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Vassão PG, Credidio BM, Balão AB, Santos TIR, Carvalho C, Ribeiro DA, Parisi JR, Franco FS, Laakso EL, Avila MA, Renno ACM. Effects of photobiomodulation and an aerobic exercise on the level of pain and quality of life in women with fibromyalgia. Lasers Med Sci 2024; 39:189. [PMID: 39039318 DOI: 10.1007/s10103-024-04126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024]
Abstract
To evaluate the effectiveness of photobiomodulation (PBM) in conjunction with an aerobic exercise program (AEP) on the level of pain and quality of life of women with fibromyalgia (FM). METHODS A double-blinded randomized controlled trial in which 51 participants with FM were allocated into 4 groups: control group (CG) (n = 12); active PBM group (APG) (n = 12); AEP and placebo PBM group (EPPG) (n = 13); AEP and active PBM group (EAPG) (n = 14). AEP was performed on an ergometric bicycle; and a PBM (with an increase dosage regime) [20 J, 32 J and 40 J] was applied using a cluster device. Both interventions were performed twice a week for 12 weeks. A mixed generalized model analysis was performed, evaluating the time (initial and final) and group (EAPG, EPPG, APG and CG) interaction. All analyses were based on intent-to-treat for a significance level of p ≤ 0.05. RESULTS The intra-group analysis demonstrated that all treated groups presented a significant improvement in the level of pain and quality of life comparing the initial and final evaluation (p < 0.05). Values for SF-36 and 6-minute walk test increased significant in intragroup analysis for EPPG comparing the initial and final evaluation. No intergroup differences were observed. CONCLUSIONS Both exercised and PBM irradiated volunteers present improvements in the variables analyzed. However, further studies should be performed, with other PBM parameters to determine the best regime of irradiation to optimize the positive effects of physical exercises in FM patients.
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Affiliation(s)
- Patricia Gabrielli Vassão
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Beatriz M Credidio
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Ana Beatriz Balão
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Thatiane Izabele Ribeiro Santos
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Cristiano Carvalho
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Daniel Araki Ribeiro
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil
| | - Julia R Parisi
- Departmento de Fisioterapia, Universidade Metropolitana de Santos, Santos, Brazil
| | - Fabio S Franco
- Sociedade Brasileira de Psicanalise de São Paulo, Instituto de Psicanálise "Durval Marcondes", São Paulo, Brazil
| | - E-Liisa Laakso
- Mater Research Institute-University of Queensland, South Brisbane, Australia Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Mariana A Avila
- Programa de Pós-Graduação de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Ana Cláudia Muniz Renno
- Departamento de Biociências, Universidade Federal de São Paulo - Campus Baixada Santista, R. Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil.
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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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Farshidfar N, Farzinnia G, Samiraninezhad N, Assar S, Firoozi P, Rezazadeh F, Hakimiha N. The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials. J Lasers Med Sci 2023; 14:e24. [PMID: 37744015 PMCID: PMC10517581 DOI: 10.34172/jlms.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/27/2023] [Indexed: 09/26/2023]
Abstract
Introduction: Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. Methods: A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. Results: A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. Conclusion: This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm2, and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.
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Affiliation(s)
- Nima Farshidfar
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnoush Farzinnia
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sahar Assar
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Parsa Firoozi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Rezazadeh
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Hakimiha
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sigaroodi AK, Motevasseli S, Maleki D, Maleki D, Fard RS. Low-level laser and management of common complications after the mandibular third molar surgery: A double-blind randomized clinical trial. Dent Res J (Isfahan) 2023; 20:14. [PMID: 36820144 PMCID: PMC9937931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 06/19/2021] [Accepted: 11/23/2021] [Indexed: 02/24/2023] Open
Abstract
Background There are controversies on the analgesic and anti-inflammatory effects of low-level laser therapy on pain, edema, and trismus after mandibular third molar extraction surgery. This study aimed to evaluate the efficacy of low-level laser therapy (LLLT) on discomforts occurring after the mandibular wisdom tooth removal. Materials and Methods This double-blind, split-mouth design, randomized clinical trial study was performed on 36 healthy controls with bilateral symmetrical mandibular third molar referred to the Department of Oral and Maxillofacial Surgery of Dental Faculty from January to November 2019. After surgical extraction, the laser group underwent laser (Ga-Al-As diode laser, 808 nm, 200 mW) intraorally and extraorally just after surgery and 24 h after surgery. For the placebo group, the handpiece was inserted without laser irradiation. The pain level was assessed by Baker Wong scale at 2, 4, 6, 12, 24, 36, 48, and 60 h postoperatively, and the edema and the extent of mouth opening were examined before surgery, at the 1st and 7th days after surgery. The data were collected and analyzed by SPSS at the significant level of 0.05. Results The statistical analysis of 32 participants' data (laser group: n = 32, placebo group: n = 32) indicated that the mean score of pain in 3 days after surgery in the interventional group was significantly lower than the score of the placebo group (P < 0.001). Furthermore, the swelling and the extent of the mouth opening differed significantly between the two groups at 1st and 7th days after the procedure (P < 0.001). Conclusion Our findings showed that the LLLT had beneficial effects on the management of pain, edema, and trismus following after 3rd molar extraction surgery.
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Affiliation(s)
- Ali Khalighi Sigaroodi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Safa Motevasseli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Dina Maleki
- Department of Oral and Maxillofacial Surgery, Student Research Committee, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Donya Maleki
- Department of Oral and Maxillofacial Surgery, Student Research Committee, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran,Address for correspondence: Dr. Donya Maleki, Dental Faculty, GUMS Complex, Fuman-Saravan Ring Road, Rasht, Guilan, Iran. E-mail:
| | - Reza Shokuhi Fard
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Maleki D, Sigaroodi A, Motevasseli S, Maleki D, Fard R. Low-level laser and management of common complications after the mandibular third molar surgery: A double-blind randomized clinical trial. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.367913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Application of photobiomodulation for chronic pain-related TMD on pain points versus pre-established points: Randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 238:112612. [PMID: 36459910 DOI: 10.1016/j.jphotobiol.2022.112612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Photobiomodulation therapy (PTB) is a therapeutic possibility for temporomandibular disorders (TMD), but its effectiveness and protocols for use remain controversial. This study is a RCT that compared the effectiveness of PTB on pain points of the masticatory muscles and TMJs, located through palpation versus application of pre-established points in women with painful TMD, diagnosis by DC/TMD (Diagnostic Criteria for Temporomandibular Disorders - Brazilian Portuguese version). Therefore, a total sample of 54 women, aged between 18 and 60 years, was investigated. Volunteers were randomly randomized and PTB was applied in four different groups with a dose of 4 J and 6 J divided into pre-established application points (PE - G1) and pain points (PD - G2) - Groups 4PE, 4PD, 6PE and 6PD. Four laser applications were performed with a wavelength of 780 nm, one session per week, totaling one month of therapy. The following assessments were performed: DC/TMD, Brief Pain Inventory (BPI), McGill Questionnaire - Short Version (SF-MPQ) and Pain Intensity, Visual Analogue Scale (VAS). Friedman's test was used for within-group comparisons, while the Mann-Whitney test was used for between-group comparisons (p < 0.05). According to the results, laser application on pain points (G2) was more effective. McGill's results showed that regardless of dose, the pain point application group had better outcomes (p = 0.004). Pain intensity evaluation (last days) also showed that application at the pain points was more effective regardless of dose (p = 0.0002). Medians and interquartile deviations showed overall that PTB was more effective at pain points, with a trend towards better outcomes at the 6 J dose. Therefore, it can be concluded that in women with chronic painful TMD, the application of PTB at pain points is more effective than the application at pre-established points. Therefore, individualized PTB protocols are proposed, based on examination palpation of the masticatory structures.
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Dias WCFGDS, Cavalcanti RVA, Magalhães Júnior HV, Pernambuco LDA, Alves GÂDS. Effects of photobiomodulation combined with orofacial myofunctional therapy on the quality of life of individuals with temporomandibular disorder. Codas 2022; 34:e20200313. [PMID: 35416889 PMCID: PMC9886175 DOI: 10.1590/2317-1782/20212020313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/25/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To analyze the impact of photobiomodulation combined with orofacial myofunctional therapy (OMT) on the oral health quality of life (OHQOL) of individuals with temporomandibular disorder, before and after the treatment. METHODS Blind, controlled, randomized clinical trial with 34 volunteers randomly distributed into two groups: G1, who received OMT combined with photobiomodulation, and G2, treated with OMT combined with inactive laser. The subjects were first assessed with a visual analog scale (VAS) to classify them according to the degree of orofacial pain and with the Oral Health Impact Profile - Short Form (OHIP-14) regarding the impact on the OHQOL. The resulting data were statistically analyzed. The significance level was set at 0.05 (95%). RESULTS "Physical pain", "psychological discomfort", "physical disability", and "psychological disability" were the aspects with the greatest impact on the OHQOL. The G1 subjects responded positively to their treatment, as well as G2 to theirs. There was a strong positive correlation between VAS and total OHIP-14 score in both groups after the treatment. However, the functional recovery in the control group individuals (G2) was the most perceived positive change in the OHQOL in comparison with the experimental group (G1). CONCLUSION The people who received photobiomodulation combined with OMT perceived an improvement in the OHQOL, as well as those treated with placebo laser. There was a strong positive correlation in both groups in the improvement of the degree of pain and self-perception of the OHQOL.
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Affiliation(s)
| | | | | | - Leandro de Araújo Pernambuco
- Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
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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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Effect of photobiomodulation therapy on painful temporomandibular disorders. Sci Rep 2021; 11:9049. [PMID: 33907210 PMCID: PMC8079391 DOI: 10.1038/s41598-021-87265-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm2, 3 regions, 60 s) or TMJ region (6 J/cm2, 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0–10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P < 0.001) for both types of interventions, however, PBMT caused greater reduction in pain scores than placebo (P = 0.014). For myalgia patients, pain intensity decreased over time (P < 0.001) but without difference between interventions (P = 0.074). PPTs increased in both myalgia (P < 0.001) and TMJ arthralgia patients over time (P < 0.001) but without difference between interventions (P ≥ 0.614). Overall, PBMT was associated with marginally better improvements in range of motion compared to placebo in both myalgia and arthralgia patients. Pain intensity, sensory function and jaw movements improve after both PBMT and placebo treatments in myalgia and arthralgia patients indicating a substantial non-specific effect of PBMT.
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Jing G, Zhao Y, Dong F, Zhang P, Ren H, Liu J, Liu Y, Yu C, Hu J, Bao G, Kang H. Effects of different energy density low-level laser therapies for temporomandibular joint disorders patients: a systematic review and network meta-analysis of parallel randomized controlled trials. Lasers Med Sci 2020; 36:1101-1108. [PMID: 33230581 DOI: 10.1007/s10103-020-03197-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effects of different energy density LLLT on TMD patients' pain reduction. METHODS Reviewers searched RCTs published in Embase, PubMed and The Cochrane Library before 1 April 2020. Reviewers included parallelRCTs that compared the effects of LLLT with placebo or different energy density LLLT for TMD patients' pain reduction. Reviewers did network meta-analysis and evaluated the quality of evidence using the GRADE process. RESULTS From 352 studies, reviewers included 16 RCTs. Immediately after treatment, the d1 laser therapy (energy density ranging from 0 to 10 J/cm2) ranked first. The d1 laser therapy showed more pain reduction than placebo ( MD = 2.49, 95% CI ranging from 1.28 to 3.71). The quality of "d1 vs p" comparison was assessed as "moderate" quality. A month after treatment, the d1 laser therapy also performed better than placebo (MD = 1.69, 95%CI = [-0.78, 4.16]). The quality of secondary outcome was assessed as "low" quality. CONCLUSIONS For clinical application, d1 laser therapy (energy density ranging from 0 to 10 J/cm2) is recommended for short-term pain management of TMD patients (moderate quality evidence). A month after treatment, the d1 laser therapy also performed better than placebo and other laser groups but the result didn't reach the point of statistical significance (low quality evidence). TRIAL REGISTRATION PROSPERO-CRD42018118313.
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Affiliation(s)
- Guoyi Jing
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Yatao Zhao
- Department of Orthodontics, Xiangya Hospital and School of Stomatology, Central South University, Changsha, 410078, People's Republic of China
| | - Fangrui Dong
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Pengfei Zhang
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Hui Ren
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Jingying Liu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Yang Liu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Caiyun Yu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Jingjing Hu
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China
| | - Guangjie Bao
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, 730000, People's Republic of China.
| | - Hong Kang
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Dong Gang Xi Road 199#, Lanzhou, 730000, People's Republic of China.
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Micarelli A, Viziano A, Granito I, Micarelli RX, Augimeri I, Alessandrini M. Temporomandibular disorders and cervicogenic dizziness: Relations between cervical range of motion and clinical parameters. Cranio 2020; 40:348-357. [PMID: 32544368 DOI: 10.1080/08869634.2020.1780772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the cervical range of motion (CROM) and clinical parameters in patients affected by myogenous temporomandibular disorders (TMD), cervicogenic dizziness (CGD), both TMD and CGD (TMD/CGD), and a group of healthy subjects (HS). METHODS CROM degrees, Dizziness Handicap Inventory (DHI), Tampa Scale for Kinesiophobia (TSK-17), Hospital Anxiety and Depression Scale (HADS), and Jaw Functional Limitation Scale 20 (JFLS-20) scores were compared between 46 TMD patients, 49 CGD subjects, 43 TMD/CGD patients, and 98 HS. RESULTS TMD/CGD and CGD patients demonstrated significantly lower CROM degrees and higher DHI, TSK-17, and HADS values when compared to TMD patients. TMD/CGD and TMD patients demonstrated higher JFLS-20 values when compared to CGD and HS. Significant negative correlations were found in TMD/CGD and TMD patients between JFLS-20 and CROM in flexion and extension. DISCUSSION Present findings demonstrated a relation between spine movement impairment and TMD.
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Affiliation(s)
- Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ivan Granito
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Riccardo Xavier Micarelli
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Ivan Augimeri
- Dental and Rehabilitation Department, ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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12
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Herrero Babiloni A, Lam JTAT, Exposto FG, Beetz G, Provost C, Gagnon DH, Lavigne GJ. Interprofessional Collaboration in Dentistry: Role of physiotherapists to improve care and outcomes for chronic pain conditions and sleep disorders. J Oral Pathol Med 2020; 49:529-537. [PMID: 32531851 DOI: 10.1111/jop.13068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/04/2020] [Indexed: 01/10/2023]
Abstract
Physiotherapists can manage chronic pain patients by using technical interventions such as mobility, strengthening, manual therapy, or flexibility in a specific and functional manner, being a key component of a multidisciplinary team. Dentists are involved in the management of different chronic pain conditions such as temporomandibular disorders and sleep disorders such as obstructive sleep apnea. However, they are frequently unaware of the benefits of collaborating with physical therapists. In this review, the collaboration of physical therapists and dentists will be explored when managing orofacial pain, headaches, and sleep disorders. The physical therapist is important in the management of these disorders and also in the screening of risk factors.
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Affiliation(s)
- Alberto Herrero Babiloni
- Sacre-Cœur Hospital, CIUSS du Nord-de-l'île-de-Montréal, Montreal, Canada.,Faculté de Medicine Dentaire, Université de Montréal, Montreal, Canada.,Division of Experimental Medicine, McGill University, Montreal, Canada
| | - Jacqueline T A T Lam
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Fernando G Exposto
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Gabrielle Beetz
- Sacre-Cœur Hospital, CIUSS du Nord-de-l'île-de-Montréal, Montreal, Canada
| | - Catherine Provost
- Sacre-Cœur Hospital, CIUSS du Nord-de-l'île-de-Montréal, Montreal, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Gilles J Lavigne
- Sacre-Cœur Hospital, CIUSS du Nord-de-l'île-de-Montréal, Montreal, Canada.,Faculté de Medicine Dentaire, Université de Montréal, Montreal, Canada.,Division of Experimental Medicine, McGill University, Montreal, Canada
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13
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Maracci LM, Stasiak G, de Oliveira Chami V, Franciscatto GJ, Milanesi J, Figueiró C, Bernardon Silva T, Guimarães MB, Marquezan M. Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: A double-blind, randomized clinical trial. Cranio 2020; 40:433-439. [PMID: 32491964 DOI: 10.1080/08869634.2020.1773661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To compare the effect of a rapid low-level laser therapy (LLLT) protocol to Michigan occlusal splint in the treatment of myofascial pain, as well as to evaluate their impact on Oral Health-Related Quality of Life (OHRQoL). METHODS Thirty participants were randomly allocated into three groups: G1: occlusal splint (n = 11), G2: LLLT (n = 10), and G3: LLLT placebo (n = 9). LLLT and placebo were applied in the points of pain upon palpation. RESULTS G1 presented improvement in pain (p = 0.014) and in the diagnosis of myofascial pain (p = 0.008), while G2 and G3 did not. Regarding OHRQoL, G1 and G2 presented significant improvement (p = 0.005, in both), whereas, G3 did not. CONCLUSION Michigan occlusal splint was effective in reducing pain and improving OHRQoL. Treatment with the rapid LLLT protocol only provided an improvement in OHRQoL.
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Affiliation(s)
| | - Gabriela Stasiak
- Federal University of Santa Maria, Sant'Ana do Livramento, RS, Brazil
| | | | | | - Jovana Milanesi
- Private Practice, Volunteer at Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Cláudio Figueiró
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Magáli Beck Guimarães
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Marquezan
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
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14
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Monteiro L, Ferreira R, Resende T, Pacheco JJ, Salazar F. Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and Placebo-Controlled Clinical Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:280-288. [DOI: 10.1089/photob.2019.4730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Luís Monteiro
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Cancer Research Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Laser Applications Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Raquel Ferreira
- Cancer Research Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Tiago Resende
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Laser Applications Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - José Júlio Pacheco
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Diseases Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Filomena Salazar
- Oral Medicine and Oral Surgery Department, University Institute of Health Sciences, CESPU, Gandra, Portugal
- Oral Diseases Group—IINFACTS, University Institute of Health Sciences, CESPU, Gandra, Portugal
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15
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Dantas CMG, Vivan CL, de Fantini SM, de Freitas Costa e Silva PM, Pannuti CM, Witzel AL, Dominguez GC. The influence of educational measures and low-level laser phototherapy on temporomandibular disorders: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore) 2020; 99:e19005. [PMID: 32150048 PMCID: PMC7478391 DOI: 10.1097/md.0000000000019005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Photobiomodulation therapy (PBMT) with low-power laser is used for pain relief in several clinical conditions, including temporomandibular disorders (TMD). As musculoskeletal pain often produces changes in motor behavior, it is common for patients with TMD to present limited mandibular movements. To the date, there is no consensus about the optimal dosimetric parameters of PMBT for TMD. This randomized, controlled, double-blind clinical trial aims to evaluate pain relief and mandibular mobility in patients with TMD following treatments with 2 laser wavelengths, red (660 nm) and infrared (808 nm) individually and in combination as compared to a placebo treatment. One-hundred participants presenting myalgia and arthralgia, with disk displacement or not, will be selected based on the Research Diagnostic Criteria for Temporomandibular Disorders. All participants will be instructed about the etiology, prognosis, and self-care techniques for pain control on TMD, and followed up for 2 weeks. After this period, those who still present pain score over 4 in a visual analog scale (VAS) will be included in the study. Participants will be randomly assigned to 4 treatment groups: G1 = placebo (SHAM); G2 = PBMT with red laser (660 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); G3 = PBMT with infrared laser (808 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); and G4 = PBMT with red and infrared laser alternated between sessions. The treatment consists of 8 sessions, 2 times a week. The effect of the proposed therapies will be measured by: pain reduction in VAS; pressure pain threshold on TMJ, masseter and temporal muscles; and the amplitude of mandibular movements (opening, protrusion, and right and left lateral movements). The data will be collected at the following times: initial (T1), after the 1st treatment session (T2), at the end of treatment (T3), and 30 days after the last PBMT session (T4). For statistical analysis will be used 2-way repeated measures analysis of variance test, complemented by a post hoc Tukey test (P < .05).
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Affiliation(s)
| | | | | | | | - Claudio Mendes Pannuti
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
| | - Andrea Lusvarghi Witzel
- Department of Stomatology, School of Dentistry - University of São Paulo, São Paulo, SP, Brazil
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16
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Barbosa JS, Amorim A, Arruda M, Medeiros G, Freitas A, Vieira L, Melo DP, Bento PM. Infrared thermography assessment of patients with temporomandibular disorders. Dentomaxillofac Radiol 2019; 49:20190392. [PMID: 31794257 DOI: 10.1259/dmfr.20190392] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess patients with and without temporomandibular disorders (TMD) infrared thermography according to the differences in thermal radiance using quantitative sensitivity and specificity tests; and to evaluate the thermal asymmetry and the correlation of the thermal intensity with the intensity of pain upon palpation. METHODS This cross-sectional study performed a quantitative evaluation of clinical and thermographic examinations. The volunteers were evaluated for the presence of TMD using RDC/TMD (Diagnostic Research Criteria for Temporomandibular Disorders), and were divided into two groups: TMD group (n = 45); control group (n = 41), composed of volunteers without TMD, according to the Fonseca Anamnestic Index. The images were assessed for selected regions of interest for the masseter, anterior temporal and TMJ muscles. The mean values of the areas of both groups were compared under the receiver operating characteristic curve. Spearman correlation analysis (non-parametric data) between pain level and mean temperature, by region, and the Pearson's χ2 test was used to verify the association between the presence of temperature and pain asymmetry. The level of significance was set at p < 0.05. RESULTS Both Groups, with and without TMD, presented with absolute and non-dimensional mean temperature without statistical differences (p>0.05). When correlating temperature with intensity of pain upon palpation, a negative correlation was observed for the masseter muscle. CONCLUSION Infrared Thermography resulted in low area under the curve, making it difficult to differentiate TMD via thermographic analysis. The intensity of pain upon palpation in patients with TMD may be accompanied by a decrease in local temperature.
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Affiliation(s)
- J S Barbosa
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Amam Amorim
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Mjalla Arruda
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Gbs Medeiros
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Aplf Freitas
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Lem Vieira
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - D P Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - P M Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
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Magri LV, Bataglion C, Leite-Panissi CRA. Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins. Cranio 2019; 39:502-509. [PMID: 31585522 DOI: 10.1080/08869634.2019.1673588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To characterize short- and long-term assessment of the low-intensity laser therapy (LLLT) effectiveness in women with TMD of muscular origins and to evaluate whether the information about the treatment received (active or placebo) modifies the pain intensity.Methods: Forty-one women with painful TMD (31.7 ± 5.2 years) were divided into laser (n = 20) and placebo (n = 21) groups. The pain intensity was measured at the baseline, after the LLLT (T8), 6 and 12 months. At the 6-month follow-up, the groups received information about the active or placebo treatment.Results: At T8 and 6-month, both active and placebo LLLT were effective in reducing pain (p < .05). After one year, the groups showed similar pain. Active LLLT was more effective in reducing pain palpation (p = .001) and referred pain (p = .04) in the region of the TMJs. The information about the treatment modified the perceived pain intensity.Conclusion: Active and placebo LLLT are effective for painful TMD of muscular origins in the short-term. Information about the treatment impairs the subjective perception of pain.
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Affiliation(s)
- Laís Valencise Magri
- Department of Psychology, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.,Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - César Bataglion
- Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
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18
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Photobiomodulation-induced analgesia in experimental temporomandibular disorder involves central inhibition of fractalkine. Lasers Med Sci 2019; 34:1841-1847. [DOI: 10.1007/s10103-019-02785-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
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19
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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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20
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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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21
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Girasol CE, Dibai-Filho AV, de Oliveira AK, de Jesus Guirro RR. Correlation Between Skin Temperature Over Myofascial Trigger Points in the Upper Trapezius Muscle and Range of Motion, Electromyographic Activity, and Pain in Chronic Neck Pain Patients. J Manipulative Physiol Ther 2018; 41:350-357. [PMID: 29631764 DOI: 10.1016/j.jmpt.2017.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 10/25/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the correlation between skin temperature over a myofascial trigger point in the upper trapezius muscle and range of motion of the cervical spine, electromyographic activity, and pain in patients with chronic neck pain. METHODS This is a single-blind cross-sectional study. Forty participants of both sexes, aged 18 to 45 years, with chronic neck pain and myofascial trigger points in the upper trapezius muscle were included in the study. The participants were assessed using the Numeric Rating Scale, the Neck Disability Index, infrared thermography, algometry, fleximetry, and electromyographic activity. RESULTS A positive association was observed between skin temperature to the right with the range of motion of cervical flexion (r = 0.322, P = .043), the median frequency of isometrics to the right (r = 0.341, P = .032), and the median frequency of rest to the left (rs = 0.427, P = .006); as were a negative association between skin temperature to the right and the root mean square of rest to the right (rs = -0.447, P = .004), and a positive association of skin temperature to the left with the median frequency of isometrics to the right (r = 0.365, P = .020), and the median frequency of rest to the left (rs = 0.573, P < .001). CONCLUSION Patients with chronic neck pain who had reduction of skin temperature over myofascial trigger points in the upper trapezius muscle had reduced cervical range of motion for flexion, reduced median frequency at rest and during isometric contraction, and increased root mean square at rest.
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Affiliation(s)
- Carlos Eduardo Girasol
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine, and Rehabilitation of the Locomotor Apparatus, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine, and Rehabilitation of the Locomotor Apparatus, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Alessandra Kelly de Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine, and Rehabilitation of the Locomotor Apparatus, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine, and Rehabilitation of the Locomotor Apparatus, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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22
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Herpich CM, Gomes CAFDP, Dibai-Filho AV, Politti F, Souza CDS, Biasotto-Gonzalez DA. Correlation Between Severity of Temporomandibular Disorder, Pain Intensity, and Pressure Pain Threshold. J Manipulative Physiol Ther 2018; 41:47-51. [DOI: 10.1016/j.jmpt.2017.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/10/2017] [Accepted: 08/23/2017] [Indexed: 11/15/2022]
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Leal de Godoy CH, Motta LJ, Garcia EJ, Fernandes KPS, Mesquita-Ferrari RA, Sfalcin RA, Motta PDB, Politti F, Bussadori SK. Electromyographic evaluation of a low-level laser protocol for the treatment of temporomandibular disorder: a randomized, controlled, blind trial. J Phys Ther Sci 2017; 29:2107-2111. [PMID: 29643585 PMCID: PMC5890211 DOI: 10.1589/jpts.29.2107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Problems involving the temporomandibular joint and associated structures can
lead to temporomandibular disorder (TMD). The aim of the present study was to evaluate
muscle activity in individuals with a diagnosis of TMD before and after treatment with
low-level laser therapy (LLLT) through the use of electromyography (EMG). [Subjects and
Methods] Male and female individuals aged 14 to 23 years were evaluated. TMD was
determined by a clinical examination and the administration of the Research Diagnostic
Criteria for Temporomandibular Disorders, followed by the evaluation of sensitivity to
palpation of the masseter and anterior temporal muscles as well as the EMG determination
of muscle activity. The participants were randomly allocated to an active LLLT group (n=9)
and sham group (n=7). Twelve sessions of LLLT were conducted using a wavelength of 780 nm,
energy density of 25 J/cm2, power of 50 mW, power density of
1.25 W/cm2 and a 20-second exposure time or sham LLLT. Muscle activity was
determined prior to treatment and after the last session. [Results] During the isometric
evaluation of the masseter and anterior temporal muscles, an increase in the mean EMG
signal was found in the group submitted to active LLLT. When evaluated individually, some
participants in the active LLLT group demonstrated a reduction in muscle activity, but no
significant differences were found in the mean EMG signal between the initial and final
evaluations. [Conclusion] Further studies with a larger sample size are needed to confirm
the present findings.
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Burger M, Kriel R, Damon A, Abel A, Bansda A, Wakens M, Ernstzen D. The effectiveness of low-level laser therapy on pain, self-reported hand function, and grip strength compared to placebo or “sham” treatment for adults with carpal tunnel syndrome: A systematic review. Physiother Theory Pract 2017; 33:184-197. [PMID: 28272964 DOI: 10.1080/09593985.2017.1282999] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marlette Burger
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Réna Kriel
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Andrea Damon
- Phillo Beukes Physiotherapy, Hunters Medical Services, Knysna, South Africa
| | - Amy Abel
- Department of Physiotherapy, Jacquie Kieck Physiotherapy, Port Alfred, South Africa
| | - Anisha Bansda
- Linksfield Netcare Hospital and New Life Kensington Hospital, Johannesburg, South Africa
| | - Marinique Wakens
- Department of Physiotherapy, Prof ZK Matthews Hospital, Barkly West, South Africa
| | - Dawn Ernstzen
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Melchior MDO, Machado BCZ, Magri LV, Mazzetto MO. Efeito do tratamento fonoaudiológico após a laserterapia de baixa intensidade em pacientes com DTM: estudo descritivo. Codas 2016; 28:818-822. [DOI: 10.1590/2317-1782/20162015099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO O aumento da dor/desconforto durante atividades como mastigar, falar e deglutir é comumente relatado por pacientes com Disfunção Temporomandibular (DTM) e a terapia fonoaudiológica miofuncional orofacial (TMO) tem sido proposta como parte do tratamento desta condição. Porém é uma modalidade que deve ser instituída quando o quadro de DTM e dor não está exacerbado a fim de não impedir ou dificultar a realização dos exercícios. Objetivo O objetivo deste estudo foi analisar o efeito da TMO no tratamento de pacientes com DTM, segundo o Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD), após analgesia com laserterapia de baixa intensidade (LBI), quanto às condições miofuncionais orofaciais (CMO) e quanto à percepção dos sintomas de DTM. Método Transcorridos 30 dias após a finalização da LBI, cinco pacientes foram avaliados, com idades entre 50 e 61 anos. A aplicação do questionário ProDTMMulti para investigação da autopercepção da sintomatologia de DTM e do exame clínico AMIOFE (Avaliação Miofuncional Orofacial com Escores) para constatação das condições miofuncionais orofaciais foram realizados por fonoaudióloga experiente, antes e após a TMO. Resultados As CMO apresentaram aumento dos escores após TMO, indicando aumento do equilíbrio miofuncional orofacial. De acordo com a percepção das pacientes, após a TMO houve alívio dos sinais e sintomas de DTM. Conclusão A TMO instituída após a analgesia com LBI promoveu equilíbrio das funções orofaciais da amostra estudada e diminuição dos sinais e sintomas de DTM remanescentes, de acordo com a autopercepção dos indivíduos tratados.
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Dickerson SM, Weaver JM, Boyson AN, Thacker JA, Junak AA, Ritzline PD, Donaldson MB. The effectiveness of exercise therapy for temporomandibular dysfunction: a systematic review and meta-analysis. Clin Rehabil 2016; 31:1039-1048. [DOI: 10.1177/0269215516672275] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the effectiveness of exercise therapy on pain, function, and mobility outcomes in patients with temporomandibular joint dysfunction. Study design: Systematic review with meta-analysis. Methods: A systematic review and meta-analysis undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that met the inclusion criteria: (1) randomized controlled trials; (2) a population with the diagnosis of temporomandibular joint dysfunction; and (3) interventions that included exercise therapy were considered for review. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis. Results: Six articles with a total of 419 participants were included in the review and only four studies were included in the meta-analysis. Mobility and mixed exercise therapy approaches appear to be the most common exercise approaches utilized for management of temporomandibular joint dysfunction. Exercise therapy and the associated dosage provide moderate short-term and varying long-term benefits in reduction of pain and improvement of range of motion of the in patients with temporomandibular joint dysfunction. Conclusion: Included studies suggest a mobility or a mixed approach to exercise therapies have impact on reducing pain, significant impact for increasing range of motion, but lack a significant impact for functional improvement. Level of evidence: Therapy, level 1a-.
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Affiliation(s)
| | - Jarod M Weaver
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Ashley N Boyson
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Jared A Thacker
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Andrew A Junak
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Pamela D Ritzline
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Megan B Donaldson
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
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Marquezan M, Figueiró C. Temporomandibular disorder treatment in a patient wearing removable prostheses: A case report. Cranio 2016; 35:122-127. [PMID: 27240163 DOI: 10.1080/08869634.2016.1187823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM The purpose of this intervention was to treat the patient, a 51-year-old woman, who was wearing a maxillary denture and a mandibular bilateral distal-extension partial denture (both unfit) and was suffering from temporomandibular disorder (TMD). METHODOLOGY The treatment suggested was to construct a superior repositioning splint (SRS), and after remission of the symptomatology, fabricate new dentures. RESULTS The occlusal splint was effective and the symptomatology ceased after about five months of treatment. The new dental prostheses were made and followed up for 10 years with no return of the pain. CONCLUSIONS SRS and subsequent construction of new dentures after remission of the symptomatology was an effective treatment for TMD in the case described.
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Affiliation(s)
- Mariana Marquezan
- a Department of Pediatric Dentistry and Orthodontics , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil.,b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
| | - Cláudio Figueiró
- b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
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28
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De Carli BMG, Magro AKD, Souza-Silva BN, Matos FDS, De Carli JP, Paranhos LR, Magro ED. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: A randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 159:120-3. [PMID: 27045280 DOI: 10.1016/j.jphotobiol.2016.03.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/17/2016] [Accepted: 03/24/2016] [Indexed: 12/20/2022]
Abstract
This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.
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Affiliation(s)
| | - Alessandra Kuhn Dall Magro
- Department of Oral and Maxillofacial Surgery, Hospital São Vicente de Paulo de Passo Fundo, Rio Grande do Sul, Brazil
| | | | | | - João Paulo De Carli
- Department of Oral Medicine, School of Dentistry, University of Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Eduardo Dall Magro
- Department of Restorative Dentistry, School of Dentistry, University of Passo Fundo, Rio Grande do Sul, Brazil
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Ghurye S, McMillan R. Pain-Related Temporomandibular Disorder - Current Perspectives and Evidence-Based Management. ACTA ACUST UNITED AC 2015; 42:533-6, 539-42, 545-6. [PMID: 26506809 DOI: 10.12968/denu.2015.42.6.533] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three'pillars'of pain management: physical therapies, pharmacotherapy and clinical psychology.
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30
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Sancakli E, Gökçen-Röhlıg B, Balık A, Öngül D, Kıpırdı S, Keskın H. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health 2015; 15:131. [PMID: 26496720 PMCID: PMC4619518 DOI: 10.1186/s12903-015-0116-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the effect of Low Level Laser (LLL) application at the points of greatest pain in patients with chronic masticatory muscle pain. METHODS A total number of 30 (21 women, 9 men, with a mean age of 39.2) were selected after the diagnosis of MPDS according to the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). The patients were randomly divided into three groups; laser group I (n = 10); patients received the LLL at the point of greatest pain, laser group II (n = 10); patients received LLL at pre-established points in the effected muscles and placebo group (n = 10). LLL and placebo were applied three times per week, for a total of 12 sessions. Mandibular mobility was examined, masticator muscles tenderness were assessed and PPT values were obtained. Subjective pain levels were evaluated using VAS. The measurements performed before the treatment and after the completion of the therapy. Descriptive statistics (mean, standard deviation, and frequency) Student's t-test, Mann-Whitney U-test and paired-sample t-tests were used for analysis. RESULTS In both laser groups, there was a statically significant reduction in PPT values of the muscles, number of muscles without any pain on palpation increased significantly, mandibular movements' ranges were improved. Laser group I demonstrated statistically better results than the Laser group II in all of the measured values. Plasebo group did not show any statistically difference in any of the measured values. CONCLUSIONS LLLT can be accepted as an alternative treatment modality in the management of masticatory muscle pain and direct irradiation seems to effect better. TRIAL REGISTRATION Current Controlled Trials ISRCTN31085 , Date of registration 28/08/20145.
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Affiliation(s)
- Erkan Sancakli
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Bilge Gökçen-Röhlıg
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Ali Balık
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Değer Öngül
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Selin Kıpırdı
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Haluk Keskın
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, 34390, Istanbul, Turkey
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31
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Fabre HSC, Navarro RL, Oltramari-Navarro PVP, Oliveira RF, Pires-Oliveira DAA, Andraus RAC, Fuirini N, Fernandes KBP. Anti-inflammatory and analgesic effects of low-level laser therapy on the postoperative healing process. J Phys Ther Sci 2015; 27:1645-8. [PMID: 26180289 PMCID: PMC4499952 DOI: 10.1589/jpts.27.1645] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/07/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] This study aimed to evaluate the anti-inflammatory and analgesic effects of
intraoral application of low-level laser therapy (660 nm) to control pain, swelling and
interincisal opening following the extraction of mandibular third molars. [Subjects and
Methods] Ten patients underwent removal of lower third molars using the same surgical
protocol and pharmacological approach. In the postoperative period, all patients received
four consecutive daily sessions of low-level laser therapy, beginning 24 hours after the
surgery. Intraoral applications using the diode laser with 660 nm wavelength in the
continuous scan mode were performed covering the entire surgical area, which was divided
into four quadrants, each of 1 cm2 area at a distance of 1 cm. The energy
applied at each point was 5 J/cm2 during 8 seconds. [Results] The swelling and
interincisal opening returned to normal 24 hours after the first low-level laser therapy
application (Friedman test). Moreover, the pain intensity was reduced on the third
postoperative day, according to the Friedman test. [Conclusion] Low-level laser therapy
(660 nm), at the dosimetry used in this study, was effective in reducing postoperative
pain and swelling following oral surgery.
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Affiliation(s)
| | | | | | | | | | | | - Nelson Fuirini
- School of Medical Sciences, Pontifical University Catholic of Campinas, Brazil
| | - Karen B P Fernandes
- Health Sciences Research Center, University of Northern Parana, Brazil ; School of Medicine, Pontificial University Catholic of Paraná, Brazil
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