Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature (original) (raw)
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Pain Research and Management
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...
World Journal of Dentistry
Objective: The purpose of this clinical study is to assess the capability of low-level laser therapy (LLLT) in the treatment of temporomandibular joint disorders (TMJDs). Materials and methods: Twenty-four temporomandibular disorder (TMD) patients were selected based on TMD pain screening, Wong and Baker pain scale, and clinical evaluation for signs of TMJDs. Sixteen patients were randomly selected and placed in an experimental group, and a placebo group comprised of eight patients. Painful muscular areas were identified by digital pressure, and laser was applied to these areas for an average of 300 seconds for each patient. The laser device was directed to painful areas without emission in the placebo group. Patients were evaluated before and immediately after each session and after 1 month. Results: Before and after treatment, the changes in pain levels in group I were statistically significant (p < 0.0001). The changes in pain levels before and after treatment in group II did not show any statistical significance (p = 1.000). The results were statistically significant (p = 0.000), on comparing the pain levels after 1 month in groups I and II. Conclusion: The results revealed a significant amount of pain reduction after LLLT on a short-term basis, the majority of patients reported a decrease in clicking frequency, and a softer mandibular movement compared with the placebo group. Clinical significance: The LLLT can be advocated as an adjunct in reducing pain levels in most TMJDs on a short-term basis. Observations from this study second this view.
Effectiveness of low‐level laser therapy in temporomandibular disorder
Scandinavian Journal of Rheumatology, 2003
Objective: To investigate the effectiveness of low-level laser therapy in the treatment of temporomandibular disorder and to compare treatment effects in myogenic and arthrogenic cases. Methods: Thirty-five patients were evaluated by magnetic resonance imaging and randomly allocated to active treatment (n~20) and placebo treatment (n~15) groups. In addition to a daily exercise program, all patients were treated with fifteen sessions of low-level laser therapy. Pain, joint motion, number of joint sounds and tender points were assessed. Results: Significant reduction in pain was observed in both active and placebo treatment groups. Active and passive maximum mouth opening, lateral motion, number of tender points were significantly improved only in the active treatment group. Treatment effects in myogenic and arthrogenic cases were similar. Conclusion: Low-level laser therapy can be considered as an alternative physical modality in the management of temporomandibular disorder.
Low-level laser therapy in temporomandibular joint disorders: a systematic review
Journal of Medicine and Life, 2021
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.
Photomedicine and Laser Surgery, 2007
Objective: Low-level laser therapy (LLLT) treatment for pain caused by temporomandibular joint disorders (TMD) was investigated in a controlled study comparing applied energy density, subgroups of TMD, and duration of disorders. Background Data: Although LLLT is a physical therapy used in the treatment of musculoskeletal disorders, there is little evidence for its effectiveness in the treatment of TMD. Methods: The study group of 61 patients was treated with 10 J/cm 2 or 15 J/cm 2 , and the control group of 19 patients was treated with 0.1 J/cm 2. LLLT was performed by a GaAlAs diode laser with output of 400 mW emitting radiation wavelength of 830 nm in 10 sessions. The probe with aperture 0.2 cm 2 was placed over the painful muscle spots in the patients with myofascial pain. In patients with TMD arthralgia the probe was placed behind, in front of, and above the mandibular condyle, and into the meatus acusticus externus. Changes in pain were evaluated by self-administered questionnaire. Results: Application of 10 J/cm 2 or 15 J/cm 2 was significantly more effective in reducing pain compared to placebo, but there were no significant differences between the energy densities used in the study group and between patients with myofascial pain and temporomandibular joint arthralgia. Results were marked in those with chronic pain. Conclusion: The results suggest that LLLT (application of 10 J/cm 2 and 15 J/cm 2) can be considered as a useful method for the treatment of TMD-related pain, especially long lasting pain.
Research, Society and Development, 2021
Introduction: Temporomandibular disorders (TMD) - recognized as the most common chronic orofacial pain condition - significantly impacts individuals’ quality of life and social coexistence. Therefore, this study aimed to analyze the effects of low-level laser therapy (LLLT) on functional improvements in the temporomandibular joints (TMJ). Method: The research was carried out at the Universidade Federal do Piaui on 32 young adults with signs and symptoms of TMD, who were divided into the intervention group (IG) and the control group (CG). The IG was administered the LLLT application directly on the TMJ. While both groups were subjected to the same procedures, for the CG, the laser device was turned off. Results: The mean age of the participants was 21.87 ± 2.4 years, with a predominance of females (87.5%) over males (12.5%). Homogeneity was observed between the CG and IG concerning the presence of pain from palpation. The decrease in the pain of the musculature was relevant, with emp...
Evaluation of Low-Level Laser Therapy in the Treatment of Temporomandibular Disorders
Photomedicine and Laser Surgery, 2006
Objective: The purpose of this study was to assess the effectiveness of low-level laser therapy (LLLT) in the treatment of myogenic originated temporomandibular disorders (TMD). Background Data: Limited studies have demonstrated that LLLT may have a therapeutic effect on the treatment of TMD. Methods: Thirty-nine patients with myogenic TMD-associated orofacial pain, limited mandibular movements, chewing difficulties, and tender points were included in this study. Twenty-four of them were treated with LLLT for 10 sessions per day excluding weekends as test group, and 15 patients with the same protocol received placebo laser treatment as a control group. These parameters were assessed just before, just after, and 1 month after the treatment. Results: Maximal mouth-opening improvement, and reductions in pain and chewing difficulty were statistically significant in the test group when compared with the control group. Statistically significant improvements were also detected between two groups regarding reduction in the number of tender points. Conclusion: Based on the results of this placebo-controlled report, LLLT is an appropriate treatment for TMD and should be considered as an alternative to other methods.
Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders
Lasers in Medical Science, 2012
The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ0 830 nm, P040 mW, CW, ED08 J/cm 2). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/ after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p<0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p<0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p00.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p00.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.
Journal of Applied Oral Science, 2012
T emporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected. Objective: To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD. Material and Methods: The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events. Results: After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm², while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo. Conclusion: Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol for pain relief in patients with TMD.