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Ahrari F, Shafaee H, Haghpanahi M, Bardideh E. Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement : A randomized clinical trial. J Orofac Orthop 2024; 85:198-207. [PMID: 38683401 DOI: 10.1007/s00056-024-00526-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/16/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement. METHODS This randomized, parallel-group, single-blind clinical trial included 60 female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group 1 took ibuprofen (400 mg), whereas those in group 2 received LLLT (808 nm, 200 mW, 2 J/cm2) on both buccal and lingual sides of the teeth. In group 3 (LAT), the laser (808 nm, 200 mW, 24 J/cm2) was applied bilaterally to acupuncture points (SI 18, ST 6, LI 4, SJ 2, and SJ 5). Subjects in group 4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using a visual analogue scale (VAS). RESULTS The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to a negligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05). CONCLUSIONS With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients. TRIAL REGISTRATION IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121.
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Affiliation(s)
- Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd Melat Park Square, Mashhad, Iran
| | - Hooman Shafaee
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd Melat Park Square, Mashhad, Iran.
| | - Melika Haghpanahi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Erfan Bardideh
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd Melat Park Square, Mashhad, Iran
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Puvvada S, Kasiviswanathan M, Kishore P, Jose EC, Vigna Dutt P, Parameshwaran A, Kumar A, Prasad K, Sangeetha G. Role of Low-Level Laser Therapy in the Management of Temporomandibular Joint Arthralgia. Indian J Otolaryngol Head Neck Surg 2024; 76:3412-3417. [PMID: 39130227 PMCID: PMC11306669 DOI: 10.1007/s12070-024-04705-9] [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: 03/25/2024] [Accepted: 04/12/2024] [Indexed: 08/13/2024] Open
Abstract
To study the efficacy of low-level laser therapy in the management of temporomandibular joint arthralgia. Design Interventional study (pre-post study), Setting Meenakshi Medical College And Hospital, Research Institute. Subjects 50 patients with temporomandibular joint arthralgia were evaluated for pain, mouth opening and clicking sound while mouth opening before and after treatment. Method Patients are subjected to undergo low-level laser therapy with Infrared and red rays with a therapeutic dosage ranging from 8 J/cm2 to 15 J/cm2 up to 3-5 sessions for a month each session lasts for 15-20 min. The patients are to be followed up regularly after 1, 3, 6 and 8 months in the study.The study measured the range of mouth opening in patients before and after undergoing low-level laser therapy. Before treatment, the range of mouth opening was from 2.78 to 3.97 cm, with a mean value of 2.78 cm and a standard deviation of 0.22. After treatment, the range of mouth opening was from 2.78 to 3.97 cm, with a mean value of 3.97 cm and a standard deviation of 0.24. The study also measured the VAS score for pain, with a mean and standard deviation of 7.9 ± 0.73 before treatment and 0.88 ± 0.718 after treatment. There was a significant difference between the pretreatment and post-treatment VAS scores, with a P-value of 0.05. Low-level laser therapy is an effective non invasive treatment modality for temporomandibular joint arthralgia. The patients who underwent this procedure had symptomatic relief and no remissions were observed.
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Affiliation(s)
- Sravanthi Puvvada
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Muthubabu Kasiviswanathan
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - P. Kishore
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Eliza chinna Jose
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - P. Vigna Dutt
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - A. Parameshwaran
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Ashwin Kumar
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Krishna Prasad
- Department of Otorhinolaryngology, Meenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - G. Sangeetha
- Department of Physical Medicine and RehablitationMeenakshi Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Chennai, India
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Al-Moraissi EA, Almaweri AA, Al-Tairi NH, Alkhutari AS, Grillo R, Christidis N. Treatments for painful temporomandibular disc displacement with reduction: a network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg 2024; 53:45-56. [PMID: 37802670 DOI: 10.1016/j.ijom.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
There is currently no consensus on the best treatment for painful temporomandibular disc displacement with reduction (DDwR), and no network meta-analysis of randomized clinical trials (RCTs) comparing all types of treatment for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), manual therapy, no treatment (control), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection of platelet-rich plasma (Arthro-PRP) or hyaluronic acid (Arthro-HA), and Arthro plus occlusal splint. Predictor variables were pain intensity and maximum mouth opening (MMO). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. Twenty RCTs reporting 1107 patients were identified in the literature search; 980 of these patients were included in the network meta-analysis. Direct meta-analysis showed that Arthro-PRP significantly reduced pain intensity compared to Arthro alone, while occlusal splint and manual therapy were superior to conservative treatment (all very low quality evidence). Arthro with intra-articular injection of PRP/HA ranked as the most effective treatment in terms of pain reduction, whereas LLLT ranked the best choice for increasing MMO for patients with DDwR. However, it is important to note that the evidence for the superiority of these treatments is generally of very low quality. Therefore, further high-quality research is needed to confirm these findings and provide more reliable recommendations for the treatment of DDwR.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - A A Almaweri
- Department of Oral Medicine, Thamar University, Thamar, Yemen
| | - N H Al-Tairi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - A S Alkhutari
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - R Grillo
- Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - N Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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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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Ferrillo M, Nucci L, Giudice A, Calafiore D, Marotta N, Minervini G, d'Apuzzo F, Ammendolia A, Perillo L, de Sire A. Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis. Cranio 2022:1-17. [PMID: 36148997 DOI: 10.1080/08869634.2022.2126079] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD). METHODS PubMed, Scopus, and Web of Science were systematically searched until January 1st, 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome. RESULTS Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 [0.17, 1.34], reporting splint appliance and laser therapy as significantly effective treatments. CONCLUSION Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Ludovica Nucci
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Minervini
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Letizia Perillo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Can Photobiomodulation Support the Management of Temporomandibular Joint Pain? Molecular Mechanisms and a Systematic Review of Human Clinical Trials. PHOTONICS 2022. [DOI: 10.3390/photonics9060420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to point out the correlation between photobiomodulation (PBM) targets and effects and management of temporomandibular disorders (TMDs) pain using diode lasers with infrared wavelengths ranging from 780 up to 980 nanometers (nm). A systematic search of multiple electronic databases was done to identify the clinical trials published between 1st January 2010 and 18th December 2021. The included studies were limited to human subjects who had TMD pain, involving two genders with age > 18 years, and were treated with PBM using a diode laser (780–980 nm) as a non-pharmacological therapy to decrease the intensity of the pain associated to TMDs. The risk of bias for included studies was assessed using the Cochrane RoB tool (for randomized studies). The methodologic quality was rated using the Delphi list. The findings suggest that PBM is an effective tool in alleviating TMDs’ pain and increasing the range of movement in patients with Axis 1 of TMDs. However, TMDs’ pain related to underlying pathology cannot be solely treated by PBM. The causative factors must be treated first. Studies displaying the highest quality Delphi score may represent a suggested PBM therapy protocol to follow for TMDs pain management.
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Ebrahimi M, Changiz S, Makarem A, Ahrari F. Clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) partial pulpotomy with low power or high power diode laser irradiation in deciduous molars: a randomized clinical trial. Lasers Med Sci 2022; 37:2293-2303. [PMID: 35075598 DOI: 10.1007/s10103-022-03503-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/03/2022] [Indexed: 12/31/2022]
Abstract
This study investigated the clinical and radiographic effectiveness of MTA partial pulpotomy with low power or high power diode laser irradiation in primary molars. In this randomized single-blind clinical trial, 63 mandibular second molars were assigned into three groups (n = 21). After pulp amputation and achieving hemostasis, MTA was placed over pulp stumps in group 1 (MTA). The patients in groups 2 (LLLT-MTA) and 3 (DL-MTA) underwent low level (660 nm, 200 mW) and high power (810 nm, 1 W) diode laser radiation prior to MTA placement, respectively. The occurrence of clinical failure (spontaneous pain, tenderness upon percussion, swelling, fistula, mobility) and radiographic failure (periodontal ligament widening, external or internal root resorption, periapical or furcal radiolucency) was recorded up to 18 months after therapy. MTA and LLLT-MTA groups showed clinical success rate of 100% throughout the experiment. The clinical success rate of DL-MTA group was 95.2%, 95.2%, and 87.5% after 6, 9, and 18 months. The radiographic success rates were 90.5%, 90.5%, and 87.5% in the MTA group; 100%, 95.2%, and 88.2% in the LLLT-MTA group, and 85.7%, 76.2%, and 68.7% in the DL-MTA group, at 6-, 9-, and 18-month follow-ups, respectively. No significant differences were found in the frequency of clinical or radiographic failure among the groups at any interval (p > 0.05). MTA partial pulpotomy was a suitable technique for vital pulp therapy in deciduous teeth. The addition of low power or high power diode laser radiation to the procedure did not cause a significant difference in success rate values.
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Affiliation(s)
- Masoumeh Ebrahimi
- Dental Material Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sima Changiz
- Department of Pediatric dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Makarem
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083821] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Temporomandibular disorders (TMD) are primarily characterized by pain as well as issues concerning the proper functioning of individual elements of the stomatognathic system. The aim of the study was to assess the safety and efficacy of physical exercise, with or without radial Extracorporeal Shock Wave Therapy (rESWT), in patients with TMD. Eligible patients were adults (≥18 years) with diagnosed myofascial pain with or without mouth opening limitation (Group Ia, Ib) based on the Diagnostic Criteria for TMD (DC/TMD). Enrolled patients (n = 15) were randomly assigned 1:1 to receive physical exercise combined with rESWT (n = 8) or sham rESWT (n = 7) for four weeks. The primary endpoint was the pain intensity measured by a visual analogue scale (VAS). The secondary endpoints were muscle activity and function assessed through the surface electromyography evaluation of the anterior temporalis and the masseter muscles. The rESWT group (mean age: 28.50 ± 8.85 years) showed a statistically significant pain reduction (VAS Right side: ΔT0-T1 MD = −3.00; p = 0.023, Left side: ΔT0-T1, MD = 3.57, p = 0.021), whereas patients in the sham WBV group (mean age: 30.71 ± 8.98 years), did not reach statistical significance (VAS: Right side: ΔT0-T1 MD = 1.00, p = 0.155; Left side: ΔT0-T1 MD = 1.25 SE = 0.25, p = 0.094). Concurrently, muscle activity and performance significantly improved in the active rESWT group, with an improvement in the percentage of the overlapping coefficient (POC) compared to the control group. No dropouts and no side effects were recorded. Taken together, the findings of this pilot RCT suggested that rESWT combined with physical therapy could be effective in relieving pain and improving function in muscle-related TMD patients.
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Argueta-Figueroa L, Flores-Mejía LA, Ávila-Curiel BX, Flores-Ferreyra BI, Torres-Rosas R. Nonpharmacological Interventions for Pain in Patients with Temporomandibular Joint Disorders: A Systematic Review. Eur J Dent 2022; 16:500-513. [PMID: 35259762 PMCID: PMC9507562 DOI: 10.1055/s-0041-1740220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This systematic review aimed to compare the efficacy of nonpharmacological therapies for painful temporomandibular joint disorders. The protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020171364). The search was performed on the electronic databases PubMed, Google Scholar, Clinical Trials, and Web of Science. The eligibility criteria were randomized controlled trials in patients diagnosed with painful temporomandibular joint disorders comparing the pain relief between conventional treatment and nonpharmacological therapies such as acupuncture, physiotherapy, low-level laser, and massage. Fourteen articles were included in this review. At the overall bias of the studies included, 71.42% exhibited some concerns and 28.57% had high risk. The efficacy of nonpharmacological interventions was found to be moderate in the short term and variable in the long term for pain reduction in patients with temporomandibular joint disorders. The evidence pointed out that acupuncture, laser therapy, and physiotherapy are potentially useful interventions for pain relief in patients with temporomandibular joint disorders. However, there is a lack of consistency and short-term follow-up in the studies to determine the lasting of such effect.
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Affiliation(s)
- Liliana Argueta-Figueroa
- CONACyT - Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca, México
| | | | - Beatriz Xóchitl Ávila-Curiel
- Laboratorio de Medicina Complementaria, Centro de Estudios en Ciencias de la Salud y la Enfermedad, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca Oaxaca, México
| | | | - Rafael Torres-Rosas
- Laboratorio de Medicina Complementaria, Centro de Estudios en Ciencias de la Salud y la Enfermedad, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca Oaxaca, México
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Shousha T, Alayat M, Moustafa I. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: A randomized-controlled study. PLoS One 2021; 16:e0258063. [PMID: 34597318 PMCID: PMC8486092 DOI: 10.1371/journal.pone.0258063] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022] Open
Abstract
Background Low level lasers have been used as an alternative pain relief therapy for muscle and joint pain, since it induces analgesic, anti-inflammatory, and biomodulation effects of the physiological cell functions. The effectiveness of low-level laser therapy in temporomandibular joint dysfunction (TMD) treatment, however, is not well established. Although Surface electromyography (sEMG) has been suggested as a complementary means in TMD diagnosis, the effect of conservative treatments on muscle activity has not yet been thoroughly correlated with (sEMG) findings. Purpose To assess the efficacy of low-level laser therapy (LLLT) as compared to occlusive splint therapy (OST) on the TMJ opening index (TOI) and sEMG of masticatory muscles. Materials and methods 112 female subjects suffering from unilateral myogenous TMD, aged 21–30 years-old, were recruited and divided into three groups: LLLT; soft occlusive splint therapy OST and a waitlist group as controls. Outcome measures TMJ opening index (TOI), Visual analogue scale (VAS), surface electromyography (sEMG). Results A significant reduction was reported in TOI, VAS and the sEMG within the LLLT and OST groups as well as significant decrease in all outcomes between groups in favor of the LLLT group (P< 0.0001). Meanwhile, there was a weak significant difference within the control group probably attributed to the analgesic. Post-hoc pairwise comparisons between groups [control vs occlusive splints, control vs low-level laser and low-level laser vs occlusive splints] revealed significant differences in the VAS and TOI [P = 0.0001; 95% CI: 0.9–2.2, 1.61–4.01, 0.65–1.96]. Conclusions Findings support an evident short term therapeutic effect of the LLLT on improving VAS, TOI and sEMG in females suffering from myogenous TMD.
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Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- * E-mail:
| | - Mohamed Alayat
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, KSA
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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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: 25] [Impact Index Per Article: 8.3] [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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Duarte de Oliveira FJ, Brasil GMLC, Araújo Soares GP, Fernandes Paiva DF, de Assis de Souza Júnior F. Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis. J Craniomaxillofac Surg 2021; 49:1088-1096. [PMID: 34217567 DOI: 10.1016/j.jcms.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022] Open
Abstract
This Systematic Review and Meta-analysis was conducted with the following PICOS question: patients undergoing third molar surgery (P) can benefit from low-intensity laser therapy (I) as compared to other postoperative management (C) to reduce pain, edema, and trismus (O), evaluated in previous randomized clinical trials (S). Databases used were PubMed, SCOPUS, Web of Science, and Biblioteca Virtual em Saúde, screening for studies published between 2015 and 2020. The meta-analysis was based on the standardized mean difference (SMD), under a 95% confidence interval (CI). 246 studies were initially included, and after the screening of data, 10 studies were selected for the final sample. The qualitative analysis resulted in favorable results for pain and edema management in most studies, whereas trismus remained controversial. Meta-analysis resulted in (SMD, -0.53; 95% CI, -0.82,-0.24), (SMD, -0.60; 95% CI, -0.81,-0.39), and (SMD, -0.62; 95% CI, -2.63, 1.39) for pain, edema, and trismus, respectively, indicating statistical success on pain and edema reduction, but not for trismus. LLLT can act on reducing postoperative pain and edema following third molar surgery, whereas, trismus remains not significantly changed.
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Moeintaghavi A, Ahrari F, Nasrabadi N, Fallahrastegar A, Sarabadani J, Rajabian F. Low level laser therapy, Er,Cr:YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: A randomized clinical trial. Lasers Med Sci 2021; 36:1949-1956. [PMID: 33881673 DOI: 10.1007/s10103-021-03310-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
This clinical trial aimed to compare the effects of low-level laser therapy (LLLT), Er,Cr;YSGG laser, and fluoride varnish, as compared to the placebo laser on decreasing dentin hypersensitivity (DH). This randomized, double-blinded clinical trial included 60 jaw quadrants in 24 patients who underwent periodontal surgery. The quadrants were randomly assigned to 4 groups and received treatments as follows. Group 1: LLLT with a combination of red and infrared wavelengths, group 2: Er,Cr:YSGG laser (0.25 W and 0.5 W), group 3: fluoride varnish, and group 4: placebo laser. The sensitivity response to the cold spray was recorded using visual analogue scale (VAS) at baseline, immediately, and 1 week post-treatment. The data were analyzed by repeated measures analysis at the significance level of P<0.05. There was a significant reduction in DH after treatment by low-level lasers, Er,Cr:YSGG laser, or fluoride varnish compared to the baseline data (P<0.05), but the placebo group displayed no significant alteration in DH (P=0.069). At 1 week, the VAS score in the Er,Cr:YSGG laser group was significantly lower than that of the LLLT (P= 0.043) and placebo (P<0.001) groups. Furthermore, the subjects who received fluoride varnish exhibited significantly lower DH compared with the placebo group (P = 0.023). Er,Cr:YSGG laser was the most effective strategy in dealing with DH, as it caused the greatest pain reduction over the study period and showed a significant superiority over LLLT and placebo groups. Alternatively, the application of fluoride varnish could be recommended for attenuating DH following periodontal surgery.
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Affiliation(s)
- Amir Moeintaghavi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran.
| | - Nahid Nasrabadi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Javad Sarabadani
- Oral and Maxillofacial Disease Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Rajabian
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
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Chen CH, Huang CY, Chang CY, Cheng YF. Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Brain Sci 2020; 10:brainsci10120931. [PMID: 33276501 PMCID: PMC7761002 DOI: 10.3390/brainsci10120931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
STUDY OBJECTIVE Tinnitus is a common disorder characterized by sound in the ear in the absence of external or internal stimuli. Low-level laser therapy (LLLT) was discovered enhancing tissue repair via increasing the blood microcirculation and cell proliferation in 1960s. In the last two decades, LLLT delivered to the cochlea has frequently been used to reduce the severity of tinnitus. However, whether LLLT effectively attenuates the severity of tinnitus remains controversial. We aimed to evaluate the efficacy of low-level laser therapy on adult patients with complaints of tinnitus. DESIGN Systematic review and meta-analysis with trial sequential analysis. INTERVENTIONS Low-level laser therapy (LLLT). MEASUREMENTS Tinnitus Handicap Inventory (THI) score; improvement rates of the visual analog scale (VAS), verbal rating scale (VRS) and numeric rating scale (NRS) scores. METHODS We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception through 17 September 2020. Randomized control trials that involved adult patients with complaints of tinnitus, compared LLLT to a placebo and provided sufficient information for meta-analysis were considered eligible. MAIN RESULTS Overall, 11 studies involving 670 patients were included. No significant difference in the overall effect according to the THI score (mean difference (MD), -2.85; 95% CI, -8.99 to 3.28; p = 0.362; I2 = 0%) and the rating scale score improvement rate (risk ratio (RR), 1.35; 95% CI, 0.81 to 2.27; p = 0.250; I2 = 67%) was demonstrated between patients receiving LLLT and those receiving a placebo. None of the subgroup analyses showed significant differences, regardless of underlying sensorineural hearing loss, the number of irradiation sessions or the wavelength used. CONCLUSIONS Our meta-analysis suggests that the value of LLLT in controlling the severity of tinnitus remains unclear, in part due to the relatively small number of patients and underlying heterogeneity. More large-scale investigations of LLLT for tinnitus related to inner ear disease are required to further elucidate the therapeutic effects.
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Affiliation(s)
- Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
- Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Chun-Yu Chang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan;
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
- Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-2-2871-2121 (ext. 1292)
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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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Yanik S, Polat ME, Polat M. Effects of arthrocentesis and low-level laser therapy on patients with osteoarthritis of the temporomandibular joint. Br J Oral Maxillofac Surg 2020; 59:347-352. [PMID: 33280948 DOI: 10.1016/j.bjoms.2020.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
This retrospective study examined whether arthrocentesis combined with 10 sessions of low-level laser therapy (LLLT) improved the clinical outcomes of patients with temporomandibular joint osteoarthritis (TMJ-OA) compared with arthrocentesis alone. Data from two groups of patients (total: n=36) with unilateral TMJ-OA were evaluated. The groups were established according to their treatment regimens: Group 1 (arthrocentesis alone; n=19) and Group 2 (arthrocentesis plus LLLT; n=17). All patients had been diagnosed in accordance with the Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) (Axis I Group IIIb) protocol. They all underwent the same arthrocentesis protocol, but those in Group 2 also received 10 sessions of LLLT immediately afterwards. The outcome variables were the visual analogue scale scores (VAS 1, VAS 2) for various treatment outcomes and millimetric measurements of mandibular movements over both the short and long term. Intra-group comparisons showed significant short and long-term improvements for both groups, but outcomes were better over the long term than the short term in both. In addition, greater improvements in muscle palpation scores and mandibular movements were achieved in Group 2 than in Group 1. In conclusion, although both techniques improved joint pain and function, a combination with LLLT seemed to have an additional benefit for myofascial components.
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Affiliation(s)
- S Yanik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kahramanmaras Sutcu Imam University, 46040 Kahramanmaras, Turkey.
| | - M E Polat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey.
| | - M Polat
- Department of Orthodontics, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey
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Ahrari F, Eshghpour M, Zare R, Ebrahimi S, Fallahrastegar A, Khaki H. Effectiveness of Low-Level Laser Irradiation in Reducing Pain and Accelerating Socket Healing After Undisturbed Tooth Extraction. J Lasers Med Sci 2020; 11:274-279. [PMID: 32802287 DOI: 10.34172/jlms.2020.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: This study aimed to determine the effect of low-level laser therapy (LLLT) on reducing complications following tooth extraction. Methods: This randomized clinical trial consisted of 40 subjects who underwent lower molar extraction. The patients were randomly assigned to 4 groups. Group 1 was irradiated with a 660 nm laser (200 mW, 30 seconds radiation to lingual, buccal and occlusal surfaces of the socket, 6 J/area). In group 2, an 810 nm laser was applied similar to group 1. In group 3, a combination of 660 and 810 nm lasers was used. The patients in group 4 served as a placebo group. LLLT was performed after 0.5-1 hour of extraction and 2 days later. The participants were asked to record pain degree using a visual analogue scale (VAS) over 7 days. The amount of wound healing was evaluated on the third and seventh days. Results: There was no significant difference in pain scores among the groups at any of the assessment intervals (P >0.05). The between-group differences in wound healing scores were small and insignificant (P >0.05). Conclusion: LLLT with 660 nm or 810 nm lasers or their combination had no greater effect than the placebo laser for reducing the complications of tooth extraction.
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Affiliation(s)
- Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Eshghpour
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare
- Oral & Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Ebrahimi
- Department of Operative Dentistry, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan/Branch), Isfahan, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Evaluation the effects of low-level laser therapy on disc displacement with reduction. Turk J Phys Med Rehabil 2020; 66:24-30. [PMID: 32318671 DOI: 10.5606/tftrd.2020.3355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/04/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the effects of additional low-level laser therapy (940 nm GaAlAs) to the routine occlusal splint therapy on maximal mouth opening (MMO), visual analog scale (VAS) scores, and passive mouth opening (PMO). Patients and methods Between January 2016 and March 2018, a total of 40 patients (10 males, 30 females; mean age 22.35 years; range, 18 to 60 years) with disc displacement with reduction of the temporomandibular joint were included. The patients were divided into two groups. Group 1 (control group, n=20) received routine non-steroidal anti-inflammatory drug (NSAID) therapy and occlusal splint therapy for eight hours per day for a total of three months. Group 2 (laser group, n=20) received NSAID, occlusal splint therapy and 940 nm wavelength diode laser therapy for two sessions per week for a total of four weeks. The MMO, PMO, and VAS scores were recorded before and at one, two, three, four, and 12 weeks after treatment. The joint and muscle examinations were performed. Results A constant decrease was found in the VAS scores in both groups. At four (p=0.008) and 12 weeks (p=0.003), a statistically significant difference in the VAS scores was observed. At all time points, PMO and MMO scores increased in both groups. The MMO scores were statistically higher in the laser group at all time points (p<0.005). Conclusion Our study results suggest that short-term low-level laser therapy additional to conventional treatment may yield satisfactory outcomes.
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Yamaner FE, Celakil T, Gökcen Roehlig B. Comparison of the efficiency of two alternative therapies for the management of temporomandibular disorders. Cranio 2020; 40:189-198. [DOI: 10.1080/08869634.2020.1727667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Tamer Celakil
- Department of Prosthodontics, Istanbul University, Istanbul, Turkey
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Effects of Light Therapy on Osteoarthritis and Its Sequelae in Aging and Older Adults. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tunér J, Hosseinpour S, Fekrazad R. Photobiomodulation in Temporomandibular Disorders. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:826-836. [DOI: 10.1089/photob.2019.4705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jan Tunér
- Private Practice, Swedish Laser Medical Society (SLMS), Stockholm, Sweden
| | | | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Khairnar S, Bhate K, S N SK, Kshirsagar K, Jagtap B, Kakodkar P. Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain. J Dent Anesth Pain Med 2019; 19:289-294. [PMID: 31723669 PMCID: PMC6834715 DOI: 10.17245/jdapm.2019.19.5.289] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/26/2019] [Accepted: 10/05/2019] [Indexed: 12/03/2022] Open
Abstract
Background Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods This prospective study included 42 patients (age range, 25–45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.
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Affiliation(s)
- Sanyukta Khairnar
- Department of Oral & Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Kalyani Bhate
- Department of Oral & Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Santhosh Kumar S N
- Department of Oral & Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Kapil Kshirsagar
- Department of Oral and Maxillofacial Surgery, D Y Patil Dental School, Charoli Bk, Pune, India
| | - Bhagyashree Jagtap
- Department of Oral & Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Pradnya Kakodkar
- Department of Oral & Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
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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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Porporatti AL, Costa YM, Réus JC, Stuginski-Barbosa J, Conti PCR, Velly AM, De Luca Canto G. Placebo and nocebo response magnitude on temporomandibular disorder-related pain: A systematic review and meta-analysis. J Oral Rehabil 2019; 46:862-882. [PMID: 31155735 DOI: 10.1111/joor.12827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/26/2019] [Accepted: 05/28/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The aim of this systematic review (SR) was to answer the following question: "In adult patients with temporomandibular disorder (TMD)-related pain, what is the placebo or nocebo effect of different therapies?" METHODS A SR was performed with randomised clinical placebo-controlled trials on diagnosed painful TMD studies from five main databases and from three grey literature. Studies included must have sample older than 18 years, with painful TMD, which diagnosis was done by Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD). RESULTS Out of 770 articles obtained, 42 met the inclusion criteria for qualitative and 26 for quantitative analysis. Meta-analysis indicated mean variation on pain intensity for placebo therapy was higher on laser acupuncture with 45.5 mm point reduction, followed by avocado soya bean extract with 36 mm and amitriptyline 25 mg with 25.2 mm. Laser showed a 29% of placebo effect, as well medicine with 19% and other therapies with 26%. Possible nocebo effect of 8% pain increase was found for intra-articular injection of Ultracain. CONCLUSIONS Based on the available data, the placebo response could play a major effect on TMD pain management and may be responsible from 10% to 75% of pain relief. Laser acupuncture, avocado soya bean and amitriptyline promoted the higher placebo effect. Possible nocebo effect was found only for Ultracain injection with 8%. CLINICAL RELEVANCE Clinicians could apply such evidence to optimise pain management and judgement about treatment efficacy, and researches may find it useful when designing their investigations.
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Affiliation(s)
- André Luís Porporatti
- Brazilian Centre for Evidence Based Research, Dentistry Department, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Yuri Martins Costa
- Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Jéssica Conti Réus
- Dentistry Department, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Ana Míriam Velly
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence Based Research, Dentistry Department, Federal University of Santa Catarina, Florianópolis, Brazil
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Fangel R, Vendrusculo-Fangel LM, Albuquerque CPD, Parizotto NA, Paz CCDSC, Matheus JPC. Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) can reduce, modulate inflammation, and reduce deformities. Low-Level Laser Therapy is a biomodulator and may aid in the clinical picture of these conditions. Objective: To analyze the parameters most frequently used to determine the responses of patients with RA and OA in controlled and uncontrolled clinical trials. Method: This is a systematic review with search of articles in English, Portuguese and Spanish in PUBMED, SCOPUS, LILACS and Web of SCIENCE, of articles published between 2006 and 2018. MeSH terms were used. Inclusion criteria: evaluation of LLLT in the evaluations, evaluation and evaluation of the period, controlled and uncontrolled clinical trials, full publications. The base date of the energy dosimetry and the analysis of mean, median and mode of energy per point and energy per treatment. Results: Three articles on RA and 16 on OA were included in this study. Regarding dosimetry, it was one of the most recent of the pain, being this one with a greater energy dose. In OA, most of the articles presented are of importance, with variability in the dosage applied. Conclusion: There are several reports for patient studies purposes, mainly with doses of 6 J per point and 48 J. In the joints affected with OA and AR, it would be important to publish more scientific articles with better methodological quality and description of dosimetry.
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Affiliation(s)
- Renan Fangel
- Centro Universitário EuroAmericano, Brazil; Universidade de Brasília, Brazil
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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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Borges RMM, Cardoso DS, Flores BC, da Luz RD, Machado CR, Cerveira GP, Daitx RB, Dohnert MB. Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci 2018; 33:1859-1866. [DOI: 10.1007/s10103-018-2533-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/03/2018] [Indexed: 12/21/2022]
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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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Manfredini D, Favero L, Cocilovo F, Monici M, Guarda-Nardini L. A comparison trial between three treatment modalities for the management of myofascial pain of jaw muscles: A preliminary study. Cranio 2017; 36:327-331. [PMID: 28697676 DOI: 10.1080/08869634.2017.1349571] [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
OBJECTIVES To compare three treatment modalities for the management of myofascial pain of jaw muscles. METHODS Thirty (N = 30) patients with low pain-related impairment were randomly assigned to receive laser therapy (LST), oral appliance therapy (OA), or counseling (CSL). Visual Analog Scale (VAS) pain levels and the Muscular Index (MI) of the Craniomandibular Index were the outcome variables, which were assessed at baseline, at three weeks, three months, and six months. RESULTS At six months, improvement in the MI was maintained both in the LST (p = .025) and OA groups (p < .001). As for VAS values, positive changes were still shown for LST (p = .001), and were also shown for the OA (p = .002) and CSL groups (p = .048). CONCLUSIONS Despite differences in the short-term effectiveness of LST and OA, with respect to CSL alone, all three treatment groups improved at six months. This suggests that active treatments should be directed to maximize the positive changes in the short-term period.
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Affiliation(s)
| | - Lorenzo Favero
- a School of Dentistry, University of Padova , Padova , Italy
| | | | - Monica Monici
- b ASA Campus Joint Laboratory, ASA Research Division, Department of Experimental and Clinical Biomedical Sciences , University of Florence , Florence , Italy
| | - Luca Guarda-Nardini
- c Department of Dentistry and Maxillofacial Surgery , Treviso Hospital , Treviso , Italy
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Is Low-Level Laser Therapy Effective for Treatment of Neurosensory Deficits Arising From Sagittal Split Ramus Osteotomy? J Oral Maxillofac Surg 2017; 75:2085-2090. [PMID: 28495411 DOI: 10.1016/j.joms.2017.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/25/2017] [Accepted: 04/01/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE This study investigated the effectiveness of low-level laser therapy (LLLT) for treating neurosensory impairment after bilateral sagittal split osteotomy (BSSO). MATERIALS AND METHODS This randomized, double-blinded, split-mouth trial included patients requiring BSSO. After surgery, 1 side of each patient was randomly assigned to laser therapy and the other side served as the control. At 24, 48, and 72 hours after surgery, LLLT was accomplished by intraoral application of a 660-nm laser around the surgical site (200 mW, 10 seconds, 2 J, 1.5 J/cm2) followed by extraoral irradiation by an 810-nm laser (200 mW, 10 seconds, 2 J, 7 J/cm2) along the distribution of the inferior alveolar nerve. Subsequently, extraoral irradiation was repeated 2 times per week for 3 weeks along the path of the inferior alveolar nerve, lower lip, and chin. On the control side, the treatment was similar to the laser side but with laser simulation. The main outcome was assessing nerve damage by a "2-point discrimination test" before and up to 60 days after surgery. RESULTS The sample consisted of 16 patients. No significant difference was found between the laser and control sides before and after surgery and on postoperative days 15 and 30 (P > .05). The 2-point discrimination distance was significantly shorter on the laser side than on the control side on postoperative days 45 and 60 (P < .05). CONCLUSION LLLT was effective in the treatment of neurosensory disturbances arising from BSSO. Therefore, LLLT can be recommended to accelerate the recovery of sensory aberrations in patients undergoing BSSO.
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Bidar M, Moushekhian S, Gharechahi M, Talati A, Ahrari F, Bojarpour M. The Effect of Low Level Laser Therapy on Direct Pulp Capping in Dogs. J Lasers Med Sci 2016; 7:177-183. [PMID: 28144439 DOI: 10.15171/jlms.2016.31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The aim of this study was to determine the histologic effect of low level laser therapy (LLLT) with or without the use of mineral trioxide aggregate (MTA) on exposed pulp tissues of dogs. Methods: Twenty-five premolar teeth in three healthy mature dogs were randomly divided into five groups. In group 1, the pulp tissue was capped with MTA. In groups 2 and 3, before capping with MTA, the exposure site was irradiated by low power lasers at 630 nm (20 mW, 150 seconds, 7.5 J/cm2) and 810 nm (peak power 80 W, average power 50 mW, 1500 Hz, 50 seconds, 6.25 J/cm2) wavelengths, respectively. In groups 4 and 5, the exposure site was irradiated similar to that described in groups 2 and 3, but the pulp tissue was covered by gold foil instead of MTA. After 2 months, the animals were sacrificed and the samples were prepared for histologic evaluation. Results: There were differences in pulpal response and dentinal barrier formation among the study groups. The morphology of pulpal tissue and the integrity of dentinal barrier and formation of odontoblastic layer were more favorable in the first three groups. The occurrence of extensive and intense inflammation and necrosis was more frequent in groups 4 and 5. Conclusion: Under the conditions used in this study, the presence of MTA as a pulp capping material was more important than laser therapy in the success of direct pulp capping (DPC) treatment. MTA proved to be an effective material either alone or in combination with laser irradiation in vital pulp therapy.
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Affiliation(s)
- Maryam Bidar
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Siavash Moushekhian
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Gharechahi
- Dental Materials Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talati
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Ahrari
- Laser Research Center, Department of Orthodonthics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery? J Oral Maxillofac Surg 2016; 74:1322.e1-8. [DOI: 10.1016/j.joms.2016.02.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/30/2016] [Accepted: 02/27/2016] [Indexed: 11/19/2022]
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Conti PCR, Costa YM, Gonçalves DA, Svensson P. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements? J Oral Rehabil 2016; 43:702-15. [DOI: 10.1111/joor.12410] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 12/12/2022]
Affiliation(s)
- P. C. R. Conti
- Department of Prosthodontics; Bauru School of Dentistry; University of São Paulo; Bauru Brazil
- Bauru Orofacial Pain Group; University of São Paulo; Bauru Brazil
| | - Y. M. Costa
- Bauru Orofacial Pain Group; University of São Paulo; Bauru Brazil
- Section of Head and Face Physiology; Department of Biological Sciences; Bauru School of Dentistry; University of São Paulo; Bauru Brazil
| | - D. A. Gonçalves
- Department of Dental Materials and Prosthodontics; Araraquara Dental School; Sao Paulo State University; Araraquara Brazil
| | - P. Svensson
- Section of Orofacial Pain and Jaw Function; Department of Dentistry; Aarhus University; Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON)
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Machado BCZ, Mazzetto MO, Da Silva MAMR, de Felício CM. Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 2016; 31:945-54. [PMID: 27085322 DOI: 10.1007/s10103-016-1935-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 03/28/2016] [Indexed: 01/05/2023]
Abstract
This study investigated the efficacy of combining low-level laser therapy (LLLT) with oral motor exercises (OM-exercises) for rehabilitation of patients with chronic temporomandibular disorders (TMDs). Eighty-two patients with chronic TMD and 20 healthy subjects (control group) participated in the study. Patients were randomly assigned to treatment groups: GI (LLLT + OM exercises), GII (orofacial myofunctional therapy-OMT-which contains pain relief strategies and OM-exercises), and GIII (LLLT placebo + OM-exercises) and GIV (LLLT). LLLT (AsGaAl; 780-nm wavelength; average power of 60 mW, 40 s, and 60 ± 1.0 J/cm²) was used to promote analgesia, while OM-exercises were used to reestablish the orofacial functions. Evaluations at baseline (T1), after treatment immediate (T2), and at follow-up (T3) were muscle and joint tenderness to palpation, TMD severity, and orofacial myofunctional status. There was a significant improvement in outcome measures in all treated groups with stability at follow-up (Friedman test, P < 0.05), but GIV did not show difference in orofacial functions after LLLT (P > 0.05). Intergroup comparisons showed that all treated groups had no difference in tenderness to palpation of temporal muscle compared to GC at follow-up (Kruskal-Wallis test, P < 0.01). Moreover, GI, GII, and GIII showed no difference from GC in orofacial functional condition (T2 and T3) while they differed significantly from GIV (P < 0.01). In conclusion, LLLT combined with OM-exercises was more effective in promoting TMD rehabilitation than LLLT alone was. Similar treatment results were verified with the OMT protocol.
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Affiliation(s)
- Barbara Cristina Zanandréa Machado
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil
| | - Marcelo Oliveira Mazzetto
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio M Rodrigues Da Silva
- Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.,Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cláudia Maria de Felício
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. .,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.
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Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching. Lasers Med Sci 2016; 31:713-9. [DOI: 10.1007/s10103-016-1913-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
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39
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Safety assessment of trans-tympanic photobiomodulation. Lasers Med Sci 2016; 31:323-33. [PMID: 26738500 DOI: 10.1007/s10103-015-1851-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/08/2015] [Indexed: 12/16/2022]
Abstract
We evaluated functional and morphological changes after trans-tympanic laser application using several different powers of photobiomodulation (PBM). The left (L) ears of 17 rats were irradiated for 30 min daily over 14 days using a power density of 909.1 (group A, 5040 J), 1136.4 (group B, 6300 J), and 1363.6 (group C, 7560 J) mW/cm(2). The right (N) ears served as controls. The safety of PBM was determined by endoscopic findings, auditory brainstem response (ABR) thresholds, and histological images of hair cells using confocal microscopy, and light microscopic images of the external auditory canal (EAC) and tympanic membrane (TM). Endoscopic findings revealed severe inflammation in the TM of C group; no other group showed damage in the TM. No significant difference in ABR threshold was found in the PBM-treated groups (excluding the group with TM damage). Confocal microscopy showed no histological difference between the AL and AN, or BL and BN groups. However, light microscopy showed more prominent edema, inflammation, and vascular congestion in the TM of BL ears. This study found a dose-response relationship between laser power parameters and TM changes. These results will be useful for defining future allowance criteria for trans-tympanic laser therapies.
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Bayani S, Rostami S, Ahrari F, Saeedipouya I. A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement. Laser Ther 2016; 25:121-129. [PMID: 27721564 DOI: 10.5978/islsm.16-or-10] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background and aims: This study aimed to evaluate the efficacy of ibuprofen, bite wafer and low power red and infrared lasers in orthodontic pain management. Subjects and methods: One hundred subjects were randomly assigned to 5 groups of 20 each. The patients in each group received one of the following treatments after the placement of fixed orthodontic appliances: 1. placebo medication, 2. ibuprofen, 3. bite wafer, 4. irradiation from a low level red laser (LLRL; 660 nm, 200 mW, 1 J/point, 6 points), 5. irradiation from a low level infrared laser (LLIL; 810 nm, 200 mW, 1 J/point, 6 points). A Visual Analogue Scale (VAS) was used to record pain intensity while chewing, biting, fitting front teeth, and fitting back teeth at 2 hours, 6 hours, bedtime, 24 hours, 2 days, 3 days and 7 days following arch wire placement. Results: Significant between-group differences were found in pain at chewing, biting, fitting front teeth and fitting back teeth at all time points (p<0.001). Generally, VAS scores in the LLIL, ibuprofen and bite wafer groups were close to each other and significantly lower than those in the LLRL and control groups (p<0.05), which showed comparable pain level at most intervals. The infrared laser group (LLIL) showed significantly lower pain than all other groups at some points over the experiment (p<0.05). Conclusions: A single irradiation from a low level infrared laser proved to be the best strategy for orthodontic pain control. Alternatively, chewing on a bite wafer could be recommended. These methods should be considered as suitable alternatives for ibuprofen in orthodontic patients.
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Affiliation(s)
- Shahin Bayani
- Department of Orthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Shima Rostami
- Department of Orthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Iman Saeedipouya
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Eshghpour M, Ahrari F, Najjarkar NT, Khajavi MA. Comparison of the effect of low level laser therapy with alvogyl on the management of alveolar osteitis. Med Oral Patol Oral Cir Bucal 2015; 20:e386-92. [PMID: 25662557 PMCID: PMC4464928 DOI: 10.4317/medoral.20375] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/15/2015] [Indexed: 11/16/2022] Open
Abstract
Background This study investigated the efficacy of low level laser therapy (LLLT) for managing alveolar osteitis (AO). Material and Methods Sixty patients with alveolar osteitis of mandibular third molars were randomly divided into three groups. In group 1, socket irrigation was followed by alvogyl placement, and the treatment was repeated 48 hours later. In group 2, socket was irradiated with a low power red laser for 3 consecutive days (200 mW, 30 seconds on each of the buccal and lingual surfaces and 30 seconds at the middle of the socket, 6 J per area). The subjects in group 3 underwent treatment with a low power infrared laser with the same parameters as group 2. A visual analogue scale (VAS) was used to record the degree of pain at the morning (T0, before intervention) and at 6 (T1) and 12 (T2) hours later for 3 days. Results Pain was significantly lower in the alvogyl group than the other groups at T1 and T2 points on day 1 and at T0 and T1 points on day 2 (p<0.05). At T2 point on day 2 and on day 3, VAS became significantly lower in the red laser group compared to the other groups (p<0.05). The infrared laser was not more efficacious than the other groups at any of the treatment intervals, but it reduced VAS to an acceptable level. Conclusions LLLT displayed good results in this study for treatment of alveolar osteitis and should be further investigated as an alternative to alvogyl for AO management. Key words:
Low level laser, low power laser, therapy, alvogyl, dry socket, alveolar osteitis, mandibular third molar.
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Affiliation(s)
- Majid Eshghpour
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Boulevard, Mashhad, Iran,
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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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Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors. Am J Orthod Dentofacial Orthop 2014; 146:565-72. [DOI: 10.1016/j.ajodo.2014.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 11/18/2022]
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Moosavi H, Maleknejad F, Sharifi M, Ahrari F. A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations. Lasers Med Sci 2014; 30:1245-9. [PMID: 24811085 DOI: 10.1007/s10103-014-1565-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 03/09/2014] [Indexed: 10/25/2022]
Abstract
This study aimed to investigate the efficacy of low-level laser irradiation when applied just before placement of resin composite on reducing postoperative sensitivity of class V lesions. In this randomized clinical trial, 31 patients with 62 class V cavities were included (two teeth in each participant). The teeth were randomly assigned into laser and placebo groups. After cavity preparation, the teeth in the experimental group were subjected to irradiation from a low-power red laser (630 nm, 28 mW, continuous wave, 60 s, 1.68 J), which was applied for 1 min on the axial wall of the cavity. In the control group, the same procedure was performed but with laser simulation. Then, a self-etch adhesive was applied and the cavities were restored with a microhybrid resin composite. Before treatment and on days 1, 14, and 30 after treatment, tooth sensitivity to a cold stimulus was recorded using a visual analogue scale. Data were analyzed by Friedman and Wilcoxon signed-rank tests (p < 0.05). Pain scores after restorative procedures were significantly lower in the laser group compared to the placebo application (p < 0.05). Although both groups experienced a significant improvement in pain and discomfort throughout the follow-up periods (p < 0.001), the changes in visual analogue scale (VAS) scores between baseline and each follow-up examination were significantly greater in the laser than the placebo group (p < 0.05). Low-level laser therapy (LLLT) before placement of resin composite could be suggested as a suitable approach to reduce postoperative sensitivity in class V restorations.
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Affiliation(s)
- Horieh Moosavi
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Boulevard, Mashhad, Iran
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