The aim of this study is to compare the pain intensity reduction between the mean radiation doses per session of gallium-aluminum-arsenide (GaAIAs) laser with superluminous diodes (SLD) in four of the most common pain-related chronic temporomandibular disorders (TMD) - local myalgia, myofascial pain, myofascial pain with a referral, and arthralgia. This study was implemented on 124 patients with pain-related temporomandibular disorders according to the DC/TMD criteria. We applied trigger point oriented near-infrared laser (785 nm, 100 s, 8 J/cm2) and SLD cluster sessions (the cluster is composed of 49 SLDs with a combination of visible red (633 nm) and infrared (880 nm) diodes, 200 mW, 300 s, 8 J/cm2) for the temporomandibular joints and the affected muscles. Patients were evaluated at the start of the treatment, and after the 6th session of combined phototherapy. The pain intensity scores were measured according to the Visual Analogue Scale (VAS). Our results show that the most statistically manifested pain reduction is found for the SLD dose, р = 0,000118, followed by the overall dose (laser plus SLD); р = 0,001031, and the laser dose; р = 0,030942 (ANOVA dispersion analyses). Consequently, it can be concluded that myalgia is better treated through lower doses of red light compared to infrared laser doses because SLDs combine the prooxidative effect of photons with 633 nm wavelength, a large area of exposure, sufficient tissue penetration, and some positive warming thermal impact of the SLD clusters.
Summary The objective of this study was to test the clinical effectiveness of the combined gallium-aluminum-arsenide laser (GaAlAs; 785 nm) and superluminiscent diods (SLD; 633 nm) phototherapy (MedX 1100 device) for the treatment of 62 patients with 7 of the most common pain-related temporomandibular disorders with highest sensitivity and specificity according to diagnostic criteria DC/TMD. Using paired samples t-test a positive effect in the pain relief for all tested conditions was demonstrated. The most manifested and statistically significant reduction of pain was found in arthralgia attributed to osteoarthritis and systemic (rheumatoid) arthritis (p = 0.0000001), and disc displacement without reduction with limited opening (p = 0.0000002). Similar levels of pain reduction were found in arthralgia attributed to subluxation, myofascial pain with referral, local myalgia (p values vary between 0.000001 and 0.000284); the lowest values were recorded for myofascial pain (p = 0.001789) and hypermobility-related myalgia (p = 0.018443). The combined laser and SLD phototherapy can be defined as very effective treatment option particularly in pain reduction of internal derangement disorders as well as in some myogenic-related pain conditions affected by TMJ dysfunction.
лицево-челюстна хирургия", Медицински университет -София 2 Център по интегрирана дентална медицина, Медицински университет -София 3 Катедра "Орална и лицево-челюстна хирургия и специална образна диагностика", Медицински университет -Варна
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