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Alam M, Karami S, Mohammadikhah M, Badkoobeh A, Golkar M, Abbasi K, Soufdoost RS, Hakim LK, Talebi S, Namanloo RA, Hussain A, Heboyan A, Tebyaniyan H. The effect of photobiomodulation therapy in common maxillofacial injuries: Current status. Cell Biochem Funct 2024; 42:e3951. [PMID: 38349051 DOI: 10.1002/cbf.3951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.
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Affiliation(s)
- Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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Medhat A, El-Zainy MA, Fathy I. Photo biomodulation of dental derived stem cells to ameliorate regenerative capacity: In vitro study. Saudi Dent J 2024; 36:347-352. [PMID: 38419992 PMCID: PMC10897600 DOI: 10.1016/j.sdentj.2023.11.018] [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: 08/13/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
Background Dental regeneration benefits from improving the features of dental derived stem cells. Gallium-aluminum-arsenide laser had a significant role in modification of cell behavior in different cell lines and culture conditions. Hence, exploring its mechanism and effect on dental derived stem cells would benefit prospective regenerative dental therapies. Objectives To assess the impact of photo biomodulation by Low-Level-Laser on isolated Dental Pulp derived Stem Cells and Periodontal Ligament derived Stem Cells regarding their proliferation and osteogenic differentiation. Methods Isolated DPSCs and PDLSCs from impacted third molars were subjected to Gallium-aluminum-arsenide laser for 12 sec and 3.6 J/cm2. The proliferative capacity was evaluated via 3-(4,5-dimethylthiazol-2-yl),2,5-diphenyltetrazolium bromide (MTT) Assay and Trypan blue stain. Cell osteogenic differentiation potentials were assessed by alkaline phosphatase assay and alizarin red stain, polymerase chain reaction was performed to quantify Nuclear factor Kappa gene expression. Results DPSCs subjected to laser bio-stimulation showed the best results regarding cell viability (MTT) and osteogenic differentiation (ALP assay), and calcium deposition at 3 intervals (3, 7, 14 days), meanwhile, PDLSCs subjected to laser bio-stimulation showed better result than control but less than DPSCs. While NF-KB gene expression was proven to be approximately comparable for both groups. Generally, the Photo-bio modulated groups showed better results than their control groups. Conclusion Low-level laser bio-stimulation (LLL) therapy improves DPSC and PDLSC osteogenic differentiation and proliferation via the activation of the NF-KB pathway. Also, the DPSCs outperformed PDLSCs in terms of performance. Clinical significance These results can be beneficial information and a reference database for more research in tissue engineering, dental therapy, and regeneration.
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Affiliation(s)
- Alaa Medhat
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Medhat A El-Zainy
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Iman Fathy
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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de Oliveira-Souza AIS, Mohamad N, de Castro Carletti EM, Müggenborg F, Dennett L, de Oliveira DA, Armijo-Olivo S. What are the best parameters of low-level laser therapy to reduce pain intensity and improve mandibular function in orofacial pain? A systematic review and meta-analysis. Disabil Rehabil 2023; 45:3219-3237. [PMID: 36263978 DOI: 10.1080/09638288.2022.2127933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the effectiveness of laser therapy for managing patients with orofacial pain (OFP). In addition, to determine which parameters provide the best treatment effects to reduce pain, improve function, and quality of life in adults with OFP. METHODS Systematic review. Searches were conducted in six databases; no date or language restrictions were applied. Studies involving adults with OFP treated with laser therapy were included. The risk of bias (RoB) was performed with the Revised Cochrane RoB-2. A meta-analysis was structured around the OFP type, and outcomes. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessed the overall certainty of the evidence. RESULTS Eighty-nine studies were included. Most studies (n = 72, 80.9%) were considered to have a high RoB. The results showed that laser therapy was better than placebo in improving pain, maximal mouth open (MMO), protrusion, and tenderness at the final assessment, but with a low or moderate level of evidence. The best lasers and parameters to reduce pain are diode or gallium-aluminum-arsenide (GaAlAs) lasers, a wavelength of 400-800 or 800-1500 nm, and dosage of <25 J/cm2. CONCLUSIONS Laser therapy was better than placebo to improve pain, MMO, protrusion, and tenderness. Also, it was better than occlusal splint to improve pain, but not better than TENS and medication.Implications for rehabilitationLaser therapy was found to be good in improving pain, maximal mouth opening, jaw protrusion, and tenderness at the end of the treatment.For patients with all types of temporomandibular disorders (TMDs) (myogenous, arthrogenous, and mixed), the following lasers and parameters are recommended: diode or gallium-aluminum-arsenide (GaAlAs) laser, wavelength of 400-800 or 800-1500 nm, and a dosage <25 J/cm2.For patients with arthrogenous TMDs, the following lasers and parameters are recommended: Diode laser and a wavelength between 400 and 800 nm.For patients with myogenous TMDs, the following lasers and parameters are recommended: diode laser, wavelength between 800 and 1500 nm, and dosage of <25 J/cm2.For patients with mixed TMDs, the following lasers and parameters are recommended: diode, GaAlAs, or infrared laser, a wavelength of 800-1500 nm, a dosage >100 J/cm2, and an application time between 15 and 30 s or >60 seconds.
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Affiliation(s)
- Ana Izabela Sobral de Oliveira-Souza
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Brazil
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Norazlin Mohamad
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Frauke Müggenborg
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Liz Dennett
- FORBs - Specialist Medical Center for Orthopedics and Rehabilitation of the Locomotor System, Osnabrück, Germany
| | | | - Susan Armijo-Olivo
- Faculty of Economics and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Kim H, Shim JW, Shin WC, Lee YJ, Ha IH, Kim KW, Cho JH. Korean Medicine Clinical Practice Guideline Update for Temporomandibular Disorders: An Evidence-Based Approach. Healthcare (Basel) 2023; 11:2364. [PMID: 37628561 PMCID: PMC10454242 DOI: 10.3390/healthcare11162364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Many updated clinical research results have been published since the Korean Medicine Clinical Practice Guidelines (KMCPGs) for temporomandibular disorders (TMDs) were published in 2018. Therefore, it is necessary to update the existing clinical practice guidelines (CPGs). This study presents updated recommendations for TMD treatment based on current research data published up to February 2020. The draft version of the level of evidence and grade of recommendation was determined through an assessment of the risk of bias and a meta-analysis of selected literature based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The final guidelines were derived using the Delphi method. Eighteen recommendations were derived for eight items of Korean medicine treatment for TMDs. Compared with previous Korean medicine CPGs for TMDs, the grades of seven recommendations, including acupuncture, pharmacopuncture, and Chuna manual therapy, were increased. The grades of the two recommendations have been changed. Six new recommendations were added to fully reflect clinical reality. Acupuncture, pharmacopuncture, and Chuna manual therapy are recommended for TMD patients in clinical practice. Concurrent conventional conservative therapy with Korean medicine or a combination of Korean medicines should be considered in clinical practice in patients with temporomandibular disorders.
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Affiliation(s)
- Hyungsuk Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae Woo Shim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Woo-Chul Shin
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
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Emam ANM, Abdel-Gawwad EA, Baiomy AAA, Farhat MY, Atito E, Helal MA. Efficacy of Occlusal Splints and Low-Level Laser Therapy on the Mandibular Range of Motion in Subjects with Temporomandibular Joint Disc Displacement with Reduction. J Int Soc Prev Community Dent 2023; 13:229-236. [PMID: 37564171 PMCID: PMC10411297 DOI: 10.4103/jispcd.jispcd_159_22] [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: 07/30/2022] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 08/12/2023] Open
Abstract
Aims and Objectives The study was carried out to evaluate the efficacy of four conservative therapeutic modalities on the mandibular range of motion (MRM) in subjects with anterior disc displacement with reduction (ADDwR) of the temporomandibular joint (TMJ). Materials and Methods One hundred patients (64 women and 36 men) were selected, and randomly distributed into four groups. Group I: Subjects receiving behavioral therapy (BT). Group II: Subjects receiving low-level laser therapy (LLLT). Group III: Subjects receiving maxillary anterior repositioning splint (MARS). Group IV: Subjects receiving stabilization splint (SS). The MRM was evaluated for each patient before treatment and after 6 months. Paired t test and one-way analysis of variance (ANOVA) tests were used for statistical analysis followed by a post hoc Tukey test (P ≤ 0.05). Results All groups showed significant improvement in MRM after 6 months of treatment (P ≤ 0.05) except for BT. There was a significant improvement for SS and MARS on the different movements of MRM, more than for LLLT and BT (P ≤ 0.05). Conclusion The MARS and the SS are effective in increasing the MRM for patients with ADDwR.
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Affiliation(s)
- Abdel-Naser M Emam
- Department of Prosthetic Dental Science, College of Dentistry, Najran University, Najran, Saudi Arabia
| | | | | | - Mostafa Yassin Farhat
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
| | - Ehap Atito
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
| | - Mohamed Ahmed Helal
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
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Desai AP, Roy SK, Semi RS, Balasundaram T. Efficacy of Low-Level Laser Therapy in Management of Temporomandibular Joint Pain: A Double Blind and Placebo Controlled Trial. J Maxillofac Oral Surg 2022; 21:948-956. [PMID: 36274894 PMCID: PMC9474957 DOI: 10.1007/s12663-021-01591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background Stomatognathic system is an interaction of the muscles of mastication, dentition, neural component, and temporomandibular joint. Any dysfunction in this system may lead to temporomandibular disorders (TMDs). Various non-surgical modalities have been employed for treating TMDs. Aim and objectives The aim of the study was to objectively evaluate the effects of low-level laser therapy (LLLT) in treatment of patients with TMDs. Materials and Methods Sixty individuals diagnosed with TMDs were divided randomly into two groups (Group I-placebo and Group II -LLLT). A series of 20 sessions of LLLT applied both in closed mouth and maximum mouth opening position were given over a period of 08 weeks. Assessment was done in terms of improvement in mouth opening, pain, clicking, and deviation of mandible. The data collected were analyzed statistically. Results The results showed improvement in the pain reduction, improvement in the maximum mouth opening, reduction in deviation, and clicking in both groups but better treatment outcome in the low-level laser group. Conclusion Though conservative measures improved the symptoms in TMD but LLLT has shown better results in comparison with the placebo group. Being non-surgical can be employed in combination with other modes for effectively treating such disorders. Keywords: Pain, Dysfunction, Temporomandibular joint disorders (TMDs), Low-level laser therapy (LLLT).
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Affiliation(s)
- Ajay Premanand Desai
- Oral and Maxillofacial Surgery, Army Dental Centre (Research & Referral), New Delhi, 110010 India
| | - S. K. Roy
- Oral and Maxillofacial Surgery, Army Dental Corps, New Delhi, 110010 India
| | | | - T. Balasundaram
- Oral and Maxillofacial Surgery, Military Dental Centre, Jabalpur, 482001 India
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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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Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Parvaie P, Anbari F. The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS). J Dent Anesth Pain Med 2022; 22:19-27. [PMID: 35169617 PMCID: PMC8814725 DOI: 10.17245/jdapm.2022.22.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/06/2022] [Accepted: 01/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Hamid Reza Khalighi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Science Research Center, Shohada Tajrish Hospital, Tajrish Square, Tajrish Street, Tehran, Iran
| | - Parvin Parvaie
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Fahimeh Anbari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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NEGUCIOIU M, KUI A, MITARIU M, MANZIUC M, CONDOR D, MITARIU L, BUDURU S. The outcomes of ultrasonic and laser therapy in case of temporomandibular disorders – an evidence based update. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Temporomandibular disorders (TMDs) are considered multifactorial conditions, thereby with different therapy options, from occlusal equilibration, splint therapy, pharmacotherapy or physical therapy. Among the physical therapies, over the last years, laser therapy and ultrasound therapy have gained attention, as different experimental or clinical studies suggest their efficacy in case of TMDs. The aim of our literature review is to evaluate the available evidence on the effectiveness of laser and ultrasound therapy in the treatment of temporomandibular disorders. Material and method. A research of literature has been performed - articles published over the last 5 years (January 2016 until June 2021) were searched by introducing a combination of different terms, using the Pubmed, Scopus and Google Scholar databases. Results and discussions. A total number of 332 articles was found. For multiple publications regarding the same group of patients, the most recent studies were included. Initial analysis of titles and abstracts eliminated 232 articles, leaving 35 articles whose full text was examined. 20 articles met the inclusion criteria Conclusions. According to the findings of this literature update we can conclude that low level laser therapy, ultrasound therapy, and photobiomodulation may effectively reduce pain for patients suffering of muscular and joint TMDs. However, their effects appear to be only shortly maintained, and only for less complex cases. In addition, it was difficult to compare the studies included, as they do not offer an optimal usage (program, duration of sessions, or number of sessions) of each technique. In this context, we consider that further randomized clinical studies are necessarily to compare each physical technique as well as their synergic effect on the symptoms in case of temporomandibular disorders.
Keywords: temporomandibular disorders, low level laser therapy, ultrasound therapy, photobiomodulation, TMD, LLLT
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Affiliation(s)
- Marius NEGUCIOIU
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
| | - Andreea KUI
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania 2.“Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Mihai MITARIU
- “Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Manuela MANZIUC
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
| | - Daniela CONDOR
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Periodontics, Cluj Napoca, Romania
| | - Loredana MITARIU
- “Lucian Balga” University, Department of Dental Medicine, Sibiu, Romania
| | - Smaranda BUDURU
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Prosthodontics, Cluj Napoca, Romania
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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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Sobral APT, Sobral SDS, Campos TM, Horliana ACRT, Fernandes KPS, Bussadori SK, Motta LJ. Photobiomodulation and myofascial temporomandibular disorder: Systematic review and meta-analysis followed by cost-effectiveness analysis. J Clin Exp Dent 2021; 13:e724-e732. [PMID: 34306537 PMCID: PMC8291152 DOI: 10.4317/jced.58084] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/16/2021] [Indexed: 11/05/2022] Open
Abstract
Background Photobiomodulation (PBM) is a non-invasive and non-pharmacological treatment, which, has shown beneficial results in the treatment of temporomandibular disorders (TMD) related pain. This systematic review and meta-analysis study aimed to evaluate the efficacy of photobiomodulation in the treatment of myofascial pain associated with (TMD by analyzing randomized clinical trials published from 2007 to February 2019. The secondary objective of the study was to perform a cost-effectiveness analysis of TMD treatment with photobiomodulation in patients with myofascial pain. Material and Methods International databases were used: Pubmed, Medline and Web of Science; the initial search raised 316 papers, and only 17 papers met the inclusion criteria for the systematic review (SR). Of these, only 04 papers met the inclusion criteria for meta-analysis: VAS data represented by numerical scores and placebo control group. Results As for the wavelength, the most used value was 780nm (followed by 830nm. The most used treatment time was 4 offered treatments for 4 weeks; followed by 10 sessions. Regarding periodicity, 9 studies used 2 times a week. The meta-analysis showed that laser-treated groups had painful symptoms improvement that was superior to the control group (mean difference 1.49;95% CI = -1.67; -1.32). Laser therapy showed a cost-effectiveness of $1,464.28 by controlled pain intensity and placebo showed $2,866.20 by controlled pain intensity. Conclusions The studies were considered to have moderate quality of evidence. Laser-treated groups had painful symptoms improvement that was superior to the control group and photobiomodulation was more cost-effective than placebo in patients with TMD and myofascial pain. Key words:Temporomandibular disorder, Myofascial pain, Photobiomodulation, Placebo, Cost-effectiveness.
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Affiliation(s)
| | - Sergio-de Sousa Sobral
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | - Thalita-Molinos Campos
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | | | | | - Sandra-Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | - Lara-Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil.,Postgraduate Program
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12
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Ahmad SA, Hasan S, Saeed S, Khan A, Khan M. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life 2021; 14:148-164. [PMID: 34104237 PMCID: PMC8169142 DOI: 10.25122/jml-2020-0169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Temporomandibular joint disorders (TMDs) encompass a wide array of ailments affecting the temporomandibular joint (TMJ), muscles of mastication, and the allied structural framework. Myofascial pain, internal derangement of the joint, and degenerative joint diseases constitute the majority of TMDs. TMDs usually have a multifactorial etiology, and treatment modalities range from conservative therapies to surgical interventions. Low-level laser therapy (LLLT) has evolved as an efficient non-invasive therapeutic modality in TMDs. Previously conducted systematic reviews and meta-analyses have shown variable results regarding the efficiency of LLLT in TMJ disorder patients. Hence, this systematic review was carried out as an attempt to evaluate the efficacy of LLLT in the treatment of temporomandibular joint disorder patients.
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Affiliation(s)
- Syed Ansar Ahmad
- Department of Oral Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shazina Saeed
- Laboratory of Disease Dynamics and Molecular Epidemiology, Amity Institute of Public Health, Amity university, Noida, Uttar Pradesh, India
| | - Ateeba Khan
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Munna Khan
- Department of Electrical Engineering, Jamia Millia Islamia, New Delhi, India
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13
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Lezcano MF, Dias FJ, Chuhuaicura P, Navarro P, Fuentes R. Symmetry of mandibular movements: A 3D electromagnetic articulography technique applied on asymptomatic participants. J Prosthet Dent 2021; 125:746-752. [DOI: 10.1016/j.prosdent.2020.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/21/2020] [Accepted: 01/21/2020] [Indexed: 11/25/2022]
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14
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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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15
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Momeni H, Noshirvani F, Sadighi A. The Effect of 660-nm Low Level Laser Therapy on Mandibular Lateral Movement After Orthognathic Surgery: A Randomized Phase 1 Trial. DENTAL HYPOTHESES 2021. [DOI: 10.4103/denthyp.denthyp_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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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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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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18
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De Oliveira Chami V, Maracci LM, Tomazoni F, Centeno ACT, Porporatti AL, Ferrazzo VA, Marquezan M. Rapid LLLT protocol for myofascial pain and mouth opening limitation treatment in the clinical practice: An RCT. Cranio 2020; 40:334-340. [PMID: 32491956 DOI: 10.1080/08869634.2020.1773660] [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] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the effect of a rapid treatment protocol of low-level laser therapy (LLLT) in patients with myofascial pain and mouth opening limitation. METHODS Twenty patients were randomly allocated into the laser group (LG) (n = 10) and the placebo group (PG) (n = 10). Two LLLT sessions or placebo were performed. They were applied to the pain points upon palpation, with a 48-hr interval. Patients were evaluated for spontaneous pain sensitivity during mandibular movements and for oral health-related quality of life, which was assessed using the Oral Health Impact Profile for Temporomandibular Disorders (OHIP/TMD) questionnaire. RESULTS Two patients from the placebo group were lost during the study. A significant increase in the maximum mouth opening (p = 0.04) and improvement in OHIP/TMD scores (p = 0.003) were observed in the LG after 30 days. CONCLUSION Spontaneous pain was reduced in both groups with low-level laser therapy.
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Affiliation(s)
| | | | - Fernanda Tomazoni
- Department of Physiology, Federal University of Santa Maria , Santa Maria, Brazil
| | | | - André Luiz Porporatti
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis, Brazil
| | | | - Mariana Marquezan
- Department of Stomatology, Federal University of Santa Maria , Santa Maria, Brazil
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19
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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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20
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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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21
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Azangoo Khiavi H, Ebrahimi H, Najafi S, Nakisa M, Habibzadeh S, Khayamzadeh M, Kharazifard MJ. Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study. J Lasers Med Sci 2020; 11:37-44. [PMID: 32099625 DOI: 10.15171/jlms.2020.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Myofascial pain dysfunction syndrome (MPDS) is a common temporomandibular joint disorder. Due to its multifactorial etiology, treatment usually involves more than one modality to obtain complementary results. The purpose of this study was to compare the combined effect of a low-level laser, a hard occlusal appliance, and conventional pharmacotherapy with pharmacotherapy only in the management of patients with MPDS. Methods: In this study, 15 patients with MPDS were diagnosed and randomly assigned to 3 groups (n=5). Subjects in Group 1 were treated with pharmacotherapy (PT); Group 2 received the diode laser (940 nm gallium arsenide) every other day for a total of 10 sessions, plus pharmacotherapy (PTL) and Group 3 were given hard occlusal splint 12 h/day for 4 weeks, plus pharmacotherapy (PTO). The intensity of pain was measured using the visual analog scale (VAS) prior to the treatment, 2 and 4 weeks after the onset of treatment and 2 weeks later. The maximum painless mouth opening and pain intensity at muscle palpation were also recorded. Comparisons were made between the groups via repeated measure analysis of variance (ANOVA) (P<0.05). Results: Pain relief in the subjective VAS was observed in both laser and appliance groups in the third and fourth examination sessions (P<0.05). No statistically significant reduction in pain was noted using pharmacotherapy only. The maximum painless mouth opening and muscle tenderness were not significantly different between the 3 groups (P>0.05). Conclusion: Both the laser and the occlusal appliance combined with pharmacotherapy proved to be effective for pain reduction in patients with MPDS. All groups, however, failed to result in a significant improvement in the maximum mouth opening or tenderness in masticatory muscles.
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Affiliation(s)
- Hassan Azangoo Khiavi
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Hooman Ebrahimi
- Oral Medicine Department, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Shamsolmolouk Najafi
- Department of Oral and Maxillofacial Disease, Dental Research Center, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sareh Habibzadeh
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Mina Khayamzadeh
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
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Photobiostimulation activity of different low-level laser dosage on masticatory muscles and temporomandibular joint in an induced arthritis rat model. Lasers Med Sci 2019; 35:1129-1139. [PMID: 31834562 DOI: 10.1007/s10103-019-02933-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
This study aimed to investigate the anti-inflammatory effects of different dosage of low-level laser therapy (LLLT) in an experimental model of temporomandibular joint (TMJ) arthritis. One hundred male Wistar rats were used and divided into the following groups: CG, control group; AG, animals group with left TMJ arthritis induced by intra-articular injection of Complete Freund's adjuvant - CFA; LG5, LG10 and LG20 - animals with arthritis and treated with LLLT at doses 5, 10, and 20 J/cm2, respectively. Morphological analysis was performed by TMJ histological sections stained with hematoxylin-eosin (HE), picrosirius (PSR), and toluidine blue (TB), as well as histomorphometric evaluation of cartilage, articular disc, and masticatory muscles. The amount of feed consumed within 3 weeks was evaluated, and biochemical analysis of TMJ tissues included measurement of sulfated glycosaminoglycans (GAGs), matrix metalloproteinases (MMPs) 2 and 9 zymography, and ELISA for cytokines IL-6, TNF-α, and IL-1β. Only the 20 J/cm2 dose promoted higher feed intake compared to AG. On the other hand, all LLLT doses promoted better organization of articular disc collagen fibers, greater number of proteoglycans in articular cartilage, increased area and diameter of left lateral pterygoid fibers, reduced latent and active MMP 9 and 2 activity, and lower IL-1β concentration compared to AG. Considering the study limitations, it was observed that LLLT treatments were effective in protecting and tissue cleansing joint structures, accelerating tissue repair, especially at lower doses.
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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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24
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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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25
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Kim KW, Ha IH, Lee YJ, Kim MR, Shin BC, Song MY, Cho JH. A clinical practice guideline for temporomandibular disorders in traditional Korean medicine: An evidence-based approach. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Rasca E, Namour A, Fauchon-Giumelli A, Nammour S. Laser phototherapy in acute posttraumatic trismus - Case-series study. Laser Ther 2018; 27:219-226. [PMID: 32158068 DOI: 10.5978/islsm.27_18-or-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Backgroud and aims There are very few studies on laser phototherapy (LPT) in acute temporomandibular disorders (TMDs). Our objective is to assess the effectiveness of laser phototherapy (LPT) on the limitation of the mouth opening due to an acute mandibular trauma. Subjects and methods Fourteen women of 41 ± 3 years and 24 men of 38 ± 3 years, with no history of TMD and having sustained a mandibular trauma within the prior 20 hours, were treated exclusively by using an 810-nm laser beam in a continuous wave mode, with an output power of 1 W. At a speed of 2 cm/s, it scanned twice, for 60 seconds, with a pause in between of 2 minutes, a large cutaneous area (25 cm2), covering the temporomandibular joint (TMJ), the masseter muscle and a part of the temporalis fossa; also, it scanned just once, for 7 seconds, a small mucous area (3 cm2), covering the internal pterygoid muscle. The clinical outcomes were evaluated by comparing the maximum unassisted opening (MUO), measured at the baseline and immediately after the end of the LPT procedure. Results The MUO improvement of 24.6 ± 4.4 mm represented a highly significant difference (p < .0001) between the measurements, in all the patients, regardless of gender. Conclusions By scanning with an 810-nm laser beam, within less than 20 hours after the trauma, large areas of all the involved tissues and not just a few points, as described until now, the limited mouth opening in acute posttraumatic trismus was immediately and greatly resolved.
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Affiliation(s)
- Emilia Rasca
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Amaury Namour
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Aude Fauchon-Giumelli
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liège, Belgium Institut de dentisterie - Polycliniques Brull, Liège, Belgium
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Brochado FT, Jesus LHD, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018; 32:e50. [PMID: 29995062 DOI: 10.1590/1807-3107bor-2018.vol32.0050] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/25/2018] [Indexed: 12/22/2022] Open
Abstract
The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
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Affiliation(s)
- Fernanda Thomé Brochado
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Luciano Henrique de Jesus
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Vinicius Coelho Carrard
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Angelo Luiz Freddo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Buco Maxillofacial Surgery and Traumatology, Porto Alegre, RS, Brazil
| | - Karen Dantur Chaves
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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28
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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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29
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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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Sobral APT, Godoy CLHD, Fernandes KPS, Bussadori SK, Ferrari RAM, Horliana ACRT, Monken SF, Motta LJ. Photomodulation in the treatment of chronic pain in patients with temporomandibular disorder: protocol for cost-effectiveness analysis. BMJ Open 2018; 8:e018326. [PMID: 29730613 PMCID: PMC5942461 DOI: 10.1136/bmjopen-2017-018326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Epidemiological data show that the signs and symptoms of temporomandibular disorder (TMD) start becoming apparent from 6 years of age, and during adolescence these signs and symptoms are similar to those of adults. The present study aims to estimate the direct costs for treatment of chronic muscle pain with photobiomodulation therapy, occlusal splint and placebo in patients with TMD; to evaluate the effectiveness of photobiomodulation therapy and occlusal splint for treatment of muscle pain in patients with TMD; to analyse the cost-effectiveness of the two proposed treatments for pain; and to describe and compare the results of the analyses of these treatments. METHODS AND ANALYSIS This is a prospective trial of clinical and economic analyses that will include 135 patientswith TMD aged between 15 years and 25 years, randomly assigned to a treatment group: G1 (photobiomodulation), G2 (occlusal splint) and G3 (placebo). The analyses will be based on the cost of each treatment during the 12-month period. The outcome of the analysis of effectiveness will be pain, measured periodically by means of clinical examination of Research Diagnostic Criteria for Temporomandibular Disorders. The cost-effectiveness ratio will be calculated using, as end points, pain and the ratio of the differences in costs between the groups studied. The evaluation of the impact of the treatment on quality of life will be determined by applying the adapted EuroQol-5D. ETHICS AND DISSEMINATION This protocol has been ethically approved by the local medical ethical committee, protocol number 2.014.339. Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT03096301.
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Affiliation(s)
- Ana Paula Taboada Sobral
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Camila Leal H de Godoy
- Dentistry School from Universidade Nove de Julho - UNINOVE, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Kristianne P Santos Fernandes
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | | | | | - Sonia F Monken
- Professional Master Health Administration Program, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Lara J Motta
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
- Professional Master Health Administration Program, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
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Langella LG, Silva PFC, Costa-Santos L, Gonçalves MLL, Motta LJ, Deana AM, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. Photobiomodulation versus light-emitting diode (LED) therapy in the treatment of temporomandibular disorder: study protocol for a randomized, controlled clinical trial. Trials 2018; 19:71. [PMID: 29373998 PMCID: PMC5787298 DOI: 10.1186/s13063-018-2444-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is described as a subgroup of orofacial pain with a set of signs and symptoms that involve the temporomandibular joint, masticatory muscles, ears, and neck. TMD can occur unilaterally or bilaterally and approximately 70% of the population is affected with at least one sign. The disorder progresses with orofacial pain, muscle pain involving the masticatory and cervical muscles, joint noises (clicks and pops), joint block, mandibular dysfunction, and headache. The etiology can be abnormal occlusion and/or posture, trauma involving local tissues, repetitive microtrauma, parafunctional habits, and an increase in emotional stress. Studies have demonstrated that phototherapy is an efficient option for the treatment of TMD, leading to improvements in pain and orofacial function. METHODS The aim of the proposed study is to compare the effects of two sources of photobiomodulation in individuals with TMD. A randomized, controlled, double-blind, clinical trial is proposed, which will involve 80 individuals aged 18-65 years allocated to either a laser group or light-emitting diode (LED) group submitted to 12 sessions of phototherapy. The Research Diagnostic Criteria for TMDs will be used to evaluate all participants. Pain will be measured using the visual analog scale and maximum vertical mandibular movement will be determined with the aid of digital calipers. DISCUSSION This study compares the effects of two modalities of laser therapy on the pain and orofacial function of patients with TMD dysfunction. Photobiomodulation and LED therapy are treatment options for reducing the inflammatory process and pain as well as inducing the regeneration of the target tissue. TRIAL REGISTRATION ClinicalTrials.gov, NCT03257748 . Registered on 8 August 2017.
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Affiliation(s)
- Luciana G Langella
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | - Paula F C Silva
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | - Larissa Costa-Santos
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | - Marcela L L Gonçalves
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | - Lara J Motta
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | - Alessandro M Deana
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil
| | | | | | - Sandra Kalil Bussadori
- Nove de Julho University, 235/249 Vergueiro Street, Liberdade, São Paulo, 01504-001, Brazil.
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Costa SAP, Florezi GP, Artes GE, Costa JRD, Gallo RT, Freitas PMD, Witzel AL. The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study. Braz Oral Res 2017; 31:e107. [DOI: 10.1590/1807-3107bor-2017.vol31.0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 11/22/2017] [Indexed: 12/12/2022] Open
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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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Dzingutė A, Pileičikienė G, Baltrušaitytė A, Skirbutis G. Evaluation of the relationship between the occlusion parameters and symptoms of the temporomandibular joint disorder. Acta Med Litu 2017; 24:167-175. [PMID: 29217971 PMCID: PMC5709056 DOI: 10.6001/actamedica.v24i3.3551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background. The aetiology of temporomandibular joint disorders (TMD) is multifactorial, whereas occlusal disharmony is one of the predisposing factors. Researchers still discuss the relation between occlusion and TMD. Objective. The study aims to investigate the relation between static occlusal parameters and TMD clinical symptoms using T-Scan II analysis system. Material and methods. The sample consisted of 44 persons divided into the treatment group of 20 TMD patients and the control group of 24 subjects without TMD. The main task of T-Scan II computerized occlusal analysis system was to record every patient’s occlusion and estimate static occlusal parameters: centre of occlusal force, asymmetry index of maximum occlusal force and occlusion time. These results were compared between groups, data related to patients’ complaints and clinical symptoms. The analysis was carried out using Mann-Whitney U, Kruskal-Wallis and Chi-square tests. Results. Averages of the centre of occlusal force in TMD subjects were 6.55 ± 0.99 mm, in the control group – 5.88 ± 0.69 mm; the asymmetry index of maximum occlusal force averages: 15.90 ± 2.71 and 12.93 ± 1.88; occlusion time: 0.281 ± 0.036 s and 0.236 ± 0.022 s, respectively. There were no statistically significant differences between two groups but they were found in the centre of occlusal force and the asymmetry index in the two groups (p < 0.05). Conclusions. There exists a relation between complaints of patients with TMD and static occlusion parameters. Values of the centre of the occlusal force distance and the asymmetry index of occlusal force in TMD patients with pain in the temporomandibular joint (TMJ) were significantly higher than in the control group.
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Affiliation(s)
- Agnė Dzingutė
- Clinical Department of Dental and Maxillary Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gaivilė Pileičikienė
- Clinical Department of Dental and Maxillary Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Aušra Baltrušaitytė
- Clinical Department of Dental and Maxillary Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gediminas Skirbutis
- Clinical Department of Dental and Maxillary Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg 2017; 46:1403-1410. [DOI: 10.1016/j.ijom.2017.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
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Lauriti L, de Cerqueira Luz JG, Agnelli Mesquita-Ferrari R, Fernandes KPS, Deana AM, Tempestini Horliana ACR, Costa-Santos L, Brugnera Junior A, Bussadori SK. Evaluation of the Effect of Phototherapy in Patients with Mandibular Fracture on Mandibular Dynamics, Pain, Edema, and Bite Force: A Pilot Study. Photomed Laser Surg 2017; 36:24-30. [PMID: 29023221 DOI: 10.1089/pho.2017.4334] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of phototherapy on bite force, facial swelling, mandibular movements, and pain in patients having undergone surgical treatment for mandibular fractures. BACKGROUND These are among the predominant types of facial fractures, and treatment involving surgical fixation with titanium plates is one of the most common procedures in oral-maxillofacial surgery. Phototherapy has been used to accelerate the muscle healing process and significantly improves muscle regeneration by inducing the formation of new muscle fibers. METHODS The patients were divided into two groups: Group 1-active phototherapy, and Group 2-sham phototherapy. Both groups underwent the surgical procedure by the same surgeon using the same surgical technique. Dosimetric parameters are wavelength, 660 nm; power, 108 mW; radiant energy, 21.6 J; fluency, 21.6 J/cm2; radiance, 38197 mW/cm2; exposure time, 200 sec per point, 10 points bilaterally. Photobiomodulation was performed in 15 sessions. RESULTS The primary variable was bite force measured with a gnathodynamometer and the secondary variables were facial swelling, mandibular movements (measured with digital calipers), and pain. The Student's t-test was used to determine intergroup differences. CONCLUSIONS The findings suggest improvements in the laser group in comparison with the sham group with regard to mandibular dynamics, a reduction in postoperative facial swelling, a reduction in pain, and an increase in bite force.
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Affiliation(s)
- Leandro Lauriti
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Raquel Agnelli Mesquita-Ferrari
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Alessandro Melo Deana
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Larissa Costa-Santos
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | - Aldo Brugnera Junior
- 4 National Institute of Science and Technology-INCT, IFSC, University of São Paulo , São Carlos, Brazil
| | - Sandra Kalil Bussadori
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
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Seifi M, Ebadifar A, Kabiri S, Badiee MR, Abdolazimi Z, Amdjadi P. Comparative effectiveness of Low Level Laser therapy and Transcutaneous Electric Nerve Stimulation on Temporomandibular Joint Disorders. J Lasers Med Sci 2017; 8:S27-S31. [PMID: 29071032 DOI: 10.15171/jlms.2017.s6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Temporomandibular joint disorders (TMDs) are the most common source of pain on the face. There are multiple etiologies, and several types of treatment have been reported. The use of non-invasive and reversible therapies in the treatment of such problems is recommended. The present study evaluated the effect of low-level laser (LLL) therapy and transcutaneous electric nerve stimulation (TENS) on TMDs. Methods: In this single-blind study, 40 patients with temporomandibular disorders were randomly divided into four groups: TENS (TENSTem dental), LLL (diode 810 nm CW), shamTENS, and sham-LLL. All subjects were examined and data on pain and tenderness in the temporomandibular joint (TMJ) and masticatory muscles (using the visual analogue scale) and mouth-opening (distance between incisal edges before feeling pain; mm) were collected before baseline (T1), after each session (T2-T5) and one month after the end of the sessions (T6)), and analyzed using repeated measure analysis of variance (ANOVA) and Bonferroni statistical tests. A P value < 0.05 was considered significant. Results: The decrease in pain (P=0.000), tenderness (P=0.000) and increase in mouth-opening ability (P=0.002) was greater in the TENS and LLL groups than in the placebo groups. At the one-month follow-up, significant decrease in pain and tenderness was recorded in the TENS and LLL groups (P=0.000). There was no significant differences between TENS and LLL and the placebo groups for maximum mouth-opening at the end of the study (P=0.692). Conclusion: Using TENS or LLL therapy can improve TMD symptoms at least for the short term. Although the effects of the placebo played a role in improving symptoms, their effects were less important.
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Affiliation(s)
- Massoud Seifi
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ebadifar
- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Sattar Kabiri
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Badiee
- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Zahra Abdolazimi
- Pediatric Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amdjadi
- Department of Dental Materials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Antonić R, Brumini M, Vidović I, Muhvić Urek M, Glažar I, Pezelj-Ribarić S. he effects of low level laser therapy on the management of chronic idiopathic orofacial pain: trigeminal neuralgia, temporomandibular disorders and burning mouth syndrome. ACTA ACUST UNITED AC 2017. [DOI: 10.21860/medflum2017_173373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Moradi Abbasabadi F. Low Level Laser Therapy Versus Pharmacotherapy in Improving Myofascial Pain Disorder Syndrome. J Lasers Med Sci 2016; 7:45-50. [PMID: 27330698 DOI: 10.15171/jlms.2016.10] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Temporomandibular disorders (TMD) lead to masticatory muscle pain, jaw movement disability and limitation in mouth opening. Pain is the chief complaint in 90% of the TMD patients which leads to disability and severe socioeconomic costs. The purpose of this study was to evaluate the therapeutic effects of low level laser therapy (LLLT) compared to pharmacotherapy with NSAIDs (naproxen) in myofascial pain disorder syndrome (MPDS). METHODS In this randomized controlled clinical trial, 40 MPDS patients were divided into two groups. One group received naproxen 500 mg bid for 3 weeks as treatment modality and also had placebo laser sessions. The other group received active laser (diode 810 nm CW) as treatment and placebo drug. Pain intensity was measured by visual analogue scale (VAS) and maximum painless mouth opening was also measured as a functional index every session and at 2 months follow up. Data was collected and analyzed with SPSS software. Independent t test was used to analyze the data. A P < 0.05 was considered significant. RESULTS Low level laser caused significant reduction in pain intensity (P < 0.05) and a significant increase in mouth opening. In naproxen group neither pain intensity nor maximum mouth opening had significant improvement. Pain relief, in subjective VAS was observed in third session in LLLT group, but did not occur in naproxen group. Maximum mouth opening increased significantly in laser group compared to the naproxen group from the eighth session. CONCLUSION Treatment with LLLT caused a significant improvement in mouth opening and pain intensity in patients with MPDS. Similar improvement was not observed in naproxen group.
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Affiliation(s)
- Hamid Reza Khalighi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran,Iran
| | - Saranaz Azari-Marhabi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Moradi Abbasabadi
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran
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Shukla D, Muthusekhar MR. Efficacy of low-level laser therapy in temporomandibular disorders: A systematic review. Natl J Maxillofac Surg 2016; 7:62-66. [PMID: 28163481 PMCID: PMC5242077 DOI: 10.4103/0975-5950.196127] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose: The aim of this systematic review was to assess the efficacy of low-level laser therapy (LLLT) in patients with temporomandibular disorders (TMDs). Methods: Medline search was done from 1997 to 2011 using search terms appropriate to establishing a relation between LLLT and TMD. Only randomized controlled trials were included in this study. Outcome variables related to pain, muscle tenderness, mandibular movements, and Electromyographic (EMG) activity were considered. Of the 242 articles examined, 13 were finally included in the critical analysis conducted as a part of the present systematic review. Results: Of the 242 titles reviewed, only 13 articles were considered eligible. 7 articles showed significant improvement in the study group, whereas 5 showed no significant improvement between the study and control groups. The primary outcome of most of the studies was pain. Other variables considered were muscle tenderness, mandibular movements; EMG activity was considered. Conclusion: Our results have shown that LLLT seems to be effective in reducing pain in TMD's. It may be a treatment option for patients with an interest in a noninvasive, complementary therapy.
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Affiliation(s)
- Deepankar Shukla
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - M R Muthusekhar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
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Evaluation of Low-Level Laser Therapy in TMD Patients. Case Rep Dent 2015; 2015:424213. [PMID: 26587294 PMCID: PMC4637444 DOI: 10.1155/2015/424213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 02/07/2023] Open
Abstract
Light amplification by stimulated emission of radiation (laser) is one of the most recent treatment modalities in dentistry. Low-level laser therapy (LLLT) is suggested to have biostimulating and analgesic effects through direct irradiation without causing thermal response. There are few studies that have investigated the efficacy of laser therapy in temporomandibular disorders (TMD), especially in reduced mouth opening. The case report here evaluates performance of LLLT with a diode laser for temporomandibular clicking and postoperative findings were evaluated in two cases of TMD patients. First patient had a history of limited mouth opening and pain in temporomandibular joint (TMJ) region since nine months. Second patient's main complaint was his restricted mouth opening, which was progressed in one year. LLLT was performed with a 685 nm red probed diode laser that has an energy density of 6.2 J/cm(2), three times a week for one month, and application time was 30 seconds (685 nm, 25 mW, 30 s, 0.02 Hz, and 6.2 J/cm(2)) (BTL-2000, Portative Laser Therapy Device). The treatment protocol was decided according to the literature. One year later patients were evaluated and there were no changes. This application suggested that LLLT is an appropriate treatment for TMD related pain and limited mouth opening and should be considered as an alternative to other methods.
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42
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Doeuk C, Hersant B, Bosc R, Lange F, SidAhmed-Mezi M, Bouhassira J, Meningaud J. Current indications for low level laser treatment in maxillofacial surgery: a review. Br J Oral Maxillofac Surg 2015; 53:309-15. [DOI: 10.1016/j.bjoms.2015.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 02/05/2015] [Indexed: 10/23/2022]
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43
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Leal de Godoy CH, Motta LJ, Santos Fernandes KP, Mesquita-Ferrari RA, Deana AM, Bussadori SK. Effect of Low-Level Laser Therapy on Adolescents With Temporomandibular Disorder: A Blind Randomized Controlled Pilot Study. J Oral Maxillofac Surg 2015; 73:622-9. [DOI: 10.1016/j.joms.2014.09.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 09/16/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
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Milward MR, Holder MJ, Palin WM, Hadis MA, Carroll JD, Cooper PR. Low level light therapy (LLLT) for the treatment and management of dental and oral diseases. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/denu.2014.41.9.763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael R Milward
- Senior Lecturer/Honorary Consultant in Periodontology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - Michelle J Holder
- Research Technician in Oral Biology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - William M Palin
- Reader in Biomaterials, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - Mohammed A Hadis
- Research Fellow in Biomaterials, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - James D Carroll
- Founder/CEO at THOR Photomedicine Ltd, 18A East Street, Chesham, HP5 1HQ
| | - Paul R Cooper
- Professor of Oral Biology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN, UK
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Carroll JD, Milward MR, Cooper PR, Hadis M, Palin WM. Developments in low level light therapy (LLLT) for dentistry. Dent Mater 2014; 30:465-75. [PMID: 24656472 DOI: 10.1016/j.dental.2014.02.006] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Low level light/laser therapy (LLLT) is the direct application of light to stimulate cell responses (photobiomodulation) in order to promote tissue healing, reduce inflammation and induce analgesia. There have been significant studies demonstrating its application and efficacy at many sites within the body and for treatment of a range of musculoskeletal injuries, degenerative diseases and dysfunction, however, its use on oral tissues has, to date, been limited. The purpose of this review is to consider the potential for LLLT in dental and oral applications by providing background information on its mechanism of action and delivery parameters and by drawing parallels with its treatment use in analogous cells and tissues from other sites of the body. METHODS A literature search on Medline was performed on laser and light treatments in a range of dental/orofacial applications from 2010 to March 2013. The search results were filtered for LLLT relevance. The clinical papers were then arranged to eight broad dental/orofacial categories and reviewed. RESULTS The initial search returned 2778 results, when filtered this was reduced to 153. 41 were review papers or editorials, 65 clinical and 47 laboratory studies. Of all the publications, 130 reported a positive effect in terms of pain relief, fast healing or other improvement in symptoms or appearance and 23 reported inconclusive or negative outcomes. Direct application of light as a therapeutic intervention within the oral cavity (rather than photodynamic therapies, which utilize photosensitizing solutions) has thus far received minimal attention. Data from the limited studies that have been performed which relate to the oral cavity indicate that LLLT may be a reliable, safe and novel approach to treating a range of oral and dental disorders and in particular for those which there is an unmet clinical need. SIGNIFICANCE The potential benefits of LLLT that have been demonstrated in many healthcare fields and include improved healing, reduced inflammation and pain control, which suggest considerable potential for its use in oral tissues.
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Affiliation(s)
- James D Carroll
- THOR Photomedicine Ltd., 18A East Street, Chesham HP5 1HQ, UK
| | | | | | - Mohammed Hadis
- Biomaterials, University of Birmingham, School of Dentistry, St Chads Queensway, Birmingham B4 6NN, UK
| | - William M Palin
- Biomaterials, University of Birmingham, School of Dentistry, St Chads Queensway, Birmingham B4 6NN, UK.
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46
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Effectiveness of occlusal splints and low-level laser therapy on myofascial pain. Lasers Med Sci 2014; 30:1007-12. [DOI: 10.1007/s10103-014-1522-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
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47
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Madani AS, Ahrari F, Nasiri F, Abtahi M, Tunér J. Low-level laser therapy for management of TMJ osteoarthritis. Cranio 2014; 32:38-44. [DOI: 10.1179/0886963413z.0000000004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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48
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Evaluation of pain, jaw movements, and psychosocial factors in elderly individuals with temporomandibular disorder under laser phototherapy. Lasers Med Sci 2013; 30:953-9. [PMID: 24366293 DOI: 10.1007/s10103-013-1514-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
Abstract
Few studies have been carried out on the application of laser phototherapy (LPT) for treating painful temporomandibular disorder (TMD) in elderly population that is growing worldwide. The aim of the present study was to evaluate the pain, jaw movements, and psychosocial factors in ten elderly patients with painful TMD before and after LPT. All patients were evaluated before and after LPT by using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) axes I and II. For pain assessment, a visual analogue scale (VAS) was used. The LPT was carried out with an GaAlAs diode laser (780 nm; spot size 0.04 cm(2)) in punctual and contact mode. Two settings of irradiations were applied as follows: in patients presenting myofascial pain, 10 mW, 5 J/cm(2), 20 s, 0.2 J per application point; and in patients with joint TMD, 70 mW, 105 J/cm(2), 60 s on five points, 4.2 J per point. Two sessions of LPT were carried out per week over four consecutive weeks, in the total of eight sessions. Data was statistically analyzed (p < 0.05). Significant pain reduction was found in all patients. There were increase in maximum mouth opening without pain and reduction in muscle pain during right and left lateral excursion. A significant reduction in chronic pain severity (p = 0.02) and significant improvements in depression (p = 0.038) and nonspecific physical symptoms with pain (p = 0.0167) were observed. The present findings indicate that LPT is able to promote pain relief and improvement of jaw movements in elderly patients with TMD, with a positive effect on psychosocial aspects.
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49
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Evaluation of anti-nociceptive and anti-inflammatory activity of low-level laser therapy on temporomandibular joint inflammation in rodents. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2013; 129:135-42. [PMID: 24231378 DOI: 10.1016/j.jphotobiol.2013.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 10/02/2013] [Accepted: 10/03/2013] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the analgesic and anti-inflammatory activity of low-level laser therapy (LLLT) on the nociceptive behavioral as well as histomorphological aspects induced by injection of formalin and carrageenan into the rat temporomandibular joint. The 2.5% formalin injection (FRG group) induced behavioral responses characterized by rubbing the orofacial region and flinching the head quickly, which were quantified for 45 min. The pretreatment with systemic administration of diclofenac sodium-DFN group (10 mg/kg i.p.) as well as the irradiation with LLLT infrared (LST group, 780 nm, 70 mW, 30 s, 2.1 J, 52.5 J/cm(2), GaAlAs) significantly reduced the formalin-induced nociceptive responses. The 1% carrageenan injection (CRG group) induced inflammatory responses over the time-course of the study (24 h, and 3 and 7 days) characterized by the presence of intense inflammatory infiltrate rich in neutrophils, scanty areas of liquefactive necrosis and intense interstitial edema, extensive hemorrhagic areas, and enlargement of the joint space on the region. The DFN and LST groups showed an intensity of inflammatory response that was significantly lower than in CRG group over the time-course of the study, especially in the LST group, which showed exuberant granulation tissue with intense vascularization, and deposition of newly formed collagen fibers (3 and 7 days). It was concluded that the LLLT presented an anti-nociceptive and anti-inflammatory response on the inflammation induced in the temporomandibular joint of rodents.
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50
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de Godoy CHL, Silva PFDC, de Araujo DS, Motta LJ, Biasotto-Gonzalez DA, Politti F, Mesquita-Ferrari RA, Fernandes KPS, Albertini R, Bussadori SK. Evaluation of effect of low-level laser therapy on adolescents with temporomandibular disorder: study protocol for a randomized controlled trial. Trials 2013; 14:229. [PMID: 23876095 PMCID: PMC3729421 DOI: 10.1186/1745-6215-14-229] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 07/11/2013] [Indexed: 11/13/2022] Open
Abstract
Background A number of problems involving the temporomandibular joint (TMJ) and associated structures can lead to temporomandibular disorder (TMD). The aim of the proposed study is to assess the effect of low-level laser therapy on occlusal contacts, mandibular movements, electromyography activity in the muscles of mastication and pain in adolescents with TMD. Methods/Design A randomized, controlled, double-blind, clinical trial will be carried out involving 85 male and female adolescents between 15 and 18 years of age. The research diagnostic criteria for TMD will be used to assess all individuals who agree to participate. All participants will be submitted to a clinical examination and electromyographic analysis of the masseter muscles and anterior bundle of the temporal muscles bilaterally, to determine TMD. Based on the clinical findings, the participants will be classified as having or not having TMD. Those with TMD will be divided into four groups, three of which will receive low-level laser therapy and one of which will receive a placebo treatment. The treatments will involve the TMJ region alone, the masseter and temporal muscles alone, or both these regions together. The data will be submitted to descriptive statistical analysis. The chi-square test and Fisher’s exact test will be used to determine associations among the categorical variables. The Student’s t test and analysis of variance will be used for the comparison of mean electromyographic signals. Pearson’s correlation coefficients will be calculated for the analysis of correlations among the continuous variables. Trial registration The protocol for this study has been submitted to Clinical Trials – registration number (NCT01846000).
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Affiliation(s)
- Camila Haddad Leal de Godoy
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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