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El-Qashty R, Elkashty OA, Hany E. Photobiostimulation conjugated with stem cells or their secretome for temporomandibular joint arthritis in a rat model. BMC Oral Health 2023; 23:720. [PMID: 37798702 PMCID: PMC10552280 DOI: 10.1186/s12903-023-03466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) arthritis is a debilitating, challenging condition and different methods have been implicated for its treatment. This study aimed to test the therapeutic potentials of low-level laser therapy (LLLT) associated with adipose derived stem cells (ADSC) or their derived secretome on a murine model induced arthritis. METHODS Forty eight rats were divided into four groups where group I was the sham control, the rest of animals were subjected to arthritis induction using complete Freund's adjuvant, then divided as follows: group II received phosphate buffered saline (PBS) intraarticular injection and irradiation of 0 j/cm2, group III received ADSCs derived secretome and irradiation of 38 j/cm2, and group IV received ADSCs and irradiation of 38 j/cm2 as well. One and three weeks after treatment, animals were euthanized, and paraffin blocks were processed for histological assessment by hematoxylin and eosin stain with histomorphometrical analysis. Histochemical evaluation of joint proteoglycan content was performed through toluidine blue stain, and immunohistochemical staining by the proinflammatory marker tumor necrosis factor-α (TNF-α) was performed followed by the relevant statistical tests. RESULTS The arthritis group showed histological signs of joint injury including cartilage atrophy, articular disc fibrosis, irregular osteochondral interface, and condylar bone resorption together with high inflammatory reaction and defective proteoglycan content. In contrast, the treated groups III and IV showed much restoration of the joint structure with normal cartilage and disc thickness. The inflammation process was significantly suppressed especially after three weeks as confirmed by the significant reduction in TNF-α positive immunostaining compared to the arthritic group, and the cartilage proteoglycan content also showed significant increase relative to the arthritic group. However, no significant difference between the results of the two treated groups was detected. CONCLUSION LLLT conjugated with ADSCs or ADSCs derived secretome can efficiently enhance the healing of arthritic TMJs. Stem cell secretome can be applied as a safe, potent therapy. However, further investigations are required to unravel its mechanism of action and pave its way as a safe, novel, cell free therapy.
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Affiliation(s)
- Rana El-Qashty
- Oral Biology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Osama A Elkashty
- Oral Pathology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Eman Hany
- Oral Biology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
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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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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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Al-Quisi AF, Jamil FA, Abdulhadi BN, Muhsen SJ. The reliability of using light therapy compared with LASER in pain reduction of temporomandibular disorders: a randomized controlled trial. BMC Oral Health 2023; 23:91. [PMID: 36782179 PMCID: PMC9924200 DOI: 10.1186/s12903-023-02784-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Temporomandibular Disorders (TMD) refer to a group of symptoms where pain is the most leading cause to demand a treatment by the patient. Light therapies are of great importance at current times due to its biosafety and non-invasive quality when used for the management of TMD symptoms. This study aimed to evaluate the efficacy of red LED light with low-level LASER in treating TMD patients. MATERIALS AND METHODS A double-blind randomized clinical study was conducted and included 60 patients along 3 groups (20 for each group) presented with myofascial pain related to TMD. Patients were randomly divided into 3 groups. Group A were managed by applying the LED light device into the trigger points without switching the device on. A red LED light was given to group B for 5 min at the tender muscles. Group C were treated by using low-level LASER therapy for 30 s. Patients were evaluated for any improvements regarding the pain score, presence of trigger points, and trismus along 4 visits (1 week interval between each visit). Any side effects related to the 2 devices were also assessed. RESULTS Both group B and C patients showed a statistically significant improvement in the pain value (P < 0.05) at the 3rd and 4th visits when compared to group A. Regarding tenderness, there was a reduction in the number of trigger points in both study groups; however, the results were insignificant in group B. Statistics showed insignificant differences between group B & C patients regarding pain and number of trigger points at all visits (P > 0.05). CONCLUSION Both LED light and LASER therapies could effectively relieve pain associated with myogenic TMD as there were no important differences between their outcomes. However, the biosafety and lower cost of the LED light device compared to the LASER should also be considered. Trial Registration This clinical trial was prospectively registered (TCTR ID: TCTR20190507002) on 07/05/2019. URL: http://www.thaiclinicaltrials.org/show/TCTR20190507002.
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Affiliation(s)
- Ahmed Fadhel Al-Quisi
- grid.411498.10000 0001 2108 8169Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, P.O. Box 1417, Bab-Al Moadham, Baghdad, Iraq
| | - Firas A. Jamil
- grid.411498.10000 0001 2108 8169Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, P.O. Box 1417, Bab-Al Moadham, Baghdad, Iraq
| | - Baseem Natheer Abdulhadi
- grid.444971.b0000 0004 6023 831XDepartment of Surgery (ENT), College of Medicine, Al-Iraqia University, Baghdad, Iraq
| | - Salah Jassim Muhsen
- grid.411498.10000 0001 2108 8169Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, P.O. Box 1417, Bab-Al Moadham, Baghdad, Iraq
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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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Ansari S, Charantimath S, Lagali-Jirge V, Keluskar V. Comparative efficacy of low-level laser therapy (LLLT) to TENS and therapeutic ultrasound in management of TMDs: a systematic review & meta-analysis. Cranio 2022:1-10. [PMID: 35315745 DOI: 10.1080/08869634.2022.2050975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the reduction in pain, muscle tenderness, joint clicking, and improvement in mouth opening (MO) after low-level laser therapy (LLLT) compared to transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound (US) among temporomandibular joint disorder (TMD) patients. METHODS A systematic search of online sources of electronic databases was undertaken. The quality of the study was assessed using the Cochrane risk of bias assessment tool for randomized controlled trials (RCTs). RESULTS Twelve RCTs were included in the systematic review, and 9 were included in the meta-analysis. For reduction in pain between LLLT and TENS, LLLT was found to be better than TENS, at 95% CI. LLLT was also proven to be better in reducing pain than therapeutic US, at 81% CI. CONCLUSION This systematic review and meta-analysis compared the effectiveness of LLLT, TENS, and therapeutic US in TMD. LLLT provided relatively more effective pain relief and improvement in MO.
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Affiliation(s)
- Sulem Ansari
- Department of Oral Medicine and Radiology, KAHER's KLE VK Institute of Dental Sciences, Belagavi, India
| | - Shivayogi Charantimath
- Department of Oral Medicine and Radiology, KAHER's KLE VK Institute of Dental Sciences, Belagavi, India
| | - Vasanti Lagali-Jirge
- Department of Oral Medicine and Radiology, KAHER's KLE VK Institute of Dental Sciences, Belagavi, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, KAHER's KLE VK Institute of Dental Sciences, Belagavi, India
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Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Parvaie P, Anbari F. The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS). J Dent Anesth Pain Med 2022; 22:19-27. [PMID: 35169617 PMCID: PMC8814725 DOI: 10.17245/jdapm.2022.22.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/06/2022] [Accepted: 01/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Hamid Reza Khalighi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Science Research Center, Shohada Tajrish Hospital, Tajrish Square, Tajrish Street, Tehran, Iran
| | - Parvin Parvaie
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Fahimeh Anbari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yüksek MN, Eroğlu CN. Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study. J Appl Oral Sci 2021; 29:e20210383. [PMID: 34787280 PMCID: PMC8673830 DOI: 10.1590/1678-7757-2021-0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 12/04/2022] Open
Abstract
The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited.
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Affiliation(s)
- Mehmet Nuri Yüksek
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
| | - Cennet Neslihan Eroğlu
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
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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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12
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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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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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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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Ahmad SA, Hasan S, Saeed S, Khan A, Khan M. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life 2021; 14:148-164. [PMID: 34104237 PMCID: PMC8169142 DOI: 10.25122/jml-2020-0169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Temporomandibular joint disorders (TMDs) encompass a wide array of ailments affecting the temporomandibular joint (TMJ), muscles of mastication, and the allied structural framework. Myofascial pain, internal derangement of the joint, and degenerative joint diseases constitute the majority of TMDs. TMDs usually have a multifactorial etiology, and treatment modalities range from conservative therapies to surgical interventions. Low-level laser therapy (LLLT) has evolved as an efficient non-invasive therapeutic modality in TMDs. Previously conducted systematic reviews and meta-analyses have shown variable results regarding the efficiency of LLLT in TMJ disorder patients. Hence, this systematic review was carried out as an attempt to evaluate the efficacy of LLLT in the treatment of temporomandibular joint disorder patients.
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Affiliation(s)
- Syed Ansar Ahmad
- Department of Oral Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shazina Saeed
- Laboratory of Disease Dynamics and Molecular Epidemiology, Amity Institute of Public Health, Amity university, Noida, Uttar Pradesh, India
| | - Ateeba Khan
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Munna Khan
- Department of Electrical Engineering, Jamia Millia Islamia, New Delhi, India
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Effect of photobiomodulation therapy on painful temporomandibular disorders. Sci Rep 2021; 11:9049. [PMID: 33907210 PMCID: PMC8079391 DOI: 10.1038/s41598-021-87265-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm2, 3 regions, 60 s) or TMJ region (6 J/cm2, 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0–10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P < 0.001) for both types of interventions, however, PBMT caused greater reduction in pain scores than placebo (P = 0.014). For myalgia patients, pain intensity decreased over time (P < 0.001) but without difference between interventions (P = 0.074). PPTs increased in both myalgia (P < 0.001) and TMJ arthralgia patients over time (P < 0.001) but without difference between interventions (P ≥ 0.614). Overall, PBMT was associated with marginally better improvements in range of motion compared to placebo in both myalgia and arthralgia patients. Pain intensity, sensory function and jaw movements improve after both PBMT and placebo treatments in myalgia and arthralgia patients indicating a substantial non-specific effect of PBMT.
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Jing G, Zhao Y, Dong F, Zhang P, Ren H, Liu J, Liu Y, Yu C, Hu J, Bao G, Kang H. Effects of different energy density low-level laser therapies for temporomandibular joint disorders patients: a systematic review and network meta-analysis of parallel randomized controlled trials. Lasers Med Sci 2020; 36:1101-1108. [PMID: 33230581 DOI: 10.1007/s10103-020-03197-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effects of different energy density LLLT on TMD patients' pain reduction. METHODS Reviewers searched RCTs published in Embase, PubMed and The Cochrane Library before 1 April 2020. Reviewers included parallelRCTs that compared the effects of LLLT with placebo or different energy density LLLT for TMD patients' pain reduction. Reviewers did network meta-analysis and evaluated the quality of evidence using the GRADE process. RESULTS From 352 studies, reviewers included 16 RCTs. Immediately after treatment, the d1 laser therapy (energy density ranging from 0 to 10 J/cm2) ranked first. The d1 laser therapy showed more pain reduction than placebo ( MD = 2.49, 95% CI ranging from 1.28 to 3.71). The quality of "d1 vs p" comparison was assessed as "moderate" quality. A month after treatment, the d1 laser therapy also performed better than placebo (MD = 1.69, 95%CI = [-0.78, 4.16]). The quality of secondary outcome was assessed as "low" quality. CONCLUSIONS For clinical application, d1 laser therapy (energy density ranging from 0 to 10 J/cm2) is recommended for short-term pain management of TMD patients (moderate quality evidence). A month after treatment, the d1 laser therapy also performed better than placebo and other laser groups but the result didn't reach the point of statistical significance (low quality evidence). TRIAL REGISTRATION PROSPERO-CRD42018118313.
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Affiliation(s)
- Guoyi Jing
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Yatao Zhao
- Department of Orthodontics, Xiangya Hospital and School of Stomatology, Central South University, Changsha, 410078, People's Republic of China
| | - Fangrui Dong
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Pengfei Zhang
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Hui Ren
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Jingying Liu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Yang Liu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Caiyun Yu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Jingjing Hu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Guangjie Bao
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, 730000, People's Republic of China.
| | - Hong Kang
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China.
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Effectiveness of the Laser Application in Temporomandibular Joint Disorder: A Systematic Review of 1172 Patients. Pain Res Manag 2020; 2020:5971032. [PMID: 33005278 PMCID: PMC7503120 DOI: 10.1155/2020/5971032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022]
Abstract
Objective The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder. Methods PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software. Results This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias. Conclusion TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients' better outcome. This trial is registered with PROSPERO (CRD42020177562).
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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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Dantas CMG, Vivan CL, de Fantini SM, de Freitas Costa e Silva PM, Pannuti CM, Witzel AL, Dominguez GC. The influence of educational measures and low-level laser phototherapy on temporomandibular disorders: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore) 2020; 99:e19005. [PMID: 32150048 PMCID: PMC7478391 DOI: 10.1097/md.0000000000019005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Photobiomodulation therapy (PBMT) with low-power laser is used for pain relief in several clinical conditions, including temporomandibular disorders (TMD). As musculoskeletal pain often produces changes in motor behavior, it is common for patients with TMD to present limited mandibular movements. To the date, there is no consensus about the optimal dosimetric parameters of PMBT for TMD. This randomized, controlled, double-blind clinical trial aims to evaluate pain relief and mandibular mobility in patients with TMD following treatments with 2 laser wavelengths, red (660 nm) and infrared (808 nm) individually and in combination as compared to a placebo treatment. One-hundred participants presenting myalgia and arthralgia, with disk displacement or not, will be selected based on the Research Diagnostic Criteria for Temporomandibular Disorders. All participants will be instructed about the etiology, prognosis, and self-care techniques for pain control on TMD, and followed up for 2 weeks. After this period, those who still present pain score over 4 in a visual analog scale (VAS) will be included in the study. Participants will be randomly assigned to 4 treatment groups: G1 = placebo (SHAM); G2 = PBMT with red laser (660 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); G3 = PBMT with infrared laser (808 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); and G4 = PBMT with red and infrared laser alternated between sessions. The treatment consists of 8 sessions, 2 times a week. The effect of the proposed therapies will be measured by: pain reduction in VAS; pressure pain threshold on TMJ, masseter and temporal muscles; and the amplitude of mandibular movements (opening, protrusion, and right and left lateral movements). The data will be collected at the following times: initial (T1), after the 1st treatment session (T2), at the end of treatment (T3), and 30 days after the last PBMT session (T4). For statistical analysis will be used 2-way repeated measures analysis of variance test, complemented by a post hoc Tukey test (P < .05).
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Affiliation(s)
| | | | | | | | - Claudio Mendes Pannuti
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
| | - Andrea Lusvarghi Witzel
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
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Azangoo Khiavi H, Ebrahimi H, Najafi S, Nakisa M, Habibzadeh S, Khayamzadeh M, Kharazifard MJ. Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study. J Lasers Med Sci 2020; 11:37-44. [PMID: 32099625 DOI: 10.15171/jlms.2020.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Myofascial pain dysfunction syndrome (MPDS) is a common temporomandibular joint disorder. Due to its multifactorial etiology, treatment usually involves more than one modality to obtain complementary results. The purpose of this study was to compare the combined effect of a low-level laser, a hard occlusal appliance, and conventional pharmacotherapy with pharmacotherapy only in the management of patients with MPDS. Methods: In this study, 15 patients with MPDS were diagnosed and randomly assigned to 3 groups (n=5). Subjects in Group 1 were treated with pharmacotherapy (PT); Group 2 received the diode laser (940 nm gallium arsenide) every other day for a total of 10 sessions, plus pharmacotherapy (PTL) and Group 3 were given hard occlusal splint 12 h/day for 4 weeks, plus pharmacotherapy (PTO). The intensity of pain was measured using the visual analog scale (VAS) prior to the treatment, 2 and 4 weeks after the onset of treatment and 2 weeks later. The maximum painless mouth opening and pain intensity at muscle palpation were also recorded. Comparisons were made between the groups via repeated measure analysis of variance (ANOVA) (P<0.05). Results: Pain relief in the subjective VAS was observed in both laser and appliance groups in the third and fourth examination sessions (P<0.05). No statistically significant reduction in pain was noted using pharmacotherapy only. The maximum painless mouth opening and muscle tenderness were not significantly different between the 3 groups (P>0.05). Conclusion: Both the laser and the occlusal appliance combined with pharmacotherapy proved to be effective for pain reduction in patients with MPDS. All groups, however, failed to result in a significant improvement in the maximum mouth opening or tenderness in masticatory muscles.
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Affiliation(s)
- Hassan Azangoo Khiavi
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Hooman Ebrahimi
- Oral Medicine Department, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Shamsolmolouk Najafi
- Department of Oral and Maxillofacial Disease, Dental Research Center, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sareh Habibzadeh
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Mina Khayamzadeh
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
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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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Magri LV, Bataglion C, Leite-Panissi CRA. Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins. Cranio 2019; 39:502-509. [PMID: 31585522 DOI: 10.1080/08869634.2019.1673588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To characterize short- and long-term assessment of the low-intensity laser therapy (LLLT) effectiveness in women with TMD of muscular origins and to evaluate whether the information about the treatment received (active or placebo) modifies the pain intensity.Methods: Forty-one women with painful TMD (31.7 ± 5.2 years) were divided into laser (n = 20) and placebo (n = 21) groups. The pain intensity was measured at the baseline, after the LLLT (T8), 6 and 12 months. At the 6-month follow-up, the groups received information about the active or placebo treatment.Results: At T8 and 6-month, both active and placebo LLLT were effective in reducing pain (p < .05). After one year, the groups showed similar pain. Active LLLT was more effective in reducing pain palpation (p = .001) and referred pain (p = .04) in the region of the TMJs. The information about the treatment modified the perceived pain intensity.Conclusion: Active and placebo LLLT are effective for painful TMD of muscular origins in the short-term. Information about the treatment impairs the subjective perception of pain.
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Affiliation(s)
- Laís Valencise Magri
- Department of Psychology, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.,Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - César Bataglion
- Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
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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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Altindiş T, Güngörmüş M. Thermographic evaluation of occlusal splint and low level laser therapy in myofascial pain syndrome. Complement Ther Med 2019; 44:277-281. [DOI: 10.1016/j.ctim.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022] Open
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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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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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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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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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Scrivani SJ, Khawaja SN, Bavia PF. Nonsurgical Management of Pediatric Temporomandibular Joint Dysfunction. Oral Maxillofac Surg Clin North Am 2017; 30:35-45. [PMID: 29153236 DOI: 10.1016/j.coms.2017.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Temporomandibular disorders (TMD) are a subgroup of craniofacial pain problems involving the temporomandibular joint (TMJ), masticatory muscles, and associated head and neck musculoskeletal structures. These disorders are subclassified into TMJ articular disorders and masticatory muscle disorders. Patients with TMD most commonly present with pain, restricted or asymmetric mandibular motion, and TMJ sounds during mandibular movements. The prevalence tends to increase with age. Management of TMJ articular disorders consists of a combination of patient education, home-care plan, biobehavioral therapy, physical therapy, orthotic jaw appliance therapy, pharmacotherapy, and/or surgery. The goal is to increase function, reduce pain, and improve quality of life.
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Affiliation(s)
- Steven John Scrivani
- Division of Oral and Maxillofacial Pain, Orofacial Pain Residency Program, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - Shehryar Nasir Khawaja
- Division of Oral and Maxillofacial Pain, Orofacial Pain Residency Program, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Orofacial Pain Consultant, Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Paula Furlan Bavia
- Division of Oral and Maxillofacial Pain, Orofacial Pain Residency Program, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Basili M, Barlattani A, Venditti A, Bollero P. Low-level laser therapy in the treatment of muscle-skelet pain in patients affected by temporo-mandibular disorders. ACTA ACUST UNITED AC 2017; 10:406-411. [PMID: 29682258 DOI: 10.11138/orl/2017.10.4.406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The purpose of the study is to evaluate the effectiveness of Low-Level Laser Therapy in reducing joint and muscle pain in patients with acute and chronic temporomandibular dysfunction. Materials and methods The study was conducted on a sample of 180 patients. The sample was divided into two groups according to the time of onset of the disease: acute TMD (<6 months) and chronic TMD (> 6 months). The treatment for all patients provided for the irradiation with Diode Laser Wiser Doctor Smile with tip plane wave at wavelength of 830 nm, continuous beam to 40nW diameter and radius of 6 mm. The irradiated areas were the joint area, temporal, masseter and pterygoid. The irradiation time for each zone was 60s.The protocol adopted consisted of two weekly treatment for six weeks. Pain assessment was performed using the Visual Analog Scale (VAS), in which different scores (s) depending accused of pain by the patient: s0 no pain, s1-3 mild pain, s4-6 moderate pain, s7-9 severe pain and s10 excessive pain. The pain monitoring was performed before treatment, after 15 days and after one month. Results The sample included 80 patients with acute TMD and 100 with chronic TMD. The sample belonging to acute TMD group before treatment, was distributed as follows: 0% in s0; 12,5% in s1-3; 31.3% in s4-6; 53.6% in s7-9 and 2.5% in s10. After 15 days the distribution was was as follows: 6.25% in s0; 47.5% in s1-3; 20% in s4-6; 26.3% in s7-9 and 0% in s10. After 30 days the sample was well distributed: 35% in s0; 45% in 1-3; 10% in s4-6; 10% in s7-9 and 0% in s10. The sample belonging to the chronic TMD group, at time zero, was as follows: 0% at s0; 48% in S1-3; 35% in s4-6; 15% in s7-9 and 2% in s10. After 15 days the distribution was: 29% in s0; 28% in S1-3; 33% in s4-6; 10% in s7-9 and 0% in s10. After 30 days the sample was well distributed: 45% in s0; 36% in S1-3; 15% in s4-6; 4% in s7-9 and 0% in s10. Conclusions The Low-Level-Laser-Therapy is a valuable tool that can significantly decrease the perception of pain in patients with temporomandibular joint dysfunction, acute and chronic.
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Affiliation(s)
- M Basili
- UOSD Diagnosis, Hygiene and Oral Prevention with Dental Day-hospital, Polyclinic of Rome "Tor Vergata", Rome, Italy
| | - A Barlattani
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", UOSD Diagnosis, Hygiene and Oral Prevention with Dental Day-hospital, Polyclinic of Rome "Tor Vergata", Rome, Italy
| | - A Venditti
- UOSD Diagnosis, Hygiene and Oral Prevention with Dental Day-hospital, Polyclinic of Rome "Tor Vergata", Rome, Italy
| | - P Bollero
- Department of Systems Medicine of the University of Rome "Tor Vergata", UOSD Diagnosis, Hygiene and Oral Prevention with Dental Day-hospital, Polyclinic of Rome "Tor Vergata", Rome, Italy
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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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Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Moradi Abbasabadi F. Low Level Laser Therapy Versus Pharmacotherapy in Improving Myofascial Pain Disorder Syndrome. J Lasers Med Sci 2016; 7:45-50. [PMID: 27330698 DOI: 10.15171/jlms.2016.10] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Temporomandibular disorders (TMD) lead to masticatory muscle pain, jaw movement disability and limitation in mouth opening. Pain is the chief complaint in 90% of the TMD patients which leads to disability and severe socioeconomic costs. The purpose of this study was to evaluate the therapeutic effects of low level laser therapy (LLLT) compared to pharmacotherapy with NSAIDs (naproxen) in myofascial pain disorder syndrome (MPDS). METHODS In this randomized controlled clinical trial, 40 MPDS patients were divided into two groups. One group received naproxen 500 mg bid for 3 weeks as treatment modality and also had placebo laser sessions. The other group received active laser (diode 810 nm CW) as treatment and placebo drug. Pain intensity was measured by visual analogue scale (VAS) and maximum painless mouth opening was also measured as a functional index every session and at 2 months follow up. Data was collected and analyzed with SPSS software. Independent t test was used to analyze the data. A P < 0.05 was considered significant. RESULTS Low level laser caused significant reduction in pain intensity (P < 0.05) and a significant increase in mouth opening. In naproxen group neither pain intensity nor maximum mouth opening had significant improvement. Pain relief, in subjective VAS was observed in third session in LLLT group, but did not occur in naproxen group. Maximum mouth opening increased significantly in laser group compared to the naproxen group from the eighth session. CONCLUSION Treatment with LLLT caused a significant improvement in mouth opening and pain intensity in patients with MPDS. Similar improvement was not observed in naproxen group.
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Affiliation(s)
- Hamid Reza Khalighi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran,Iran
| | - Saranaz Azari-Marhabi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Moradi Abbasabadi
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran
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Shukla D, Muthusekhar MR. Efficacy of low-level laser therapy in temporomandibular disorders: A systematic review. Natl J Maxillofac Surg 2016; 7:62-66. [PMID: 28163481 PMCID: PMC5242077 DOI: 10.4103/0975-5950.196127] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose: The aim of this systematic review was to assess the efficacy of low-level laser therapy (LLLT) in patients with temporomandibular disorders (TMDs). Methods: Medline search was done from 1997 to 2011 using search terms appropriate to establishing a relation between LLLT and TMD. Only randomized controlled trials were included in this study. Outcome variables related to pain, muscle tenderness, mandibular movements, and Electromyographic (EMG) activity were considered. Of the 242 articles examined, 13 were finally included in the critical analysis conducted as a part of the present systematic review. Results: Of the 242 titles reviewed, only 13 articles were considered eligible. 7 articles showed significant improvement in the study group, whereas 5 showed no significant improvement between the study and control groups. The primary outcome of most of the studies was pain. Other variables considered were muscle tenderness, mandibular movements; EMG activity was considered. Conclusion: Our results have shown that LLLT seems to be effective in reducing pain in TMD's. It may be a treatment option for patients with an interest in a noninvasive, complementary therapy.
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Affiliation(s)
- Deepankar Shukla
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - M R Muthusekhar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
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Sancakli E, Gökçen-Röhlıg B, Balık A, Öngül D, Kıpırdı S, Keskın H. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health 2015; 15:131. [PMID: 26496720 PMCID: PMC4619518 DOI: 10.1186/s12903-015-0116-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the effect of Low Level Laser (LLL) application at the points of greatest pain in patients with chronic masticatory muscle pain. METHODS A total number of 30 (21 women, 9 men, with a mean age of 39.2) were selected after the diagnosis of MPDS according to the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). The patients were randomly divided into three groups; laser group I (n = 10); patients received the LLL at the point of greatest pain, laser group II (n = 10); patients received LLL at pre-established points in the effected muscles and placebo group (n = 10). LLL and placebo were applied three times per week, for a total of 12 sessions. Mandibular mobility was examined, masticator muscles tenderness were assessed and PPT values were obtained. Subjective pain levels were evaluated using VAS. The measurements performed before the treatment and after the completion of the therapy. Descriptive statistics (mean, standard deviation, and frequency) Student's t-test, Mann-Whitney U-test and paired-sample t-tests were used for analysis. RESULTS In both laser groups, there was a statically significant reduction in PPT values of the muscles, number of muscles without any pain on palpation increased significantly, mandibular movements' ranges were improved. Laser group I demonstrated statistically better results than the Laser group II in all of the measured values. Plasebo group did not show any statistically difference in any of the measured values. CONCLUSIONS LLLT can be accepted as an alternative treatment modality in the management of masticatory muscle pain and direct irradiation seems to effect better. TRIAL REGISTRATION Current Controlled Trials ISRCTN31085 , Date of registration 28/08/20145.
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Affiliation(s)
- Erkan Sancakli
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Bilge Gökçen-Röhlıg
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Ali Balık
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Değer Öngül
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Selin Kıpırdı
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Haluk Keskın
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
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da Silva MM, Albertini R, Leal-Junior ECP, de Tarso Camillo de Carvalho P, Silva JA, Bussadori SK, de Oliveira LVF, Casarin CAS, Andrade EL, Bocalini DS, Serra AJ. Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial. Trials 2015; 16:252. [PMID: 26040789 PMCID: PMC4464876 DOI: 10.1186/s13063-015-0765-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/19/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin. METHODS/DESIGN A randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay. DISCUSSION This is the first randomized controlled trial in which the role of phototherapy, exercise training, and a combination of these interventions will be evaluated for chronic pain in patients with FM and TMD. The results will offer valuable clinical evidence for objective assessment of the potential benefits and risks of procedures. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02279225. Registered 27 October 2014.
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Affiliation(s)
| | - Regiane Albertini
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
| | | | | | - José Antonio Silva
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
| | - Sandra Kalil Bussadori
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
| | | | | | - Erinaldo Luiz Andrade
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
| | - Danilo Sales Bocalini
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
| | - Andrey Jorge Serra
- Nove de Julho University, Rua Vergueiro, 235, Liberdade, São Paulo, SP, 01504-000, Brazil.
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Doeuk C, Hersant B, Bosc R, Lange F, SidAhmed-Mezi M, Bouhassira J, Meningaud J. Current indications for low level laser treatment in maxillofacial surgery: a review. Br J Oral Maxillofac Surg 2015; 53:309-15. [DOI: 10.1016/j.bjoms.2015.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 02/05/2015] [Indexed: 10/23/2022]
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Pandeshwar P, Roa MD, Das R, Shastry SP, Kaul R, Srinivasreddy MB. Photobiomodulation in oral medicine: a review. ACTA ACUST UNITED AC 2015; 7:114-26. [DOI: 10.1111/jicd.12148] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 11/22/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Padma Pandeshwar
- Department of Oral Medicine and Radiology; Vydehi Institute of Dental Sciences and Research Centre; Whitefield, Bangalore India
| | - Mahesh Datta Roa
- Department of Oral Medicine and Radiology; Dayananda Sagar College of Dental Sciences; Bangalore India
| | - Reshma Das
- Department of Oral Medicine and Radiology; Vydehi Institute of Dental Sciences and Research Centre; Whitefield, Bangalore India
| | - Shilpa P. Shastry
- Department of Oral Medicine and Radiology; Vydehi Institute of Dental Sciences and Research Centre; Whitefield, Bangalore India
| | - Rachna Kaul
- Department of Oral Medicine and Radiology; Vydehi Institute of Dental Sciences and Research Centre; Whitefield, Bangalore India
| | - Mahesh B. Srinivasreddy
- Department of Oral Medicine and Radiology; Vydehi Institute of Dental Sciences and Research Centre; Whitefield, Bangalore India
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Herpich CM, Amaral AP, Leal-Junior ECP, Tosato JDP, Gomes CAFDP, Arruda ÉEC, Glória IPDS, Garcia MBS, Barbosa BRB, Rodrigues MS, Silva KL, El Hage Y, Politti F, Gonzalez TDO, Bussadori SK, Biasotto-Gonzalez DA. Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature. J Phys Ther Sci 2015; 27:295-301. [PMID: 25642095 PMCID: PMC4305586 DOI: 10.1589/jpts.27.295] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/18/2014] [Indexed: 12/02/2022] Open
Abstract
The aim of the present study was to perform a systematic review of the literature on the
effects of low-level laser therapy in the treatment of TMD, and to analyze the use of
different assessment tools. [Subjects and Methods] Searches were carried out of the
BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for
papers published in English and Portuguese using the terms: “temporomandibular joint laser
therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility
criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited
considerable methodological differences, especially with regard to the number of sessions,
anatomic site and duration of low-level laser therapy irradiation, as well as irradiation
parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are
needed, especially randomized clinical trials, to establish the exact dose and ideal
parameters for low-level laser therapy and define the best assessment tools in this
promising field of research that may benefit individuals with signs and symptoms of
TMD.
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Affiliation(s)
- Carolina Marciela Herpich
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Ana Paula Amaral
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Ernesto Cesar Pinto Leal-Junior
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Phototherapy in Sports and Exercise, University Nove de Julho (UNINOVE), Brazil
| | - Juliana de Paiva Tosato
- Postgraduate Program in Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Brazil
| | | | - Éric Edmur Camargo Arruda
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Igor Phillip Dos Santos Glória
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Marilia Barbosa Santos Garcia
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Bruno Roberto Borges Barbosa
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | | | - Katiane Lima Silva
- Graduation Phisical Therapy, Universidade Nove de Julho (UNINOVE), Brazil
| | - Yasmin El Hage
- Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE), Brazil
| | - Fabiano Politti
- Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE), Brazil
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
| | - Daniela Aparecida Biasotto-Gonzalez
- Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil
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42
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Herpich CM, Leal-Junior ECP, Amaral AP, de Paiva Tosato J, dos Santos Glória IP, Garcia MBS, Barbosa BRB, El Hage Y, Arruda ÉEC, de Paula Gomes CÁF, Rodrigues MS, de Sousa DFM, de Tarso Camillo de Carvalho P, Bussadori SK, de Oliveira Gonzalez T, Politti F, Biasotto-Gonzalez DA. Effects of phototherapy on muscle activity and pain in individuals with temporomandibular disorder: a study protocol for a randomized controlled trial. Trials 2014; 15:491. [PMID: 25514875 PMCID: PMC4301827 DOI: 10.1186/1745-6215-15-491] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 11/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session. METHODS/DESIGN A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles. DISCUSSION The study will contribute to the practice of the evidence-based use of phototherapy in individuals with a myogenous TMD. Data will be published after the study is completed. TRIAL REGISTRATION This study is registered with the Brazilian Registry of Clinical Trials, NCT02018770, date of registration: 7 December 2013.
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Affiliation(s)
- Carolina Marciela Herpich
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Ernesto Cesar Pinto Leal-Junior
- />Teaching Staff Member, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Ana Paula Amaral
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Juliana de Paiva Tosato
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Igor Phillip dos Santos Glória
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Marília Barbosa Santos Garcia
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Bruno Roberto Borges Barbosa
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Yasmin El Hage
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Éric Edmur Camargo Arruda
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Cid Ándre Fidelis de Paula Gomes
- />Department of Physical Therapy, University Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto, 109. Água Branca, São Paulo, SP 05001-100 Brazil
| | - Monique Sampaio Rodrigues
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Dowglas Fernando Magalhães de Sousa
- />Student, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Paulo de Tarso Camillo de Carvalho
- />Teaching Staff Member , Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Vergueiro, 235/249 - Liberdade, São Paulo, SP 01504-001 Brazil
| | - Sandra Kalil Bussadori
- />Teaching Staff Member, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Tabajara de Oliveira Gonzalez
- />Department of Physical Therapy, University Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto, 109. Água Branca, São Paulo, SP 05001-100 Brazil
| | - Fabiano Politti
- />Teaching Staff Member, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
| | - Daniela Aparecida Biasotto-Gonzalez
- />Teaching Staff Member, Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis, University Nove de Julho (UNINOVE), Rua Profa Maria Jose Barone Fernandes, 300, São Paulo, SP 02117-020 Brazil
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43
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Chen J, Huang Z, Ge M, Gao M. Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 2014; 42:291-9. [PMID: 25491183 DOI: 10.1111/joor.12258] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2014] [Indexed: 02/05/2023]
Affiliation(s)
- J. Chen
- West China School of Stomatology; Sichuan University; Chengdu China
| | - Z. Huang
- Department of Orthopaedics; West China Hospital; Sichuan University; Chengdu China
| | - M. Ge
- State Key Laboratory of Oral Diseases; Department of Orthodontics; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - M. Gao
- Department of Orthodontics; Stomatology Hospital of Nantong; NanTong China
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44
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Chang WD, Lee CL, Lin HY, Hsu YC, Wang CJ, Lai PT. A Meta-analysis of Clinical Effects of Low-level Laser Therapy on Temporomandibular Joint Pain. J Phys Ther Sci 2014; 26:1297-300. [PMID: 25202201 PMCID: PMC4155240 DOI: 10.1589/jpts.26.1297] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/16/2014] [Indexed: 02/06/2023] Open
Abstract
[Purpose] Temporomandibular joint (TMJ) pain is a symptom of TMJ disease. Low-level laser therapy (LLLT) is often used in the clinical treatment of TMJ pain. The aim of this study was to review the effective parameters of LLLT for TMJ pain. [Methods] This study was a systematic review in which electronic databases were searched for the period of January 2005 to January 2010. We selected reports of randomized controlled trials and calculated the effect size (ES) of the pain relief to evaluate the effect of LLLT. [Results] Seven reports are found to meet the inclusion criteria and discussed. Based on the calculation results, the pooled ES was -0.6, indicating a moderate effect of pain relief. In addition, the dosages and treatments with wavelengths of 780 and 830 nm can cause moderate and large pain relief effects. [Conclusion] Use of LLLT on the masticatory muscle or joint capsule for TMJ pain had a moderate analgesic effect. The optimal parameters for LLLT to treat TMJ pain have not been confirmed. However, our results can be a vital clinical reference for clinical physicians in treatment of patients with TMJ pain.
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Affiliation(s)
- Wen-Dien Chang
- Department of Sports Medicine, China Medical University, Taiwan
| | - Chia-Lun Lee
- Physical Education Section of General Education, National Sun Yat-sen University, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, I-Shou University, Taiwan
| | - Yung-Chun Hsu
- Rehabilitation Therapy Center, Tungs' Taichung MetroHarbor Hospital, Taiwan
| | - Chung-Jieh Wang
- Department of Rehabilitation Science, Jen-Teh Junior College of Medicine, Nursing and Management, Taiwan
| | - Ping-Tung Lai
- Department of Physical Therapy and Rehabilitation, Da-Chien General Hospital, Taiwan
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45
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Navrátil L, Navratil V, Hajkova S, Hlinakova P, Dostalova T, Vranová J. Comprehensive treatment of temporomandibular joint disorders. Cranio 2014; 32:24-30. [PMID: 24660643 DOI: 10.1179/0886963413z.0000000002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIMS Changing lifestyles, decreasing physical activity, which is increasing the number of degenerative joint diseases of various etiology, and certain dental procedures are increasing the number of patients complaining of pain in their temporomandibular joints. The aim of the study was to assess the benefits of comprehensive physiotherapy sessions in order to decrease the number of temporomandibular joint problems, thereby improving the patient's quality of life. METHODOLOGY An examination by a dentist determined each patient's treatment plan, which consisted of a medical exam, physical therapy and education. Each form of treatment was applied 10 times at intervals of 7-14 days. The main goal of the therapeutic physical education was to redress the muscle imbalance in the mandibular joint. This was achieved by restoring balance between the masticatory muscles, along with releasing the spastic shrouds found in the masticatory muscles. The aim of education was to teach the patient exercises focused on the temporomandibular joint and masticatory muscles. The intensity of the exercises and their composition were individually adjusted and adapted to their current state. Physical therapy consisted of the application of pulsed magnetic therapy, laser therapy, and non-invasive positive thermotherapy. RESULTS The above procedure was conducted on a therapeutic group of 24 patients (3 men and 20 women). In the course of therapy, there were no complications, and all patients adhered to the prescribed regime. None reported any side effects. The mean treatment duration was 123 +/- 66 days. The outcome of the therapy was evaluated as described in the methodology, the degree of pain affecting the joint, and the opening ability of the mouth. In both parameters, there was a significant decline in patient pain. CONCLUSIONS In a study devoted to tactics of rehabilitation treatment for temporomandibular joint disorders, the need for comprehensive long-term therapy, involving education, and learning proper chewing habits was made apparent for recovery and pain reduction. A priority in physical therapy, and combinations of pulsed magnetic therapy and hyperthermia-positive peloids, are also beneficial.
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46
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Chang WD, Wu JH, Wang HJ, Jiang JA. Therapeutic outcomes of low-level laser therapy for closed bone fracture in the human wrist and hand. Photomed Laser Surg 2014; 32:212-8. [PMID: 24649935 DOI: 10.1089/pho.2012.3398] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The therapeutic outcomes of low-level laser therapy (LLLT) on closed bone fractures (CBFs) in the wrist and hand were investigated in this controlled study. BACKGROUND DATA Animal research has confirmed that LLLT increases osteocyte quantity; however, little research has been conducted to determine the effect of LLLT on the treatment of human bone fractures. METHODS In this study, the therapeutic outcomes of administering 830 nm LLLT to treat CBFs in the wrist or hand were examined. Fifty patients with CBFs in the wrist and hand, who had not received surgical treatment, were recruited and randomly assigned to two groups. The laser group underwent a treatment program in which 830 nm LLLT (average power 60 mW, peak power 8 W, 10 Hz, 600 sec, and 9.7 J/cm(2) per fracture site) was administered five times per week for 2 weeks. Participants in a placebo group received sham laser treatment. The pain, functional disability, grip strength, and radiographic parameters of the participants were evaluated before and after treatment and at a 2-week follow-up. RESULTS After treatment and at the follow-up, the laser group exhibited significant changes in all of the parameters compared with the baseline (p<0.05). The results of comparing the two groups after treatment and at the follow-up indicated significant between-group differences among all of the parameters (p<0.05). CONCLUSIONS LLLT can relieve pain and improve the healing process of CBFs in the human wrist and hand.
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Affiliation(s)
- Wen-Dien Chang
- 1 Department of Sports Medicine, China Medical University , Taichung City, Taiwan (R.O.C)
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47
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Tengrungsun T, Mitrirattanakul S, Buranaprasertsuk P, Suddhasthir T. Is Low Level Laser Effective for the Treatment of Orofacial Pain?: A Systematic Review. Cranio 2014; 30:280-5. [DOI: 10.1179/crn.2012.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Tasanee Tengrungsun
- Dept. of Advanced General DentistryFaculty of Dentistry, Mahidol University, 6 Yothee Street, Bangkok 10400, Thailand,
| | - Somsak Mitrirattanakul
- Dept. of Advanced General DentistryFaculty of Dentistry, Mahidol University, 6 Yothee Street, Bangkok 10400, Thailand,
| | - Phonlakorn Buranaprasertsuk
- Dept. of Advanced General DentistryFaculty of Dentistry, Mahidol University, 6 Yothee Street, Bangkok 10400, Thailand,
| | - Theeralaksna Suddhasthir
- Dept. of Advanced General DentistryFaculty of Dentistry, Mahidol University, 6 Yothee Street, Bangkok 10400, Thailand,
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48
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Carrasco TG, Guerisoli LDC, Guerisoli DMZ, Mazzetto MO. Evaluation of Low Intensity Laser Therapy In Myofascial Pain Syndrome. Cranio 2014; 27:243-7. [DOI: 10.1179/crn.2009.035] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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49
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Madani AS, Ahrari F, Nasiri F, Abtahi M, Tunér J. Low-level laser therapy for management of TMJ osteoarthritis. Cranio 2014; 32:38-44. [DOI: 10.1179/0886963413z.0000000004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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50
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Evaluation of pain, jaw movements, and psychosocial factors in elderly individuals with temporomandibular disorder under laser phototherapy. Lasers Med Sci 2013; 30:953-9. [PMID: 24366293 DOI: 10.1007/s10103-013-1514-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
Abstract
Few studies have been carried out on the application of laser phototherapy (LPT) for treating painful temporomandibular disorder (TMD) in elderly population that is growing worldwide. The aim of the present study was to evaluate the pain, jaw movements, and psychosocial factors in ten elderly patients with painful TMD before and after LPT. All patients were evaluated before and after LPT by using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) axes I and II. For pain assessment, a visual analogue scale (VAS) was used. The LPT was carried out with an GaAlAs diode laser (780 nm; spot size 0.04 cm(2)) in punctual and contact mode. Two settings of irradiations were applied as follows: in patients presenting myofascial pain, 10 mW, 5 J/cm(2), 20 s, 0.2 J per application point; and in patients with joint TMD, 70 mW, 105 J/cm(2), 60 s on five points, 4.2 J per point. Two sessions of LPT were carried out per week over four consecutive weeks, in the total of eight sessions. Data was statistically analyzed (p < 0.05). Significant pain reduction was found in all patients. There were increase in maximum mouth opening without pain and reduction in muscle pain during right and left lateral excursion. A significant reduction in chronic pain severity (p = 0.02) and significant improvements in depression (p = 0.038) and nonspecific physical symptoms with pain (p = 0.0167) were observed. The present findings indicate that LPT is able to promote pain relief and improvement of jaw movements in elderly patients with TMD, with a positive effect on psychosocial aspects.
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