Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

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.

Effectiveness of low-level gallium aluminium arsenide laser therapy for temporomandibular disorder with myofascial pain

“…The ROB assessment was performed for a total of 8[ 10 29 31 32 33 34 35 36 ] studies. Five[ 29 31 32 33 34 ] of the 8 studies described suitable random sequence generation methods, and 2[ 32 33 ] studies reported low-risk allocation concealment methods.…”

“…(Two studies[ 33 35 ] did not report the number of subjects of each sex.) The main anatomical sites assessed in the 6 studies reporting the results for each sex[ 10 29 32 34 35 36 ] included the masseter muscles and the temporalis muscles (Table 1 ). The laser treatment parameters of each study are shown in Table 2 .…”

“…3 ). Ultimately, we analyzed the data from the remaining 6[ 10 29 31 33 34 ] articles with a fixed-effects model, which yielded I 2 = 19%, Z = 2.00 , and P = .046 and indicated a significant difference in VAS score between the interventions at the end of the treatment (Fig. 4 ).…”

“…This systematic review included a meta-analysis of 8[ 10 29 31 32 33 34 35 36 ] studies (with 6 employing sham interventions[ 10 29 31 32 33 34 35 36 ] and 2 employing other interventions [piroxicam [29] and naproxen [29] ] as the comparison interventions), and the GaAlAs laser showed good efficacy in treating myogenic TMD pain at the end of treatment. We found evidence of moderate quality compared to the control group: 1.…”

Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: A randomized-controlled study

“…The purpose of the current phase was to compare the short-term effect of LLLT to soft occlusive splints on muscular activity in cases of TMD. The effect of conservative measures in treatment of TMD is controversial across literature, whereas moderate to very low-quality evidence regarding the effectiveness of occlusal splint therapy in the treatment of TMD was reported [46,47], equivalent with other therapeutic modalities [43,48,49] or with no effect reported [50].…”