Efficacy of laser therapy for temporomandibular disorders: A systematic review and meta-analysis

The Effectiveness of Multimodality Treatment Including Stabilization Splint and Low-Level Laser Therapies on Managing Temporomandibular Disorders: A Pilot Randomized Controlled Trial

OBJECTIVES

Temporomandibular disorder (TMD) encompasses various clinical issues affecting the temporomandibular joint, masticatory muscles, and surrounding structures. Common symptoms include pain, joint and muscle tenderness, and limited jaw movement. Diverse treatment options have been utilized to manage TMD. However, evidence of the combined modality treatment approach is scarce. This pilot trial aimed to evaluate the effectiveness of combining stabilization splint therapy (SST) with low-level laser therapy (LLLT) in managing TMD.

MATERIAL AND METHODS

This pilot parallel randomized clinical trial included 30 patients with TMD. Patients were randomly allocated equally into three treatment groups: SST, LLLT, and combined treatment (CT). Outcomes, including pain and functional limitations, were measured at baseline, 1, 2, 3, and 4 weeks after the start of each treatment.

RESULTS

CT was significantly more effective in reducing pain in patients with TMD compared to LLLT and SST. Although patients in the LLLT group reported significantly reduced pain, they still had higher pain scores compared to the SST group at certain time points, indicating that LLLT was not as effective as SST. Most functional limitations were improved over time, more consistently within the CT group, but without significant differences between the three groups. Patients were more satisfied with CT compared to LLLT and SST.

CONCLUSIONS

The superior results of the CT group over the SST and LLLT groups were evident in this pilot trial's outcomes. The combined modality treatment approach seems to yield the greatest improvement for TMD patients.

Photobiomodulation therapy as an additional method for the treatment of temporomandibular disorder patients- a narrative review

The photobiomodulation therapy (PBMT) is promising additional therapy in the treatment of temporomandibular disorder (TMD). In this regard, the purpose of this narrative review is to give a wide-ranging, objective, and judicious view of the current knowledge on PBMT as an additional TMD treatment modality, with summarised updated information. Although the results of most research studies report improvement of pain in TMD patients, some state that sustainability of absence of pain after PBMT of TMD is of concern. There has been a recent surge in research around the application of lasers for the management of TMD. Nonetheless, the scarcity of scientific clinical studies with structured laser parameters makes it difficult to draw a more concrete conclusion whether lasers in the treatment of TMD are more effective than traditional TMD treatments. In conclusion, since PBMT is becoming an additional treatment of choice for the management of TMD there is a need for more research especially involving clinical studies with better structured laser parameters.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of select 2023 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertize in their subject areas that include (in order of appearance here): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine, oral and maxillofacial surgery, and oral radiology; and dental caries and cariology. The authors have focused their efforts on presenting information likely to influence the daily dental treatment decisions of the reader with an emphasis on current innovations, new materials and processes, emerging technology, and future trends in dentistry. With the overwhelming volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to inform and update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope readers find this work helpful in providing evidence-based care to patients seeking healthier and happier lives.

Efficacy of different low-level laser therapy sessions in the management of masseter muscle trigger points

BACKGROUND

Low-level laser therapy (LLLT) is one of the recent treatment modalities for myofascial pain dysfunction syndrome with trigger points. The objective of the present study was to examine the impact of varying LLLT sessions on the treatment of masseter muscle trigger points.

METHODS

90 patients diagnosed with orofacial pain and trigger points in the masseter muscle for at least 6 months were selected and divided into 3 groups (n = 30) based on the number of LLLT sessions provided to patients. Patients in Group I received one session/per week, group II received two sessions/per week, and Group III received three sessions/per week. The sessions continued for 4 weeks, evaluations of pain levels, maximum mouth opening (MMO), and quality of life were conducted before and after the procedure at 1, 2, 3, 4, and 8 weeks.

RESULTS

The pain scores exhibited a highly statistically significant difference among the three groups (p < 0.001) over the 8-week study period. MMO was statistically significantly different between groups at week 4 and week 8. The Oral Health Impact Profile-14 (OHIP-14) score was statistically significant difference between groups at week 8. The time showed a highly significant effect on the study outcomes within each group.

CONCLUSION

Increased the number of LLLT sessions reduced the pain improved the MMO, and subsequently improved the quality of life.

CLINICALTRIALS

GOV ID

NCT06327204 - retrospectively registered.

Effectiveness of Laser Therapy in Treatment of Temporomandibular Joint and Muscle Pain

Background/Objectives: Temporomandibular joint disorders (TMDs) express a condition derived from a broad spectrum of etiological factors and clinical manifestations. Many treatment options have been developed for TMDs; nevertheless, conservative and non-invasive approaches ought to be prioritized. Laser therapy is an effective treatment for pain management due to its non-invasive nature and capacity for tissue regeneration. This review aimed at bringing an overview of the present evidence regarding the efficiency of laser therapy on myofascial or temporomandibular joint disorders pain. Methods: The search was conducted in four electronic databases: PubMed, Web of Science, Embase, and Scopus, of studies published between January 1997 and January 2023. The following terms have been extensively searched: "laser treatment", pain management", "temporomandibular joint disorders", "masseter muscle pain", "pterygoid muscle pain", and "temporal muscle pain". The inclusion criteria were original papers, available in full text, and written in English. Cohen's Kappa coefficient was used to assess the inter-rater reliability for article selection. The methodological quality was assessed with the Cochrane Risk of Bias tool for randomized controlled trials and the National Heart, Lung, and Blood Institute's quality assessment tool for before-after studies with no control group. Results: Out of 846 identified records, 7 studies were included, of which 5 were randomized controlled trials. The inter-rater reliability for article selection showed an almost perfect agreement (Cohen's Kappa = 0.832, p < 0.001). The protocol of laser application was not standardized; the laser wavelength ranged from 633 to 940 nm, with a power output range from 25 to 1600 mW. The number of sessions varied from 3 to 12, with a frequency of application from 1 time per week to 3 times per week. All studies reported pain reduction after laser therapy. Conclusions: Laser therapy is an efficient method to treat TMDs related to muscle pain. To accomplish the desired results, a standard procedure must be followed; however, the protocol is still not fully designed.

Comparison of different dual-wavelength photobiomodulation protocols application in third molar extractions. A split-mouth randomized controlled trial

OBJECTIVE

To compare the use of PBMT in the soft tissue and bone healing after third molar extraction using the dual-wavelength laser directly into the post-extraction alveoli (PBMT-I), or PBMT with a red laser directly into the alveoli and with an infrared laser externally on the patient's face (PBMT-IE).

METHODS

Twenty patients underwent extraction of four third molars were involved in this split-mouth double-blind randomized controlled trial. The Post-extraction alveoli were treated with the following protocols: PBMT-IE: Application of a red laser directly into the alveolus, and infrared laser irradiation transcutaneously and PBMT-I: Application of dual-wavelength laser intraorally. Patients were clinically evaluated 3, 7, 14, 30, and 90 days after the surgical procedure. The analyses in this study were divided into qualitative (centered on the patient's report and on the evaluators' analysis), and quantitative analyses (measurement of the vertical and horizontal dimensions of the face with the objective of measuring post-surgical edema and radiographic analyses for evaluation of the density and structure of the newly formed bone).

RESULTS

A progressive improvement was observed in all parameters evaluated in this study, however, this improvement was time dependent, with no distinct effect observed between the PBMT treatments applied.

CONCLUSION

The different dual-wavelength PBMT protocols induced a similar postoperative clinical course in third molar extraction surgeries, with a reduced occurrence of complications and a good healing pattern of hard and soft tissues.

Comparison of low-level laser therapy and standard treatment for temporomandibular disorders: An assessment of therapeutic and placebo effects

BACKGROUND

Despite extensive research on the use of low-power lasers for TMD treatment, the extent of their effectiveness remains uncertain.

OBJECTIVE

This study aimed to investigate the therapeutic or placebo effect of LLLT for TMD, and to compare it with standard treatment methods. A unique aspect of this study was the inclusion of a control group that received only standard treatment, allowing for an assessment of the placebo effect of LLLT.

METHODS

A total of 42 patients with TMD were referred to Kerman Dental School Pain Clinic and were randomly assigned to three groups: group A received LLLT, group B was a placebo group and group C was a control group that received only standard treatment. The laser groups received gallium-aluminium-arsenide laser treatment twice a week for 10 sessions. Patients' jaw movement rate indicators and VAS index were evaluated at the start of treatment, and indicators were re-recorded every week for 5 weeks. SPSS 21 was used for statistical analysis, including ANOVA and Tukey's post hoc tests for inter-group comparisons. The repeated measurement test was used to analyse the data.

RESULTS

All groups showed significant improvement in VAS indicators (p = .0001), lateral jaw movements (p = .0001), forward jaw movement (p = .007) but not for maximum mouth opening. No significant difference was observed between the groups at the end of the study (p = .000).

CONCLUSION

Our study provides insights into LLLT's effectiveness for TMD, suggesting it cannot replace standard treatment alone. These findings contribute to the literature and emphasise the importance of including a control group in future studies to assess the placebo effect of LLLT.