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Altuhafy M, Ahmed S, Jabr L, Khan J. Effectiveness of photobiomodulation and orofacial myofunctional therapy in orofacial pain disorders. A systematic review of randomized control trials. Lasers Med Sci 2024; 39:127. [PMID: 38722392 DOI: 10.1007/s10103-024-04073-4] [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: 11/07/2023] [Accepted: 04/29/2024] [Indexed: 07/10/2024]
Abstract
Orofacial pain can significantly affect physical, psychological, and overall quality of life. This study aimed to compare the effectiveness of combining photobiomodulation (PBM) with orofacial myofunctional therapy (OMT) in managing orofacial pain disorders. An electronic search of randomized controlled trials in electronic databases was performed until March 2024. Randomized controlled trials (RCTs) focusing on PBM and OMT for the management of orofacial pain were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions. A total of 10 RCTs were included, out of which 7 RCTs revealed that the combined approach of PBM and OMT had a more pronounced impact on diminishing pain and enhancing functional activity in patients with orofacial disorders. One study reported significant increases in pressure pain threshold for TMJ, masseter, and anterior temporalis muscles at both sides in the post-treatment compared with the pre-treatment in both groups. The risk of bias was low in 7, moderate in 2, and high in 1 study. The efficacy of a combined modality treatment of PBM with OMT for orofacial pain disorder shows promising results. However, further randomized controlled trials with extended follow-up periods standardized PBM and OMT parameters are warranted to obtain firm conclusions.
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Affiliation(s)
- Maryam Altuhafy
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Shahneel Ahmed
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Luay Jabr
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Junad Khan
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
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Khan BS, Setty JV, Srinivasan I, Kibriya S, Anu S, Radhakrishna S, Milit Y. Low-level Laser Therapy to Alleviate Pain of Local Anesthesia Injection in Children: A Randomized Control Trial. Int J Clin Pediatr Dent 2023; 16:283-287. [PMID: 38268643 PMCID: PMC10804298 DOI: 10.5005/jp-journals-10005-2699] [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] [Indexed: 01/26/2024] Open
Abstract
Aim The aim of our study was to evaluate and compare pain perception following photobiomodulation (PBM), topical anesthesia, precooling of the injection site, and vibration during administration of local anesthesia injection in pediatric patients aged 6-13 years. Materials and methods In this split-mouth study, a total of 120 patients between the age group of 6 and 13 years were selected and randomly divided into three equal groups with 40 subjects in each. Pain was assessed using visual analog scale (VAS) and the Wong-Baker Faces Pain Rating Scale after the administration of local anesthesia. Behavior during the procedure was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale filled by the operator. Pulse rate was recorded before and during the administration of local anesthesia using pulse oximeter. After the procedure, patient compliance was also recorded using validated questionnaire. The level of significance was set at p < 0.05. Results The study showed PBM exhibited the lowest mean scores of anxiety/pain using VAS, Wong-Baker Faces Pain Rating Scale, FLACC scale and pulse rate as compared to precooling, vibration, and topical anesthesia. The differences in pain scores recorded were found to be statistically significant. Children were not anxious about the PBM method and exhibited good compliance (p < 0.001). Conclusion Photobiomodulation (PBM) was found to be effective means of reducing injection pain, demonstrating much better efficacy than other tested methods. Clinical significance Photobiomodulation (PBM) can be used effectively to better manage procedures that patients frequently find painful without the need for prescription drugs, which frequently have several side effects. How to cite this article Khan BS, Setty JV, Srinivasan I, et al. Low-level Laser Therapy to Alleviate Pain of Local Anesthesia Injection in Children: A Randomized Control Trial. Int J Clin Pediatr Dent 2023;16(S-3):S283-S287.
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Affiliation(s)
- Bisma Saher Khan
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - Jyothsna V Setty
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - Ila Srinivasan
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - Sabahath Kibriya
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - S Anu
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - Sreeraksha Radhakrishna
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
| | - Yuthi Milit
- Department of Pedodontics and Preventive Dentistry, M R Ambedkar Dental College & Hospital, Bengaluru, Karnataka, India
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de Oliveira-Souza AIS, Mohamad N, de Castro Carletti EM, Müggenborg F, Dennett L, de Oliveira DA, Armijo-Olivo S. What are the best parameters of low-level laser therapy to reduce pain intensity and improve mandibular function in orofacial pain? A systematic review and meta-analysis. Disabil Rehabil 2023; 45:3219-3237. [PMID: 36263978 DOI: 10.1080/09638288.2022.2127933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the effectiveness of laser therapy for managing patients with orofacial pain (OFP). In addition, to determine which parameters provide the best treatment effects to reduce pain, improve function, and quality of life in adults with OFP. METHODS Systematic review. Searches were conducted in six databases; no date or language restrictions were applied. Studies involving adults with OFP treated with laser therapy were included. The risk of bias (RoB) was performed with the Revised Cochrane RoB-2. A meta-analysis was structured around the OFP type, and outcomes. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessed the overall certainty of the evidence. RESULTS Eighty-nine studies were included. Most studies (n = 72, 80.9%) were considered to have a high RoB. The results showed that laser therapy was better than placebo in improving pain, maximal mouth open (MMO), protrusion, and tenderness at the final assessment, but with a low or moderate level of evidence. The best lasers and parameters to reduce pain are diode or gallium-aluminum-arsenide (GaAlAs) lasers, a wavelength of 400-800 or 800-1500 nm, and dosage of <25 J/cm2. CONCLUSIONS Laser therapy was better than placebo to improve pain, MMO, protrusion, and tenderness. Also, it was better than occlusal splint to improve pain, but not better than TENS and medication.Implications for rehabilitationLaser therapy was found to be good in improving pain, maximal mouth opening, jaw protrusion, and tenderness at the end of the treatment.For patients with all types of temporomandibular disorders (TMDs) (myogenous, arthrogenous, and mixed), the following lasers and parameters are recommended: diode or gallium-aluminum-arsenide (GaAlAs) laser, wavelength of 400-800 or 800-1500 nm, and a dosage <25 J/cm2.For patients with arthrogenous TMDs, the following lasers and parameters are recommended: Diode laser and a wavelength between 400 and 800 nm.For patients with myogenous TMDs, the following lasers and parameters are recommended: diode laser, wavelength between 800 and 1500 nm, and dosage of <25 J/cm2.For patients with mixed TMDs, the following lasers and parameters are recommended: diode, GaAlAs, or infrared laser, a wavelength of 800-1500 nm, a dosage >100 J/cm2, and an application time between 15 and 30 s or >60 seconds.
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Affiliation(s)
- Ana Izabela Sobral de Oliveira-Souza
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Brazil
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Norazlin Mohamad
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Frauke Müggenborg
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Liz Dennett
- FORBs - Specialist Medical Center for Orthopedics and Rehabilitation of the Locomotor System, Osnabrück, Germany
| | | | - Susan Armijo-Olivo
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Carvalho FR, Barros RQ, Gonçalves AS, Muragaki SP, Pedroni ACF, Oliveira KDCM, Freitas PM. Photobiomodulation Therapy on the Palliative Care of Temporomandibular Disorder and Orofacial/Cervical Skull Pain: Preliminary Results from a Randomized Controlled Clinical Trial. Healthcare (Basel) 2023; 11:2574. [PMID: 37761771 PMCID: PMC10531481 DOI: 10.3390/healthcare11182574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The main symptoms of temporomandibular disorders (TMDs) are pain from musculoskeletal and/or joint-in the head and neck region-and complaints of difficulty in mandibular movements. The photobiomodulation therapy (PBMT) has been reported as a promising treatment in the management of these symptoms. The objective of this research was to assess the effect of PBMT immediately after irradiation on TMDs symptoms under a prospective clinical trial, randomized, triple-blinded, placebo-controlled, and with two parallel arms. According to the RDC/TMD, maximum mouth opening (MMO) and pain in the orofacial/cervical muscles and temporomandibular joint (TMJ) were recorded. One hundred forty-five participants (71 placebo and 74 PBMT experimental) were analyzed after irradiation protocols (sham-PBMT or PBMT) at the orofacial/cervical skull musculature and at the TMJ. The results showed a reduction in the total pain score (p = 0.026), a reduction in the number of painful points (p = 0.013), and an increase in the MMO (p = 0.016) in the PBMT protocol group when compared to the placebo protocol (sham-PBMT). The PBMT was shown to be effective in reducing orofacial/cervical skull pain immediately after the irradiation. It is clinically relevant and should be taken into consideration by professionals who are dedicated to treating this pathology because, in addition to bringing comfort to patients who need dental treatment, it also consists of a low-cost and low technical complexity clinical approach.
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Affiliation(s)
- Fernando Rodrigues Carvalho
- Department of Restorative Dentistry, Special Laboratory of Lasers in Dentistry, School of Dentistry, University of São Paulo, São Paulo 05508-000, Brazil
| | | | - Alyne Simões Gonçalves
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (USP), São Paulo 05508-000, Brazil
| | | | | | | | - Patrícia Moreira Freitas
- Department of Restorative Dentistry, Special Laboratory of Lasers in Dentistry, School of Dentistry, University of São Paulo, São Paulo 05508-000, Brazil
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Kim H, Shim JW, Shin WC, Lee YJ, Ha IH, Kim KW, Cho JH. Korean Medicine Clinical Practice Guideline Update for Temporomandibular Disorders: An Evidence-Based Approach. Healthcare (Basel) 2023; 11:2364. [PMID: 37628561 PMCID: PMC10454242 DOI: 10.3390/healthcare11162364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Many updated clinical research results have been published since the Korean Medicine Clinical Practice Guidelines (KMCPGs) for temporomandibular disorders (TMDs) were published in 2018. Therefore, it is necessary to update the existing clinical practice guidelines (CPGs). This study presents updated recommendations for TMD treatment based on current research data published up to February 2020. The draft version of the level of evidence and grade of recommendation was determined through an assessment of the risk of bias and a meta-analysis of selected literature based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The final guidelines were derived using the Delphi method. Eighteen recommendations were derived for eight items of Korean medicine treatment for TMDs. Compared with previous Korean medicine CPGs for TMDs, the grades of seven recommendations, including acupuncture, pharmacopuncture, and Chuna manual therapy, were increased. The grades of the two recommendations have been changed. Six new recommendations were added to fully reflect clinical reality. Acupuncture, pharmacopuncture, and Chuna manual therapy are recommended for TMD patients in clinical practice. Concurrent conventional conservative therapy with Korean medicine or a combination of Korean medicines should be considered in clinical practice in patients with temporomandibular disorders.
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Affiliation(s)
- Hyungsuk Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae Woo Shim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Woo-Chul Shin
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
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Zhang Y, Qian Y, Huo K, Liu J, Huang X, Bao J. Efficacy of laser therapy for temporomandibular disorders: A systematic review and meta-analysis. Complement Ther Med 2023; 74:102945. [PMID: 36997006 DOI: 10.1016/j.ctim.2023.102945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the efficacy of laser therapy in temporomandibular disorders (TMD). METHODS Randomized controlled trials (RCTs) in regard to this issue were searched in electronic databases. Three investigators independently screened the eligible studies, and the quality of the included studies was assessed according to the risk of bias tool recommended by the Cochrane handbook. The primary outcome measure was the degree of pain, reported on a visual analog scale (VAS), and the secondary outcome measures were TMJ function, including maximum active vertical opening (MAVO), maximum passive vertical opening (MPVO), left and right lateral movement (LLE, RLE). Pooled effect sizes were calculated using random effects models and 95% confidence interval (95% CI). RESULTS A total of 28 randomized controlled trials were included. Laser therapy had a more significant effect in terms of VAS (SMD=﹣1.88; 95% CI=﹣2.46 to﹣1.30; P<0.00001; I2 =93%), MAVO (MD = 4.90; 95% CI= 3.29 to 6.50; P < 0.00001; I2 =72%), MPVO (MD=5.82; 95% CI= 4.62 to 7.01; P<0.00001; I2 =40%) and RLE (MD = 0.73; 95% CI= 0.23 to 1.22; P = 0.004; I2 = 0%) as compared to placebo group. However, there was no significant difference in LLE between two groups (MD= 0.35; 95% CI=﹣0.31 to 1.01; P=0.30; I2 =0%). CONCLUSIONS Laser therapy can effectively reduce pain but have small effect on improving mandibular movement of TMD patients. More well-designed RCTs with large sample sizes are needed for further validation. And these studies should report detailed laser parameters and provide complete outcome measure data. PROSPERO CRD42022349719.
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Affiliation(s)
- Yan Zhang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Yingqiu Qian
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Kangxin Huo
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Jingxin Liu
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Xi Huang
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Jie Bao
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China; Children's Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Ningbo, China.
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Application of photobiomodulation for chronic pain-related TMD on pain points versus pre-established points: Randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 238:112612. [PMID: 36459910 DOI: 10.1016/j.jphotobiol.2022.112612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Photobiomodulation therapy (PTB) is a therapeutic possibility for temporomandibular disorders (TMD), but its effectiveness and protocols for use remain controversial. This study is a RCT that compared the effectiveness of PTB on pain points of the masticatory muscles and TMJs, located through palpation versus application of pre-established points in women with painful TMD, diagnosis by DC/TMD (Diagnostic Criteria for Temporomandibular Disorders - Brazilian Portuguese version). Therefore, a total sample of 54 women, aged between 18 and 60 years, was investigated. Volunteers were randomly randomized and PTB was applied in four different groups with a dose of 4 J and 6 J divided into pre-established application points (PE - G1) and pain points (PD - G2) - Groups 4PE, 4PD, 6PE and 6PD. Four laser applications were performed with a wavelength of 780 nm, one session per week, totaling one month of therapy. The following assessments were performed: DC/TMD, Brief Pain Inventory (BPI), McGill Questionnaire - Short Version (SF-MPQ) and Pain Intensity, Visual Analogue Scale (VAS). Friedman's test was used for within-group comparisons, while the Mann-Whitney test was used for between-group comparisons (p < 0.05). According to the results, laser application on pain points (G2) was more effective. McGill's results showed that regardless of dose, the pain point application group had better outcomes (p = 0.004). Pain intensity evaluation (last days) also showed that application at the pain points was more effective regardless of dose (p = 0.0002). Medians and interquartile deviations showed overall that PTB was more effective at pain points, with a trend towards better outcomes at the 6 J dose. Therefore, it can be concluded that in women with chronic painful TMD, the application of PTB at pain points is more effective than the application at pre-established points. Therefore, individualized PTB protocols are proposed, based on examination palpation of the masticatory structures.
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Ferrillo M, Ammendolia A, Paduano S, Calafiore D, Marotta N, Migliario M, Fortunato L, Giudice A, Michelotti A, de Sire A. Efficacy of rehabilitation on reducing pain in muscle-related temporomandibular disorders: A systematic review and meta-analysis of randomized controlled trials. J Back Musculoskelet Rehabil 2022; 35:921-936. [PMID: 35213347 DOI: 10.3233/bmr-210236] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with temporomandibular disorders (TMD) mostly suffer from muscle-related pain. Several conservative interventions have been suggested as treatments for TMD in the last years. OBJECTIVE The aim of this systematic review with meta-analysis was to assess the efficacy of rehabilitative approaches in reducing pain in patients with muscle-related TMD. METHODS PubMed, Scopus, and Web of Science were systematically searched from inception until April 28th, 2021 to identify randomized controlled trials (RCTs) presenting: patients with painful muscle-related TMD; rehabilitative approaches as interventions; placebo or sham treatment as comparisons; pain intensity, using visual analogue scale as outcome. A meta-analysis was performed to evaluate the overall effect on painful muscle-related TMD patients. PROSPERO registration number of this systematic review is CRD42021251904. RESULTS Out of 1997 papers suitable for title/abstract screening, 189 articles were assessed for eligibility. Sixteen RCTs were included and most of them (n= 6, 37.5%) investigated the effects of the laser therapy. The meta-analysis revealed that rehabilitative interventions had a significant overall effect size (ES) of 1.44 (p< 0.0001) in decreasing pain in patients with muscle-related disorders. CONCLUSION Findings of this systematic review with meta-analysis suggested that rehabilitative approaches might be effective in reducing pain in muscle-related TMD patients. However, the low number of RCTs evaluating conservative approaches might impair the synthesis of evidence regarding the different techniques, calling for caution in the interpretation of these results.
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Affiliation(s)
- Martina Ferrillo
- Department of Health Sciences, School of Dentistry, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Sergio Paduano
- Department of Health Sciences, School of Dentistry, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Dario Calafiore
- Department of Neurosciences, Physical Medicine and Rehabilitation Unit, ASST Carlo Poma, Mantova, Italy
| | - Nicola Marotta
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Mario Migliario
- Department of Translational Medicine, Dentistry Unit, University of Eastern Piedmont, Novara, Italy
| | - Leonzio Fortunato
- Department of Health Sciences, School of Dentistry, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Ambra Michelotti
- Department of Neurosciences, School of Orthodontics, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Desai AP, Roy SK, Semi RS, Balasundaram T. Efficacy of Low-Level Laser Therapy in Management of Temporomandibular Joint Pain: A Double Blind and Placebo Controlled Trial. J Maxillofac Oral Surg 2022; 21:948-956. [PMID: 36274894 PMCID: PMC9474957 DOI: 10.1007/s12663-021-01591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background Stomatognathic system is an interaction of the muscles of mastication, dentition, neural component, and temporomandibular joint. Any dysfunction in this system may lead to temporomandibular disorders (TMDs). Various non-surgical modalities have been employed for treating TMDs. Aim and objectives The aim of the study was to objectively evaluate the effects of low-level laser therapy (LLLT) in treatment of patients with TMDs. Materials and Methods Sixty individuals diagnosed with TMDs were divided randomly into two groups (Group I-placebo and Group II -LLLT). A series of 20 sessions of LLLT applied both in closed mouth and maximum mouth opening position were given over a period of 08 weeks. Assessment was done in terms of improvement in mouth opening, pain, clicking, and deviation of mandible. The data collected were analyzed statistically. Results The results showed improvement in the pain reduction, improvement in the maximum mouth opening, reduction in deviation, and clicking in both groups but better treatment outcome in the low-level laser group. Conclusion Though conservative measures improved the symptoms in TMD but LLLT has shown better results in comparison with the placebo group. Being non-surgical can be employed in combination with other modes for effectively treating such disorders. Keywords: Pain, Dysfunction, Temporomandibular joint disorders (TMDs), Low-level laser therapy (LLLT).
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Affiliation(s)
- Ajay Premanand Desai
- Oral and Maxillofacial Surgery, Army Dental Centre (Research & Referral), New Delhi, 110010 India
| | - S. K. Roy
- Oral and Maxillofacial Surgery, Army Dental Corps, New Delhi, 110010 India
| | | | - T. Balasundaram
- Oral and Maxillofacial Surgery, Military Dental Centre, Jabalpur, 482001 India
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Nambi G, Abdelbasset WK, Soliman GS, Alessi AA, Alsalem IN, Ali ZA. Clinical and functional efficacy of gallium-arsenide super pulsed laser therapy on temporo mandibular joint pain with orofacial myalgia following healed unilateral cervicofacial burn - A randomized trial. Burns 2022; 48:404-412. [PMID: 34674896 DOI: 10.1016/j.burns.2021.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cervicofacial burn (CB) is a unique type of burn, involving the lateral part of the face, neck and chest region with significant skin contractures. Temporomandibular joint (TJ) pain and orofacial myalgia (OM) are the major problems in physiotherapy context to treat. Laser is commonly used as an adjunct therapy in painful conditions. However, clinical studies are lacking in investigating the effects of gallium-arsenide (Ga-As) super pulsed laser therapy on temporomandibular joint pain and orofacial myalgia following healed cervicofacial burn patients. OBJECTIVE To investigate the effects of clinical and functional efficacy of Ga-As super pulsed laser therapy on temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn patients. METHODS Through two block random sampling method, the eligible participants were randomized and allocated into active laser (Active-L; n = 18) and placebo laser (Placebo-L; n = 18) groups. The Active-L group received laser treatment and the Placebo-L group received placebo laser effect (inactive laser) with regular physiotherapy care for 3 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the end 4th week, 8th week and 6 month follow up. RESULTS Baseline subjective and clinical attributes show homogenous presentation among the study groups (p > 0.05). After four weeks of treatment, and at the end of 6 months follow up, the pain intensity, 2.9 (CI 95% 2.80-3.00), pain threshold 19.2 (CI 95% -30.4 to -7.9), pain frequency 3.4 (CI 95% 3.14-3.65), mouth opening, -16.0 (CI 95%-16.5 to -15.4), disability level 11.3 (CI 95%11.14-11.45), and quality of life -31.7 (CI 95%-37.1 to -26.2) showed more improvement (p < 0.001) in Active-L group than Placebo-L group. CONCLUSION The reports of this study proved that, four weeks active laser therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of temporomandibular joint pain rehabilitation.
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Affiliation(s)
- Gopal Nambi
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Gaber S Soliman
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al-Qurayyat, Jouf University, Saudi Arabia
| | - Ahmed A Alessi
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ibrahim N Alsalem
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Zeinab A Ali
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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11
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Wu X, Zhu J, Zheng B, Liu J, Wu Z. Effectiveness of low-level gallium aluminium arsenide laser therapy for temporomandibular disorder with myofascial pain: A systemic review and meta-analysis. Medicine (Baltimore) 2021; 100:e28015. [PMID: 34967349 PMCID: PMC8718212 DOI: 10.1097/md.0000000000028015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Temporomandibular disorder (TMD) causes masticatory muscle pain and mouth opening limitations and affects patients' ability to eat, practice oral health and perform other activities of daily living. Although the benefits of low-energy lasers in treating TMD have been reported, the results vary greatly depending on the equipment used and the energy output. This study systematically evaluated the efficacy of a low-level gallium aluminium arsenide (GaAlAs) laser treatment for TMD with myofascial pain and maxillary pain. METHODS We searched the PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov databases for randomized controlled trials (RCTs) published since database inception to April 5, 2020, that compared low-level laser treatment to sham/placebo treatment or no intervention in patients suffering from TMD with myofascial pain. Three reviewers independently screened the literature, extracted data, and assessed the quality of the included studies according to the risk-of-bias tool recommended by the Cochrane Handbook V.5.1.0 (Cochrane Collaboration, London, UK). Then, a meta-analysis was performed using RevMan 5.3 and Stata 15.1 software. RESULTS The data from 8 randomized controlled trials including 181 patients were analyzed. The severity of myofascial TMD pain (measured on a visual analogue scale, VAS) at the end of treatment was significantly different between the control laser therapy and the low-level GaAlAs laser therapy (weighted mean difference [WMD] = -0.76, 95% confidence interval [CI] -1.51 to 0.01, P = .046); at 3 to 4 weeks after treatment, there was no significant difference (WMD = 1.24, 95% CI -0.04 to 2.51, P = .057). In addition, there was no significant improvement in maximum mouth opening (MMO) at the end of treatment (WMD = -0.03, 95% CI -4.13 to 4.06, P = .987) or at 3 to 4 weeks after treatment (WMD = 1.22, 95% CI -2.94 to 5.39, P = .565). CONCLUSIONS The results of this study suggest that there is insufficient evidence to indicate an efficacy of low-level GaAlAs laser therapy in improving TMD pain and maximal oral opening. These results suggest that clinicians should make appropriate recommendations to inform patient decision-making.
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Affiliation(s)
- Xuelian Wu
- School of Physical Education, Southwest University, Chongqing, China
| | - Jiang Zhu
- Sport Rehabilitation Research Institute of Southwest University, Southwest University Hospital, Chongqing, China
- Southwest University Hospital
| | - Bing Zheng
- Sport Rehabilitation Research Institute of Southwest University, Southwest University Hospital, Chongqing, China
- Southwest University Hospital
- School of Physical Education, Southwest University, Chongqing, China
| | - Jie Liu
- School of Physical Education, Southwest University, Chongqing, China
| | - Zonghui Wu
- Sport Rehabilitation Research Institute of Southwest University, Southwest University Hospital, Chongqing, China
- Southwest University Hospital
- School of Physical Education, Southwest University, Chongqing, China
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12
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Sattayut S, Chotiwutthiphatthana D, Inprakhon T, Tiansongjai R. An Efficacy of Photobiomodulation of 850 nm on Pain Reduction in a Human Oral Capsaicin Pain Model. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:734-740. [PMID: 34762533 DOI: 10.1089/photob.2020.4892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The aim of this clinical trial was to evaluate the efficacy of photobiomodulation (PBM) to reduce oral pain initiated by capsaicin. Background: PBM has been used for pain reduction in oral regions; however, its clinical efficacy to alleviate burning sensations is still unknown. Methods: This clinical study was divided into two phases. There were 10 subjects in each phase. In Phase I, the burning sensation was stimulated using 0.05% in 95% ethanol capsaicin (prepared by the Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand) on filter paper and recorded with a 10-cm horizontal visual analog scale (VAS) every 1 min until the subject experienced no more pain. The area under the curve (AUC) of the graph between VAS and time was calculated. The washout period was 24 h. In Phase II, a crossover clinical trial was conducted in subjects who received the pain model as stated. Four interventions were included: (1) PBM before & after pain stimulation, (2) PBM before pain stimulation, (3) PBM after pain stimulation, and (4) Placebo. For PBM intervention, a single exposure of 850 nm Laser (AsGaAl; TOP 250 Soft Laser, Berkmed Medikal, distributed by Medical Innovation-MI, Istanbul, Turkey) with 0.10 cm2 spot size laser probe continuous wave at 1 W/cm2 and 30 J/cm2 for 30 sec was used. Results: In Phase I, there was no statistically significant difference (p = 0.09) between the average AUC of day 1 [55.63 (23.38)] and day 2 [48.99 (27.20)]. In phase II, there was no statistical difference (p = 0.20) of the average AUC among the interventions and the placebo; group 1 [56.24 (30.11)], group 2 [45.46 (45.46)], group 3 [64.15 (32.89)], and group 4 [58.59 (30.16)]. Conclusions: The human capsaicin model was suitable for a crossover design clinical trial. The PBM used in this study did not reduce oral burning sensations from capsaicin.
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Affiliation(s)
- Sajee Sattayut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.,Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | | | - Todsaphon Inprakhon
- Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Ravi Tiansongjai
- Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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13
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Razzaghi MR, Ghanei E, Malekian S, Mazloomfard MM. Intravenous Laser Therapy in Patients With Acute Kidney Injury: A Randomized Clinical Trial. J Lasers Med Sci 2021; 12:e49. [PMID: 34733772 DOI: 10.34172/jlms.2021.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/08/2021] [Indexed: 11/09/2022]
Abstract
Introduction: Although intravascular laser irradiation of blood (ILIB) is deemed an innocuous and useful technique for laser therapy, particularly when systemic effects are required, no study, to our knowledge, has been conducted on the effectiveness and innocuousness of ILIB in treating acute kidney injury (AKI). Objective: This study aimed to assess the feasibility and outcomes of ILIB in the management of patients with AKI and comparing them with the Sham-laser group. Materials and Methods: Twenty-six patients with intra-renal AKI (24-95 years old) at Tajrish Hospitals were evaluated for enrollment eligibility in this clinical trial study. This study was conducted at the nephrology department of Shahid Beheshti University of Medical Science, Tehran, Iran, between 2018 and 2019. Based on the treatment method, the patients' assignment to two groups (ILIB or Sham-laser) was randomly done. Demographic characteristics, need for dialysis, hemoglobin and serum biochemistry changes, serum and urine neutrophil gelatinase-associated lipocalin (NGAL) changes, laser complications, and the hospitalization period were recorded. Results: In terms of the baseline characteristics and biochemistry serum level, no differences were seen between the two groups. All post-treatment parameters, except the hemoglobin value, significantly improved in both groups. Urine NGAL and serum NGAL show declines from the baseline in both groups; however, the reduction slope of these parameters occurred faster in the laser group in a statistically significant manner. Conclusion: A decline in NGAL levels in the laser group during the treatment may suggest that the ILIB can help patients with AKI recover better.
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Affiliation(s)
- Mohammad Reza Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmat Ghanei
- Department of Internal Medicine, Shohada-e-Tajrish Hospital, Tajrish Sq, Tehran, Iran
| | - Sheida Malekian
- Department of Internal Medicine, Shohada-e-Tajrish Hospital, Tajrish Sq, Tehran, Iran
| | - Mohammad Mohsen Mazloomfard
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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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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15
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Ren H, Liu J, Liu Y, Yu C, Bao G, Kang H. Comparative effectiveness of low-level laser therapy with different wavelengths and transcutaneous electric nerve stimulation in the treatment of pain caused by temporomandibular disorders: A systematic review and network meta-analysis. J Oral Rehabil 2021; 49:138-149. [PMID: 34289157 DOI: 10.1111/joor.13230] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/28/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To assess the efficacy of low-level laser therapy (LLLT) with different wavelengths and transcutaneous electric nerve stimulation (TENS) and explore the optimal wavelength range of laser application in the treatment of pain caused by temporomandibular disorders (TMD). METHODS An electronic search on PubMed, Cochrane Library, Embase, Scopus and Web of Science was undertaken to identify the randomised clinical trials (RCTs) published from database inception to 16 April 2021, aiming to compare the effects of LLLT with different wavelengths (632.8-672 nm, 780-904 nm, and 910-1100 nm) or TENS or placebo group on TMD patients pain reduction. In addition, manual search of the studies was performed. The reviewers assessed the risk of bias of individual studies with the Cochrane risk of bias tool and excluded the RCTs with a high risk of bias in any field. Meanwhile, the reviewers, after performing the network meta-analysis, assessed the quality of evidence, which contributed to network estimate via the GRADE framework. RESULTS Twenty-seven RCTs with 969 patients with TMD were included. In the meta-analysis, all treatment groups showed an overall improvement in pain scores, when compared with the placebo group. LLLT with wavelength ranging from 910 nm to 1100 nm produced more pain relief in the visual analogue scale (VAS) immediately after treatment [mean difference (MD) = 4.68, 95% confidence interval (CI):(3.08,6.28)]. After one-month follow-up, LLLT with wavelength ranging from 910 nm to 1100 nm also showed superior pain-relieving effects [MD = 3.61, 95% CI: (-1.77, 8.99)]. However, no significant difference was observed. Based on the SUCRA ranking, L3 ranked first immediately after treatment and 1 month later. CONCLUSION The results of the meta-analysis showed the LLLT had better short-term efficacy than TENS in the treatment of pain caused by TMD. Better results can be achieved with higher wavelengths. Therefore, we recommended to treat TMD using LLLT with wavelength ranging from 910 nm to 1100 nm.
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Affiliation(s)
- Hui Ren
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Jingying Liu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Yang Liu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Caiyun Yu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Guangjie Bao
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, China
| | - Hong Kang
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
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16
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Role of Photobiomodulation Therapy in Modulating Oxidative Stress in Temporomandibular Disorders. A Systematic Review and Meta-Analysis of Human Randomised Controlled Trials. Antioxidants (Basel) 2021; 10:antiox10071028. [PMID: 34202292 PMCID: PMC8300797 DOI: 10.3390/antiox10071028] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 02/08/2023] Open
Abstract
This systematic review and meta-analysis (PROSPERO registration; ref CRD 42020198921) aimed to govern photobiomodulation therapy (PBMT) efficacy in temporomandibular disorder (TMD). PRISMA guidelines and Cochrane Collaboration recommendations were followed. Differences in pain reduction assessment by qualitative measurement with visual analogue scale pain (VAS), pressure threshold (PPT) and maximum mouth opening (MMO) were calculated with 95% confidence intervals and pooled in a random effects model with a subgroup analysis, evaluating the role of follow-up duration. Heterogeneity was analysed using Q and I2 tests. Publication bias was assessed by visual examination of funnel plot symmetry. Qualitative analysis revealed 46% of the 44 included studies showed a high risk of bias. Meta-analysis on 32 out of 44 studies revealed statistically significant intergroup differences (SSID) for VAS (SMD = -0.55; 95% CI = -0.82 to -0.27; Z = 3.90 (p < 0.001)), PPT (SMD = -0.45; 95% CI = -0.89 to 0.00; Z = 1.97 (p = 0.05)) and MMO (SMD = -0.45; 95% CI = -0.89 to 0.00; Z = 1.97 (p = 0.05)), favouring PBMT compared to control treatment strategies. Sensitivity analysis revealed SSID (SMD = -0.53; 95% CI = -0.73 to -0.32; Z = 5.02 (p < 0.0001)) with low heterogeneity (Τ2 = 0.02; χ2 = 16.03 (p = 0.31); I2 = 13%). Hence, this review, for first time, proposed suggested recommendations for PBMT protocols and methodology for future extensive TMD research.
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17
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Ekici Ö, Dündar Ü, Büyükbosna M. Effectiveness of high-intensity laser therapy in patients with myogenic temporomandibular joint disorder: A double-blind, placebo-controlled study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e90-e96. [PMID: 34174507 DOI: 10.1016/j.jormas.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/17/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of the study is to evaluate the effectiveness of high-intensity laser therapy (HILT) in the short and long term in the treatment of patients with the myogenic temporomandibular joint disorder(TMD). METHODS This prospective, double-blind, controlled clinical study was conducted on patients with myogenic TMD at a university's oral and maxillofacial surgery clinic. Seventy-six patients were randomized into two groups (HILT, and control group), including 38 patients in one group. The patients were evaluated for pain, the range of motion of the jaw, disability, and quality of life. Assessments were performed before therapy (week 0) and after therapy (weeks 4 and 12). Data were evaluated using SPSS-20 and the level of significance was set at p <0.05. RESULTS There was no significant difference between the groups in terms of socio-demographic characteristics of the groups at the beginning of the study. In the 4th week, the VAS pain score was significantly decreased in the HILT group (47%) compared to the placebo HILT group (4%) (p <0.001). The maximum mouth opening was significantly increased in the HILT group (27%) compared to the placebo HILT group (4%) at week 12 (p <0.001). The HILT group showed a significant improvement in Jaw Functional Limitation Scale 20 (JFLS-20) and Oral Health Impact Profile (OHIP-14) compared to the placebo HILT group (p <0.001 and p <0.005 respectively). CONCLUSION As a result of the study, it was concluded that HILT is a highly effective, non-invasive therapeutic method for patients with myogenic TMD.
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Affiliation(s)
- Ömer Ekici
- DDS, Phd, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Ümit Dündar
- Prof. Dr. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Murat Büyükbosna
- Physical therapist, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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18
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Yanik S, Polat ME, Polat M. Effects of arthrocentesis and low-level laser therapy on patients with osteoarthritis of the temporomandibular joint. Br J Oral Maxillofac Surg 2020; 59:347-352. [PMID: 33280948 DOI: 10.1016/j.bjoms.2020.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
This retrospective study examined whether arthrocentesis combined with 10 sessions of low-level laser therapy (LLLT) improved the clinical outcomes of patients with temporomandibular joint osteoarthritis (TMJ-OA) compared with arthrocentesis alone. Data from two groups of patients (total: n=36) with unilateral TMJ-OA were evaluated. The groups were established according to their treatment regimens: Group 1 (arthrocentesis alone; n=19) and Group 2 (arthrocentesis plus LLLT; n=17). All patients had been diagnosed in accordance with the Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) (Axis I Group IIIb) protocol. They all underwent the same arthrocentesis protocol, but those in Group 2 also received 10 sessions of LLLT immediately afterwards. The outcome variables were the visual analogue scale scores (VAS 1, VAS 2) for various treatment outcomes and millimetric measurements of mandibular movements over both the short and long term. Intra-group comparisons showed significant short and long-term improvements for both groups, but outcomes were better over the long term than the short term in both. In addition, greater improvements in muscle palpation scores and mandibular movements were achieved in Group 2 than in Group 1. In conclusion, although both techniques improved joint pain and function, a combination with LLLT seemed to have an additional benefit for myofascial components.
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Affiliation(s)
- S Yanik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kahramanmaras Sutcu Imam University, 46040 Kahramanmaras, Turkey.
| | - M E Polat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey.
| | - M Polat
- Department of Orthodontics, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey
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19
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Micarelli A, Viziano A, Granito I, Micarelli RX, Augimeri I, Alessandrini M. Temporomandibular disorders and cervicogenic dizziness: Relations between cervical range of motion and clinical parameters. Cranio 2020; 40:348-357. [PMID: 32544368 DOI: 10.1080/08869634.2020.1780772] [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] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the cervical range of motion (CROM) and clinical parameters in patients affected by myogenous temporomandibular disorders (TMD), cervicogenic dizziness (CGD), both TMD and CGD (TMD/CGD), and a group of healthy subjects (HS). METHODS CROM degrees, Dizziness Handicap Inventory (DHI), Tampa Scale for Kinesiophobia (TSK-17), Hospital Anxiety and Depression Scale (HADS), and Jaw Functional Limitation Scale 20 (JFLS-20) scores were compared between 46 TMD patients, 49 CGD subjects, 43 TMD/CGD patients, and 98 HS. RESULTS TMD/CGD and CGD patients demonstrated significantly lower CROM degrees and higher DHI, TSK-17, and HADS values when compared to TMD patients. TMD/CGD and TMD patients demonstrated higher JFLS-20 values when compared to CGD and HS. Significant negative correlations were found in TMD/CGD and TMD patients between JFLS-20 and CROM in flexion and extension. DISCUSSION Present findings demonstrated a relation between spine movement impairment and TMD.
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Affiliation(s)
- Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ivan Granito
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Riccardo Xavier Micarelli
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Ivan Augimeri
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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20
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Karic V, Chandran R, Abrahamse H. Photobiomodulation and Stem Cell Therapy for Temporomandibular Joint Disc Disorders. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:398-408. [PMID: 32486898 DOI: 10.1089/photob.2019.4790] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Temporomandibular disorder (TMD) refers to a group of disorders affecting the temporomandibular joint (TMJ) and its related muscles. The two commonly used treatment modalities for TMD are occlusal splint therapy and relaxation therapy. Neither comprises definitive treatment. Objective: The objective of this review was to report updated information on photobiomodulation and stem cells, as an alternative treatment for the degenerative TMJ disc as a part of TMJ disorders. Materials and methods: With only a few research studies reported till date, this review also proposes the mechanism of laser irradiation on inflammatory mediators to treat TMD. Results: Photobiomodulation of stem cells with and without scaffolds could be used indirectly or directly as modulation of degenerative changes of the TMJ disc. Conclusions: The need for a distinct shift of the research margin in this field of dentistry is evident, specifically regarding the application of photobiomodulation and stem cells for tissue engineering of the TMJ disc.
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Affiliation(s)
- Vesna Karic
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,Department of Prosthodontic and Oral Rehabilitation, and Laser Therapy in Dentistry Division, School of Oral Sciences, Health Sciences Faculty, WITS University, Johannesburg, South Africa
| | - Rahul Chandran
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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21
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Maracci LM, Stasiak G, de Oliveira Chami V, Franciscatto GJ, Milanesi J, Figueiró C, Bernardon Silva T, Guimarães MB, Marquezan M. Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: A double-blind, randomized clinical trial. Cranio 2020; 40:433-439. [PMID: 32491964 DOI: 10.1080/08869634.2020.1773661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To compare the effect of a rapid low-level laser therapy (LLLT) protocol to Michigan occlusal splint in the treatment of myofascial pain, as well as to evaluate their impact on Oral Health-Related Quality of Life (OHRQoL). METHODS Thirty participants were randomly allocated into three groups: G1: occlusal splint (n = 11), G2: LLLT (n = 10), and G3: LLLT placebo (n = 9). LLLT and placebo were applied in the points of pain upon palpation. RESULTS G1 presented improvement in pain (p = 0.014) and in the diagnosis of myofascial pain (p = 0.008), while G2 and G3 did not. Regarding OHRQoL, G1 and G2 presented significant improvement (p = 0.005, in both), whereas, G3 did not. CONCLUSION Michigan occlusal splint was effective in reducing pain and improving OHRQoL. Treatment with the rapid LLLT protocol only provided an improvement in OHRQoL.
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Affiliation(s)
| | - Gabriela Stasiak
- Federal University of Santa Maria, Sant'Ana do Livramento, RS, Brazil
| | | | | | - Jovana Milanesi
- Private Practice, Volunteer at Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Cláudio Figueiró
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Magáli Beck Guimarães
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Marquezan
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Monteiro L, Ferreira R, Resende T, Pacheco JJ, Salazar F. Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and Placebo-Controlled Clinical Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:280-288. [DOI: 10.1089/photob.2019.4730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Luís Monteiro
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Cancer Research Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Laser Applications Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Raquel Ferreira
- Cancer Research Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Tiago Resende
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Laser Applications Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - José Júlio Pacheco
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Diseases Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Filomena Salazar
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Diseases Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
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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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Yamaner FE, Celakil T, Gökcen Roehlig B. Comparison of the efficiency of two alternative therapies for the management of temporomandibular disorders. Cranio 2020; 40:189-198. [DOI: 10.1080/08869634.2020.1727667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Tamer Celakil
- Department of Prosthodontics, Istanbul University, Istanbul, Turkey
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Photobiostimulation activity of different low-level laser dosage on masticatory muscles and temporomandibular joint in an induced arthritis rat model. Lasers Med Sci 2019; 35:1129-1139. [PMID: 31834562 DOI: 10.1007/s10103-019-02933-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
This study aimed to investigate the anti-inflammatory effects of different dosage of low-level laser therapy (LLLT) in an experimental model of temporomandibular joint (TMJ) arthritis. One hundred male Wistar rats were used and divided into the following groups: CG, control group; AG, animals group with left TMJ arthritis induced by intra-articular injection of Complete Freund's adjuvant - CFA; LG5, LG10 and LG20 - animals with arthritis and treated with LLLT at doses 5, 10, and 20 J/cm2, respectively. Morphological analysis was performed by TMJ histological sections stained with hematoxylin-eosin (HE), picrosirius (PSR), and toluidine blue (TB), as well as histomorphometric evaluation of cartilage, articular disc, and masticatory muscles. The amount of feed consumed within 3 weeks was evaluated, and biochemical analysis of TMJ tissues included measurement of sulfated glycosaminoglycans (GAGs), matrix metalloproteinases (MMPs) 2 and 9 zymography, and ELISA for cytokines IL-6, TNF-α, and IL-1β. Only the 20 J/cm2 dose promoted higher feed intake compared to AG. On the other hand, all LLLT doses promoted better organization of articular disc collagen fibers, greater number of proteoglycans in articular cartilage, increased area and diameter of left lateral pterygoid fibers, reduced latent and active MMP 9 and 2 activity, and lower IL-1β concentration compared to AG. Considering the study limitations, it was observed that LLLT treatments were effective in protecting and tissue cleansing joint structures, accelerating tissue repair, especially at lower doses.
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Singh V, Garg A, Bhagol A, Savarna S, Agarwal SK. Photobiomodulation Alleviates Postoperative Discomfort After Mandibular Third Molar Surgery. J Oral Maxillofac Surg 2019; 77:2412-2421. [DOI: 10.1016/j.joms.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
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Tunér J, Hosseinpour S, Fekrazad R. Photobiomodulation in Temporomandibular Disorders. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:826-836. [DOI: 10.1089/photob.2019.4705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jan Tunér
- Private Practice, Swedish Laser Medical Society (SLMS), Stockholm, Sweden
| | | | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci 2019; 35:181-192. [DOI: 10.1007/s10103-019-02837-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
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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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Photobiomodulation-induced analgesia in experimental temporomandibular disorder involves central inhibition of fractalkine. Lasers Med Sci 2019; 34:1841-1847. [DOI: 10.1007/s10103-019-02785-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
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Kim KW, Ha IH, Lee YJ, Kim MR, Shin BC, Song MY, Cho JH. A clinical practice guideline for temporomandibular disorders in traditional Korean medicine: An evidence-based approach. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Rasca E, Namour A, Fauchon-Giumelli A, Nammour S. Laser phototherapy in acute posttraumatic trismus - Case-series study. Laser Ther 2018; 27:219-226. [PMID: 32158068 DOI: 10.5978/islsm.27_18-or-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Backgroud and aims There are very few studies on laser phototherapy (LPT) in acute temporomandibular disorders (TMDs). Our objective is to assess the effectiveness of laser phototherapy (LPT) on the limitation of the mouth opening due to an acute mandibular trauma. Subjects and methods Fourteen women of 41 ± 3 years and 24 men of 38 ± 3 years, with no history of TMD and having sustained a mandibular trauma within the prior 20 hours, were treated exclusively by using an 810-nm laser beam in a continuous wave mode, with an output power of 1 W. At a speed of 2 cm/s, it scanned twice, for 60 seconds, with a pause in between of 2 minutes, a large cutaneous area (25 cm2), covering the temporomandibular joint (TMJ), the masseter muscle and a part of the temporalis fossa; also, it scanned just once, for 7 seconds, a small mucous area (3 cm2), covering the internal pterygoid muscle. The clinical outcomes were evaluated by comparing the maximum unassisted opening (MUO), measured at the baseline and immediately after the end of the LPT procedure. Results The MUO improvement of 24.6 ± 4.4 mm represented a highly significant difference (p < .0001) between the measurements, in all the patients, regardless of gender. Conclusions By scanning with an 810-nm laser beam, within less than 20 hours after the trauma, large areas of all the involved tissues and not just a few points, as described until now, the limited mouth opening in acute posttraumatic trismus was immediately and greatly resolved.
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Affiliation(s)
- Emilia Rasca
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Amaury Namour
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Aude Fauchon-Giumelli
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
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Rodrigues CA, Melchior MDO, Valencise Magri L, Mazzetto MO. Can the severity of orofacial myofunctional conditions interfere with the response of analgesia promoted by active or placebo low-level laser therapy? Cranio 2018; 38:240-247. [PMID: 30244669 DOI: 10.1080/08869634.2018.1520950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyze the influence of orofacial myofunctional condition (OMC) on pain perception, temporomandibular disorders (TMD) severity, and the response to low-level laser therapy (LLLT) in women with painful TMD. METHODS Seventy-eight women, 59 with TMD, received active laser (30) or placebo (29), with 19 controls. OMC, TMD severity, pain intensity, and pressure pain threshold (PPT) were assessed at different times during the masticatory test: before treatment (LLLT dose: 780nm), during, and after 30 days. RESULTS No correlation was found between OMC and pain perception or TMD severity (p > 0.05). The active and placebo LLLT showed reduction of pain during chewing and better recovery levels during the rest period (p > 0.05), without differences between OMC groups. DISCUSSION The perception of pain and severity of TMD are not correlated with the OMC, and the response of analgesia promoted by active LLLT or placebo is not associated with OMC.
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Affiliation(s)
- Carolina Almeida Rodrigues
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo , Ribeirão Preto, SP, Brazil.,Department of Restorative Dentistry of University Center of Educational Foundation of Barretos , Barretos, SP, Brazil
| | | | - Laís Valencise Magri
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo , Ribeirão Preto, SP, Brazil
| | - Marcelo Oliveira Mazzetto
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo , Ribeirão Preto, SP, Brazil
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Yildiz MS, Gunpinar S. Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study. Clin Oral Investig 2018; 23:1845-1854. [PMID: 30218227 DOI: 10.1007/s00784-018-2608-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/23/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effect of low-level laser therapy (LLLT) in terms of enhancing wound healing, reducing free gingival graft (FGG) shrinkage and postoperative pain. MATERIALS AND METHODS Thirty patients were randomly assigned to receive either FGG + LLLT (test, n = 15) or FGG + plasebo LLLT (control, n = 15). In the test group, a diode laser (810 nm, 0.1 W, energy density 6 J/cm2) was applied immediately after surgery and 1, 3, 7, and 14 days later. Measurements of the graft surface areas of the groups were made with an image-analyzing software at baseline and first, third, and sixth months. Complete wound epithelialization and visual analogue scale (VAS) for pain score were evaluated after surgery. RESULTS Shrinkage of the graft was statistically higher in the control than the test group at third and sixth months (p < 0.05). In terms of epithelization of the graft area, the test and control groups did not show any significant difference during the 28-day period (p > 0.05). Besides this, statistically significant differences were observed for VAS pain score and the number of analgesic used (p < 0.05). CONCLUSIONS The use of an 810-nm diode laser provided additional benefits to FGG in terms of less shrinkage of the graft dimensions and postoperative pain. CLINICAL RELEVANCE Low-level laser therapy reduced the shrinkage of free gingival graft's surface area after 6 months and enhanced postoperative pain relief.
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Affiliation(s)
- Mehmet Selim Yildiz
- Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey
| | - Sadiye Gunpinar
- Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey.
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Martins IP, Martins RP, Caldas SGFR, Dos Santos-Pinto A, Buschang PH, Pretel H. Low-level laser therapy (830 nm) on orthodontic pain: blinded randomized clinical trial. Lasers Med Sci 2018; 34:281-286. [PMID: 29998356 DOI: 10.1007/s10103-018-2583-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022]
Abstract
The objective of this research was to compare the effect single low-level laser therapy (LLLT) irradiation on pain perception in patients having fixed appliance treatment in the clinic of orthodontics. Sixty-two patients were recruited to participate in this randomized, double-blinded, placebo-controlled study. The patients were assigned to four groups: group I-laser on the right side; group II-placebo on the right side; group III-laser on the left side; group IV-placebo on the left. The laser or placebo was applied before separation, 24 and 48 h after separation of their first permanent molars in the lower arch. Just after the separation, the average of the pain for the placebo group was 1.6, significantly greater than the average of 1.1 registered for the laser group (p = 0.013). After 24 h and before the new irradiation, the values registered among the different groups did not show any differences. In relation to the gender, only after the first irradiation in placebo group, the female had a level of pain (0.1) significantly higher (p = 0.04) compared to male, and after 48 h, the group where the laser was applied had a difference (p = 0.04) among the gender with a value of lower pain for men (0.6) than for women (1.6).The laser irradiation to minimize the pain was only effective when applied immediately after treatment and separation. In general way, there were no differences between the genders, except after the first placebo group irradiation in which the female had a significantly higher level of pain compared to male and after 48 h. The pain cycle observed in this study had its peak in 24 h, both for laser's and placebo's group.
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Affiliation(s)
- Isabela Parsekian Martins
- Department of Orthodontics, Araraquara School of Dentistry, UNESP-Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Renato Parsekian Martins
- Department of Orthodontics, Araraquara School of Dentistry, UNESP-Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | | | - Ary Dos Santos-Pinto
- Department of Orthodontics, Araraquara School of Dentistry, UNESP-Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Peter H Buschang
- Department of Orthodontics, Baylor College of Dentistry, Dallas, TX, USA
| | - Hermes Pretel
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP-Univ Estadual Paulista, Araraquara, São Paulo, Brazil. .,Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Rua Humaitá, 1680, Centro Araraquara, São Paulo, 14801-903, 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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Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis. Pain Res Manag 2018; 2018:4230583. [PMID: 29861802 PMCID: PMC5971344 DOI: 10.1155/2018/4230583] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/03/2018] [Indexed: 12/25/2022]
Abstract
Objectives We systematically reviewed randomized controlled trials (RCTs) of the effect of low-level laser therapy (LLLT) versus placebo in patients with temporomandibular disorder (TMD). Methods A systematic search of multiple online sources electronic databases was undertaken. The methodological quality of each included study was assessed using the modified Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results A total of 31 RCTs were included. Total modified Jadad scale scores showed that the methodological quality was high in 30 studies and low in 1 study. Combining data from all clinically heterogeneous studies revealed positive effects of LLLT on pain relief, regardless of the visual analogue scale (VAS) score or the change of VAS score between the baseline and the final follow-up time point, while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD. Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up. Temporomandibular joint function outcomes indicated that the overall effect favored LLLT over placebo. Conclusion This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD.
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Costa SAP, Florezi GP, Artes GE, Costa JRD, Gallo RT, Freitas PMD, Witzel AL. The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study. Braz Oral Res 2017; 31:e107. [DOI: 10.1590/1807-3107bor-2017.vol31.0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 11/22/2017] [Indexed: 12/12/2022] Open
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Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg 2017; 46:1403-1410. [DOI: 10.1016/j.ijom.2017.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
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Incidence of interstitial pneumonitis in non-Hodgkin's lymphoma patients receiving immunochemotherapy with pegylated liposomal doxorubicin and rituximab. Ann Hematol 2017; 97:141-147. [PMID: 29086009 DOI: 10.1007/s00277-017-3160-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/23/2017] [Indexed: 01/09/2023]
Abstract
Pneumonitis is a rare but severe and potentially fatal adverse effect in chemotherapy of lymphoma. This study is aimed to investigate the incidence of interstitial pneumonitis in non-Hodgkin's lymphoma (NHL) patients receiving immunochemotherapy with pegylated liposomal doxorubicin and rituximab. Lymphoma patients were retrospectively reviewed, and eligible patients were included in this study. According to the chemotherapy regimens, patients were classified in four groups: combination of vincristine, cyclophosphamide, doxorubicin, and prednisone (CHOP group) with rituximab (RCHOP group) and combination of vincristine, cyclophosphamide, pegylated liposomal doxorubicin and prednisone (CDOP group) with rituximab (RCDOP group). Incidence and severity of interstitial pneumonitis were compared among the four groups. Among 757 patients reviewed, 207 patients were included in final analysis. Thirteen patients developed chemotherapy-induced interstitial pneumonitis, and the mean cycle of chemotherapy before the onset of pneumonitis was 4. Incidence rates of pneumonitis were 0, 1.8, 17.4, and 21.1% in CHOP, RCHOP, CDOP, and RCDOP groups, respectively (p < 0.001). The mean grades of pneumonitis were 0, 2, 2.5, and 3 in four groups, respectively (p < 0.001). After adjustment of confounders, chemotherapy regimens (OR 3.491, 95% CI 1.527-7.981, p = 0.003) and neutropenia in previous cycles (OR 2.186, 95% CI 1.281-3.731, p = 0.004) were independently associated with the incidence of pneumonitis. Interstitial pneumonitis should be highlighted in NHL patients who received more than 4 cycles of RCDOP chemotherapy regimen, especially in those who had grade 4 neutropenia in the previous cycles of chemotherapy.
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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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Kahraman SA, Cetiner S, Strauss RA. The Effects of Transcutaneous and Intraoral Low-Level Laser Therapy After Extraction of Lower Third Molars: A Randomized Single Blind, Placebo Controlled Dual-Center Study. Photomed Laser Surg 2017; 35:401-407. [DOI: 10.1089/pho.2016.4252] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sevil Altundag Kahraman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - Sedat Cetiner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - Robert A. Strauss
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
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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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Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain. Lasers Med Sci 2017; 32:419-428. [DOI: 10.1007/s10103-016-2138-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/26/2016] [Indexed: 10/20/2022]
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Melchior MDO, Machado BCZ, Magri LV, Mazzetto MO. Efeito do tratamento fonoaudiológico após a laserterapia de baixa intensidade em pacientes com DTM: estudo descritivo. Codas 2016; 28:818-822. [DOI: 10.1590/2317-1782/20162015099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO O aumento da dor/desconforto durante atividades como mastigar, falar e deglutir é comumente relatado por pacientes com Disfunção Temporomandibular (DTM) e a terapia fonoaudiológica miofuncional orofacial (TMO) tem sido proposta como parte do tratamento desta condição. Porém é uma modalidade que deve ser instituída quando o quadro de DTM e dor não está exacerbado a fim de não impedir ou dificultar a realização dos exercícios. Objetivo O objetivo deste estudo foi analisar o efeito da TMO no tratamento de pacientes com DTM, segundo o Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD), após analgesia com laserterapia de baixa intensidade (LBI), quanto às condições miofuncionais orofaciais (CMO) e quanto à percepção dos sintomas de DTM. Método Transcorridos 30 dias após a finalização da LBI, cinco pacientes foram avaliados, com idades entre 50 e 61 anos. A aplicação do questionário ProDTMMulti para investigação da autopercepção da sintomatologia de DTM e do exame clínico AMIOFE (Avaliação Miofuncional Orofacial com Escores) para constatação das condições miofuncionais orofaciais foram realizados por fonoaudióloga experiente, antes e após a TMO. Resultados As CMO apresentaram aumento dos escores após TMO, indicando aumento do equilíbrio miofuncional orofacial. De acordo com a percepção das pacientes, após a TMO houve alívio dos sinais e sintomas de DTM. Conclusão A TMO instituída após a analgesia com LBI promoveu equilíbrio das funções orofaciais da amostra estudada e diminuição dos sinais e sintomas de DTM remanescentes, de acordo com a autopercepção dos indivíduos tratados.
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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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Low-level laser therapy stimulates tissue repair and reduces the extracellular matrix degradation in rats with induced arthritis in the temporomandibular joint. Lasers Med Sci 2016; 31:1051-9. [PMID: 27147076 DOI: 10.1007/s10103-016-1946-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
The objective of this study was to characterize morphological and biochemistry action of low-level laser therapy (LLLT) on induced arthritis in the temporomandibular joint (TMJ) of rats. Twenty-four male Wistar rats were randomly divided into groups with 12 animals each: (AG) group with arthritis induced in the left TMJ and (LG) group with arthritis induced in the left TMJ and treated with LLLT (830 nm, 30 mW, 3 J/cm(2)). Right TMJs in the AG group were used as noninjected control group (CG). Arthritis was induced by intra-articular injection of 50 μl Complete Freund's Adjuvant (CFA) and LLLT began 1 week after arthritis induction. Histopathological analysis was performed using sections stained with hematoxylin-eosin, Toluidine Blue, and picrosirius. Biochemical analysis was determined by the total concentration of sulfated glycosaminoglycans (GAGs) and evaluation of matrix metalloproteinases (MMP-2 and MMP-9). Statistical analysis was performed using paired and unpaired t tests, with p < 0.05. Compared to AG, LG had minor histopathological changes in the TMJ, smaller thickness of the articular disc in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001), high birefringence of collagen fibers in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001) on the articular disc, and statistically lower activity of MMP-2 latent (p < 0.0001), MMP-2 active (P = 0.02), MMP-9 latent (p < 0.0001), and MMP-9 active (p < 0.0001). These results suggest that LLLT can increase the remodeling and enhancing tissue repair in TMJ with induced arthritis.
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Machado BCZ, Mazzetto MO, Da Silva MAMR, de Felício CM. Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 2016; 31:945-54. [PMID: 27085322 DOI: 10.1007/s10103-016-1935-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 03/28/2016] [Indexed: 01/05/2023]
Abstract
This study investigated the efficacy of combining low-level laser therapy (LLLT) with oral motor exercises (OM-exercises) for rehabilitation of patients with chronic temporomandibular disorders (TMDs). Eighty-two patients with chronic TMD and 20 healthy subjects (control group) participated in the study. Patients were randomly assigned to treatment groups: GI (LLLT + OM exercises), GII (orofacial myofunctional therapy-OMT-which contains pain relief strategies and OM-exercises), and GIII (LLLT placebo + OM-exercises) and GIV (LLLT). LLLT (AsGaAl; 780-nm wavelength; average power of 60 mW, 40 s, and 60 ± 1.0 J/cm²) was used to promote analgesia, while OM-exercises were used to reestablish the orofacial functions. Evaluations at baseline (T1), after treatment immediate (T2), and at follow-up (T3) were muscle and joint tenderness to palpation, TMD severity, and orofacial myofunctional status. There was a significant improvement in outcome measures in all treated groups with stability at follow-up (Friedman test, P < 0.05), but GIV did not show difference in orofacial functions after LLLT (P > 0.05). Intergroup comparisons showed that all treated groups had no difference in tenderness to palpation of temporal muscle compared to GC at follow-up (Kruskal-Wallis test, P < 0.01). Moreover, GI, GII, and GIII showed no difference from GC in orofacial functional condition (T2 and T3) while they differed significantly from GIV (P < 0.01). In conclusion, LLLT combined with OM-exercises was more effective in promoting TMD rehabilitation than LLLT alone was. Similar treatment results were verified with the OMT protocol.
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Affiliation(s)
- Barbara Cristina Zanandréa Machado
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil
| | - Marcelo Oliveira Mazzetto
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio M Rodrigues Da Silva
- Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.,Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cláudia Maria de Felício
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. .,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.
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De Carli BMG, Magro AKD, Souza-Silva BN, Matos FDS, De Carli JP, Paranhos LR, Magro ED. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: A randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 159:120-3. [PMID: 27045280 DOI: 10.1016/j.jphotobiol.2016.03.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/17/2016] [Accepted: 03/24/2016] [Indexed: 12/20/2022]
Abstract
This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.
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Affiliation(s)
| | - Alessandra Kuhn Dall Magro
- Department of Oral and Maxillofacial Surgery, Hospital São Vicente de Paulo de Passo Fundo, Rio Grande do Sul, Brazil
| | | | | | - João Paulo De Carli
- Department of Oral Medicine, School of Dentistry, University of Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Eduardo Dall Magro
- Department of Restorative Dentistry, School of Dentistry, University of Passo Fundo, Rio Grande do Sul, Brazil
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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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