Lasers : A Boon In The Management Of Temporomandibular Disorders (original) (raw)
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A pilot study on the use of low level laser therapy in treatment of temporomandibular disorder
2018
Temporomandibular disorders (TMDs) is a collective term that embracing a number of clinical problems that involve the masticatory muscles, Temporomandibular Joint (TMJs), and the associated structures. It characterized by facial pain in the area of TMJ and muscle of mastication, restriction and sound during mandibular movement. Recently physical therapy such as Low Level Laser Therapy (LLLT) is used as one of the treatment modalities and it is believed to promote wound healing, tissue repair and induce analgesia. Convenience sampling was used which consist of 22 volunteered patients, 14 were treated with conventional treatment and 8 were treated with combination of LLLT and conventional therapy. Laser machine used was Waterlase/Biolase © 2007 with irradiation 0.5 W-30 Hz daily for three consecutive days, then once a week review treatment for two weeks. The space between laser beam and skin is 3 cm, applied as small circles for 2-3 minutes. Pain intensity before and after the treatment was recorded by using numerical rating scale (NRS). Statistical data analysis was conducted using SPSS software. Wilcoxon-sign ranked-test and Mann-Whitney U test were used. Pain intensity was reduced significantly in patients whom treated by combination of LLLT and conventional therapy. (p<0.05). Pain intensity after treatment for female were higher (M=1.20, SD=1.10) than for male (M=0.00, SD=0.00). Younger patients have higher pain intensity than older patients. LLLT is effective to be used as adjunct to the current conventional treatment in relieving pain in TMDs. Clinical article (J Int Dent Med Res 2018; 11(2): pp. 669-675
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.
Balneo Research Journal
Introduction: Temporomandibular disorders are complex pathologies with multifactorial aetiology. Due to this matter, different therapeutic approaches have been developed, one of them being physical therapy (also known as physiotherapy). Low-level laser therapy is often used in treating musculoskeletal diseases, TMJ pain and, although the exact mechanism of LLLT has not yet been completely elucidated, it seems that this kind of therapy induces analgesic, anti-inflammatory and bio-stimulating effects. The aim of this study was to create an update of scientific literature regarding the clinical use of LLLT in patients with temporomandibular disorders, and to identify the impact of this therapy on reducing pain in the masticatory muscles. Methods: A research of literature was performed - articles published over the last 10 years (January 2009 until December 2019) were searched for by introducing a combination of different keywords on the PubMed and ScienceDirect databases. Results: A to...
Journal of Advanced Clinical & Research Insights, 2016
Objective: The aim of the present study was to compare low-level laser therapy (LLLT) and transcutaneous electric nerve stimulation (TENS) in the management of patients with temporomandibular disorders (TMDs). Background: TMDs are a collective term embracing a number of clinical problems that affect the masticatory muscles, the temporomandibular joint and associated structures, or both. Materials and Methods: A total of 20 patients with TMD of muscular origin were randomly selected and divided into two groups: Group 1 comprising 10 patients who were to receive LLLT and Group 2 constituting 10 patients who were to obtain TENS therapy. Treatment included nine sessions of the respective therapy rendered over the period of 30-day to patients of either group. The visual analog scale (VAS), improvement in mouth opening and evaluation by palpation of temporalis and masseter muscle were used for follow-up analysis. A paired t-test was employed to study the significance of the results. Results: The results showed a reduction in VAS values and tenderness to muscle palpation for both groups. A significant improvement in mouth opening was also noted in the course of therapy in both groups. Conclusion: Both LLLT and TENS were effective with regard to pain control, improvement in mouth opening and reduction in temporalis and masseter muscle tenderness. LLLT appeared slightly better than TENS therapy when evaluating variables of VAS and mouth opening.
Application of Low Level Laser in Temporomandibular Disorders
The American Academy of Orofacial pain defined temporomandibular disorders (TMDs) as"a collective term that embraces a number of clinical problems that involve the masticatory muscles, the TMJ (Temporomandibular Joint), and the associated structures". Pain and dysfunctional symptoms or signs such as limitations in opening, asymmetric jaw movements and TMJ sounds are the most common findings. TMD is a prevalent disease that is most common among 20 to 40 year-olds; not a disease of senility. Researches show that about 75% of the population has one sign of TMD, and approximately 33% has at least one TMD symptom. They reported that 3.6% -7% of the population has severe TMD problems that cause patients to seek treatment. Low level laser is a conservative treatment method that has been introduced in recent years.The purpose of this article is to review the related investigations and introduce the applications of low level lasers in TMD treatment. Method: Electronic data bases were searched and hand search of published articles and texts was done. Result and Conclusion: Laser application can be beneficial in different ways for TMD problems. In many cases occlusal adjustment and taking impression for splint is necessary but the pain prevents conventional treatment. Pain relief can be achieved by irradiating the joint and tender points; musculature will be relaxed, and treatment can begin. It has been revealed in recent clinical experiences and clinical studies that for myogenic conditions rather high doses are needed and that the energy density itself is an important factor. The disagreement in result of older studies may be related to this fact.
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.
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.
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.
Lasers in Medical Science, 2013
Low-level laser therapy (LLLT) has been commonly used for the treatment of painful musculoskeletal conditions, but the results of previous studies on this subject are controversial. The aim of this study was to evaluate the efficacy of LLLT in the management of patients with myogenic temporomandibular joint disorders (TMDs). In this randomized, double-blind clinical trial, 20 patients with myogenic TMD were randomly divided into laser and placebo groups. In the laser group, a pulsed 810-nm low-level laser (average power 50 mW, peak power 80 W, 1,500 Hz, 120 s, 6 J, and 3.4 J/cm 2 per point) was used on painful muscles three times a week for 4 weeks. In the placebo group, the treatment was the same as that in the laser group, but without energy output. The patients were evaluated before laser therapy (T1), after six sessions of laser application (T2), at the end of treatment (T3), and 1 month after the last application (T4), and the level of pain and the amount of mouth opening were measured. There was a significant increase in mouth opening and a significant reduction of pain symptoms in the laser group (p<0.05). A similar improvement was not observed in the placebo group (p>0.05). Between-group comparisons revealed no significant difference in pain intensity and mouth opening measurement at any of the evaluation time points (p > 0.05). LLLT can produce a significant improvement in pain level and mouth opening in patients affected with myogenic TMD.