Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized, double-blind, placebo-controlled clinical trial

Abstract

Changes involving temporomandibular joint, masticatory musculature, and associated structures characterize temporomandibular dysfunction (TMD). The analgesic and anti-inflammatory effect produced by photobiomodulation has contributed to pain relief and functional improvement. However, the parameters to be used have not yet been well established. The aim of this study is to compare the efficacy of three different photobiomodulation dosimetries in the treatment of patients with TMD. A randomized, double-blind, placebo-controlled clinical trial with 44 subjects divided into the groups 8 J/cm (n = 11), 60 J/cm (n = 11), 105 J/cm (n = 11), and control (n = 11). Pain, symptom severity, and joint mobility were evaluated before and after a ten-session protocol of photobiomodulation with AlGaAs laser (830 nm), at a power density of 30 mW/cm. The mouth opening increased in the 8-J/cm group from 10.49 ± 4.68 to 15.40 ± 6.43 degrees, and in the right protrusion from 9.80 ± 4.2 to 12.56 ± 5.40 degrees after the intervention protocol (p < 0.05). All groups significantly decreased pain (p < 0.05). 830-nm laser photobiomodulation was effective in reducing TMD pain and symptoms at all doses tested. Only the doses of 8 J/cm were effective regarding maximal opening and protrusion of the mandible.

Non-invasive therapies for management of temporomandibular disorders: a systematic review

“…All studies evaluated the outcomes at baseline and after the treatment protocol 61 , with number of sessions varying from 1 week to 1 year. Pain levels were assessed as the primary outcome in all studies using Visual Analogic Scale (VAS) in 29 (83%) studies 1,2,10,15,16,22,24,25,31,33,36,[45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][61][62][63][64] or an algometer to evaluate the pressure pain threshold in 5 (14%) studies 2,36,46,58,62 ; one study (3%) used the Verbal Pain Scale 59 . The results of an intragroup analysis demonstrated that 27 (77%) 5,10,20,22,24,25,27,31,33,36,44...…”

“…The results of an intragroup analysis demonstrated that 27 (77%) 5,10,20,22,24,25,27,31,33,36,44,45,46,47,50,[52][53][54][55][56][57][58][59][60][61][62][63] of the studies presented reduction in pain and 22 (62%) 2,5,10,15,20,24,25,31,36,[44][45][46][47][52][53][54]56,57,59,60,62,64 , improvement in function. Among them, LLLT (34%) 2,515,…”

“…Risk of bias is shown in Chart 2. A total of 29 (82%) studies presented low risk 1,2,5,10,15,16,20,24,25,27,31,33,36,[45][46][47][48]50,51,[54][55][56][57][58][59][61][62][63][64] and three (9%) presented high risk 44,49,61 . Other three (9%) studies showed an unclear risk of bias due to insufficient information in at least one domain 22,52,53 .…”

Comparative effectiveness of low-level laser therapy and transcutaneous electric nerve stimulation in the treatment of pain caused by temporomandibular joint disorders: a systematic review and network meta-analysis

“…Then 55 potentially eligible articles were obtained by screening the titles and abstracts carefully. After careful full-text screening and assessment of the risk of bias, 20 RCTs met the inclusion criteria [4,10,12,15,28,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. This selection process and exclusion reasons were presented in the ow chart (Fig.…”

Fotobiomodulação no tratamento de desordens temporomandibulares

“…Uma possível explicação para a redução dos espasmos na musculatura da ATM tratada com fotobiomodulação pode estar associada aos níveis de energia absorvida nos citocromos e porfirinas dentro da mitocôndria e membrana celular dessas células. Tais níveis de energia disponibilizarão uma pequena quantidade de oxigênio extra dentro da célula, acelerando a glicólise e a oxidação fosforilativa com maior disponibilização de ATP, além da ativação da microcirculação, que, pela ação da histamina liberada por meio da ação do próprio laser, proporcionará mais nutrientes para que essas células possam aperfeiçoar seu metabolismo 5,9. Assim, o objetivo deste artigo é relatar um caso clínico utilizando a fotobiomodulação no tratamento da disfunção temporomandibular proporcionando analgesia e maior abertura bucal.RELATO DE CASOPaciente do gênero fem i ni no, 24 a nos, estudante universitária, se apresentou ao projeto de extensão "Laserterapia na Odontologia", realizado na Universidade Federal do Maranhão/ Brasil, com cefaleia e fortes dores bilaterais na face.…”