subjects and Methods] Searches were carried out of the
BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for
papers published in English and Portuguese using the terms: “temporomandibular joint laser
therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility
criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited
considerable methodological differences, especially with regard to the number of sessions,
anatomic site and duration of low-level laser therapy irradiation, as well as irradiation
parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are
needed, especially randomized clinical trials, to establish the exact dose and ideal
parameters for low-level laser therapy and define the best assessment tools in this
promising field of research that may benefit individuals with signs and symptoms of
TMD.
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Affiliation(s)
- Carolina Marciela Herpich
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Ana Paula Amaral
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Ernesto Cesar Pinto Leal-Junior
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Phototherapy in Sports and Exercise, University Nove de Julho (UNINOVE), Brazil
| | - Juliana de Paiva Tosato
- Postgraduate Program in Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Brazil
| | | | - Éric Edmur Camargo Arruda
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Igor Phillip Dos Santos Glória
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Marilia Barbosa Santos Garcia
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Bruno Roberto Borges Barbosa
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | | | - Katiane Lima Silva
- Graduation Phisical Therapy, Universidade Nove de Julho (UNINOVE), Brazil
| | - Yasmin El Hage
- Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE), Brazil
| | - Fabiano Politti
- Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE), Brazil
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Daniela Aparecida Biasotto-Gonzalez
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
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Effectiveness of occlusal splints and low-level laser therapy on myofascial pain. Lasers Med Sci 2014; 30:1007-12. [DOI: 10.1007/s10103-014-1522-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
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Madani AS, Ahrari F, Nasiri F, Abtahi M, Tunér J. Low-level laser therapy for management of TMJ osteoarthritis. Cranio 2014; 32:38-44. [DOI: 10.1179/0886963413z.0000000004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Pereira TS, Flecha OD, Guimarães RC, Oliveira DDDW, Botelho AM, Glória JCR, Tavano KTA. Efficacy of red and infrared lasers in treatment of temporomandibular disorders — a double-blind, randomized, parallel clinical trial. Cranio 2014; 32:51-6. [DOI: 10.1179/0886963413z.0000000005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Evaluation of pain, jaw movements, and psychosocial factors in elderly individuals with temporomandibular disorder under laser phototherapy. Lasers Med Sci 2013; 30:953-9. [PMID: 24366293 DOI: 10.1007/s10103-013-1514-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
Abstract
Few studies have been carried out on the application of laser phototherapy (LPT) for treating painful temporomandibular disorder (TMD) in elderly population that is growing worldwide. The aim of the present study was to evaluate the pain, jaw movements, and psychosocial factors in ten elderly patients with painful TMD before and after LPT. All patients were evaluated before and after LPT by using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) axes I and II. For pain assessment, a visual analogue scale (VAS) was used. The LPT was carried out with an GaAlAs diode laser (780 nm; spot size 0.04 cm(2)) in punctual and contact mode. Two settings of irradiations were applied as follows: in patients presenting myofascial pain, 10 mW, 5 J/cm(2), 20 s, 0.2 J per application point; and in patients with joint TMD, 70 mW, 105 J/cm(2), 60 s on five points, 4.2 J per point. Two sessions of LPT were carried out per week over four consecutive weeks, in the total of eight sessions. Data was statistically analyzed (p < 0.05). Significant pain reduction was found in all patients. There were increase in maximum mouth opening without pain and reduction in muscle pain during right and left lateral excursion. A significant reduction in chronic pain severity (p = 0.02) and significant improvements in depression (p = 0.038) and nonspecific physical symptoms with pain (p = 0.0167) were observed. The present findings indicate that LPT is able to promote pain relief and improvement of jaw movements in elderly patients with TMD, with a positive effect on psychosocial aspects.
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Evaluation of anti-nociceptive and anti-inflammatory activity of low-level laser therapy on temporomandibular joint inflammation in rodents. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2013; 129:135-42. [PMID: 24231378 DOI: 10.1016/j.jphotobiol.2013.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 10/02/2013] [Accepted: 10/03/2013] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the analgesic and anti-inflammatory activity of low-level laser therapy (LLLT) on the nociceptive behavioral as well as histomorphological aspects induced by injection of formalin and carrageenan into the rat temporomandibular joint. The 2.5% formalin injection (FRG group) induced behavioral responses characterized by rubbing the orofacial region and flinching the head quickly, which were quantified for 45 min. The pretreatment with systemic administration of diclofenac sodium-DFN group (10 mg/kg i.p.) as well as the irradiation with LLLT infrared (LST group, 780 nm, 70 mW, 30 s, 2.1 J, 52.5 J/cm(2), GaAlAs) significantly reduced the formalin-induced nociceptive responses. The 1% carrageenan injection (CRG group) induced inflammatory responses over the time-course of the study (24 h, and 3 and 7 days) characterized by the presence of intense inflammatory infiltrate rich in neutrophils, scanty areas of liquefactive necrosis and intense interstitial edema, extensive hemorrhagic areas, and enlargement of the joint space on the region. The DFN and LST groups showed an intensity of inflammatory response that was significantly lower than in CRG group over the time-course of the study, especially in the LST group, which showed exuberant granulation tissue with intense vascularization, and deposition of newly formed collagen fibers (3 and 7 days). It was concluded that the LLLT presented an anti-nociceptive and anti-inflammatory response on the inflammation induced in the temporomandibular joint of rodents.
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32
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de Godoy CHL, Silva PFDC, de Araujo DS, Motta LJ, Biasotto-Gonzalez DA, Politti F, Mesquita-Ferrari RA, Fernandes KPS, Albertini R, Bussadori SK. Evaluation of effect of low-level laser therapy on adolescents with temporomandibular disorder: study protocol for a randomized controlled trial. Trials 2013; 14:229. [PMID: 23876095 PMCID: PMC3729421 DOI: 10.1186/1745-6215-14-229] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 07/11/2013] [Indexed: 11/13/2022] Open
Abstract
Background A number of problems involving the temporomandibular joint (TMJ) and associated structures can lead to temporomandibular disorder (TMD). The aim of the proposed study is to assess the effect of low-level laser therapy on occlusal contacts, mandibular movements, electromyography activity in the muscles of mastication and pain in adolescents with TMD. Methods/Design A randomized, controlled, double-blind, clinical trial will be carried out involving 85 male and female adolescents between 15 and 18 years of age. The research diagnostic criteria for TMD will be used to assess all individuals who agree to participate. All participants will be submitted to a clinical examination and electromyographic analysis of the masseter muscles and anterior bundle of the temporal muscles bilaterally, to determine TMD. Based on the clinical findings, the participants will be classified as having or not having TMD. Those with TMD will be divided into four groups, three of which will receive low-level laser therapy and one of which will receive a placebo treatment. The treatments will involve the TMJ region alone, the masseter and temporal muscles alone, or both these regions together. The data will be submitted to descriptive statistical analysis. The chi-square test and Fisher’s exact test will be used to determine associations among the categorical variables. The Student’s t test and analysis of variance will be used for the comparison of mean electromyographic signals. Pearson’s correlation coefficients will be calculated for the analysis of correlations among the continuous variables. Trial registration The protocol for this study has been submitted to Clinical Trials – registration number (NCT01846000).
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Affiliation(s)
- Camila Haddad Leal de Godoy
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: a double-blind randomized placebo-controlled study. Lasers Med Sci 2013; 29:671-9. [DOI: 10.1007/s10103-013-1378-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
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34
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Herranz-Aparicio J, Vázquez-Delgado E, Arnabat-Domínguez J, España-Tost A, Gay-Escoda C. The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature. Med Oral Patol Oral Cir Bucal 2013; 18:e603-12. [PMID: 23722130 PMCID: PMC3731088 DOI: 10.4317/medoral.18794] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 02/16/2013] [Indexed: 12/03/2022] Open
Abstract
Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial.
Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies.
Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles.
Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs.
Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations.
Key words:Low level laser therapy; phototherapy; temporomandibular joint disorders.
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Maia MLDM, Bonjardim LR, Quintans JDSS, Ribeiro MAG, Maia LGM, Conti PCR. Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review. J Appl Oral Sci 2013; 20:594-602. [PMID: 23329239 PMCID: PMC3881861 DOI: 10.1590/s1678-77572012000600002] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 11/06/2011] [Indexed: 11/29/2022] Open
Abstract
Temporomandibular disorders (TMD) are characterized by the presence of
temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction.
Low-level laser is presented as an adjuvant therapeutic modality for the treatment of
TMD, especially when the presence of inflammatory pain is suspected.
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Ahrari F, Madani AS, Ghafouri ZS, Tunér J. The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci 2013; 29:551-7. [DOI: 10.1007/s10103-012-1253-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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Jang H, Lee H. Meta-analysis of pain relief effects by laser irradiation on joint areas. Photomed Laser Surg 2012; 30:405-17. [PMID: 22747309 DOI: 10.1089/pho.2012.3240] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Laser therapy has been proposed as a physical therapy for musculoskeletal disorders and has attained popularity because no side effects have been reported after treatment. However, its true effectiveness is still controversial because several clinical trials have reported the ineffectiveness of lasers in treating pain. METHODS In this systematic review, we investigate the clinical effectiveness of low-level laser therapy (LLLT) on joint pain. Clinical trials on joint pain satisfying the following conditions are included: the laser is irradiated on the joint area, the PEDro scale score is at least 5, and the effectiveness of the trial is measured using a visual analogue scale (VAS). To estimate the overall effectiveness of all included clinical trials, a mean weighted difference in change of pain on VAS was used. RESULTS MEDLINE is the main source of the literature search. After the literature search, 22 trials related to joint pain were selected. The average methodological quality score of the 22 trials consisting of 1014 patients was 7.96 on the PEDro scale; 11 trials reported positive effects and 11 trials reported negative effects. The mean weighted difference in change of pain on VAS was 13.96 mm (95% CI, 7.24-20.69) in favor of the active LLLT groups. When we only considered the clinical trials in which the energy dose was within the dose range suggested in the review by Bjordal et al. in 2003 and in World Association for Laser Therapy (WALT) dose recommendation, the mean effect sizes were 19.88 and 21.05 mm in favor of the true LLLT groups, respectively. CONCLUSIONS The review shows that laser therapy on the joint reduces pain in patients. Moreover, when we restrict the energy doses of the laser therapy into the dose window suggested in the previous study, we can expect more reliable pain relief treatments.
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Affiliation(s)
- Ho Jang
- Department of Information and Communications, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
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Assis TDO, Soares MDS, Victor MM. O uso do laser na reabilitação das desordens temporomandibulares. FISIOTERAPIA EM MOVIMENTO 2012. [DOI: 10.1590/s0103-51502012000200023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Entende-se disfunção temporomandibular comoum termo coletivo que envolve um grande número de problemas clínicos que afetam os músculos mastigatórios, a articulação temporomandibular (ATM) e estruturas associadas. Dentre os principais sinais e sintomas, incluem-se dores nos músculos da mastigação ou na ATM, ruídos articulares, limitação de abertura, retração gengival, oclusão inadequada, distúrbios auditivos, cefaleias, sensibilidade em toda a musculatura do sistema estomatognático e cervical. OBJETIVOS: Estudar a influência da laserterapia de baixa intensidade (diodo) no tratamento das desordens temporomandibulares. MATERIAIS E MÉTODOS: Trata-se de uma revisão sistemática. Foram consultadas as seguintes bases de dados: BIREME, MEDLINE, PubMed, Science Direct e LILACS. Os termos de busca utilizados foram "temporomandibular laser therapy" e "ATM laser treatment", em inglês e português. Não foram estabelecidos limites de busca. Após a busca independente de dois revisores, foram encontrados 1.344 artigos e, após a aplicação dos critérios de exclusão, 12 artigos foram selecionados para a análise. RESULTADOS: Dos 12 artigos selecionados, apenas em 1 (um) deles não foi verificada qualquer melhora do quadro doloroso na ATM em virtude dos diversos tipos de DTM. CONCLUSÃO: Apesar dos resultados satisfatórios do uso do laser na redução sintomática da dor nos DTM, ainda é controversa a utilização dos seus parâmetros para cada caso. Por isso, sugerimos a realização de outros estudos para que essas lacunas sejam preenchidas com o objetivo maior de promover uma melhor qualidade de vida para as pessoas que sofrem quaisquer transtornos na região da ATM.
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Fukuda TY, Tanji MM, de Jesus JF, da Silva SR, Sato MN, Plapler H. Infrared low-level diode laser on serum chemokine MCP-1 modulation in mice. Lasers Med Sci 2012; 28:451-6. [PMID: 22415574 DOI: 10.1007/s10103-012-1072-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
The effect of the low-level laser therapy (LLLT) in the modulation of cells related to inflammatory processes has been widely studied, with different parameters. The objective was to investigate the immediate and cumulative effect of infrared LLLT on chemokine monocyte chemotactic protein-1 (MCP-1) modulation in mice. Fifty-two isogenic mice were distributed in seven groups: control (n = 10, no surgical procedure), laser I (n = 7, surgical procedure and a single LLLT exposure 12 h after the surgery), laser II (n = 7, surgery followed by two LLLT exposures, 12 and 36 h after surgery), and laser III (n = 7, surgery followed by three LLLT exposures, 12, 36, and 60 h after surgery). For each group, a sham group (n = 21) underwent surgery without laser application. The animals in the laser groups received an infrared diode continuous laser exposure (AsGaAl, 780 nm wavelength, power of 20 mW, energy density of 10 J/cm(2), spot size of 0,04 cm(2)) on three points (20 s per point), and a final energy of 0.4 J. The animals were sacrificed 36 h (laser I and sham I groups), 60 h (laser II and sham II), and 84 h (laser III and sham III groups) after surgery. The MCP-1 concentrations were measured by cytometric bead array. There was no significant difference between the three periods in the sham group (p = 0.3). There was a lower concentration of MCP-1 in the laser III group compared to the laser I group (p = 0.05). The infrared LLLT showed a cumulative effect in the modulation of chemokine MCP-1 concentration. Three LLLT exposures were necessary to achieve the MCP-1 modulation.
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Affiliation(s)
- Thiago Y Fukuda
- Experimental Surgery, Federal University of São Paulo (UNIFESP), Rua Botucatu, 740-Vila Clementino, São Paulo, São Paulo, Brazil.
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40
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Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders. Lasers Med Sci 2012; 28:57-64. [PMID: 22367394 DOI: 10.1007/s10103-012-1065-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.
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Lee YU, Lee SK, Youn JI. Optical Spectroscopic Analysis of Muscle Spasticity for Low-Level Laser Therapy (LLLT). ACTA ACUST UNITED AC 2011. [DOI: 10.3807/josk.2011.15.4.373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Low-Level Laser Therapy (LLLT) at 830 nm Positively Modulates Healing of Tracheal Incisions in Rats: A Preliminary Histological Investigation. Photomed Laser Surg 2011; 29:613-8. [DOI: 10.1089/pho.2010.2950] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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