Laserterapia no controle da disfunção temporomandibular dolorosa: evidências científicas

Abstract

Laser Therapy in the Management of Painful Temporomandibular Dysfunction: Scientific Evidence Low-intensity laser application has been described in the literature as an intervention proposal for cases of Temporomandibular Dysfunction (TMD), and scientific evidence-based action is key for a successful treatment. This research aims to identify in literature the effectiveness of laser therapy for the control of painful TMD in adults. A systematic literature review was carried out through specific search strategies tailored for each of the databases analyzed. The researcher used PICO on PubMed, Bireme, Embase, and Scopus databases by cross-referencing the descriptors from DeCS/MESH and random keywords. Clinical trials were included involving human subjects of both sexes, aged between 18 and 55 years old, who used either GaAs or AsGaAl (infrared) low-intensity laser as an intervention in the treatment of TMD. The studies included presented laser type, application parameters and settings, and the assessment tools for potential analysis of the results for the therapy protocols that were used, with independent and non-associated therapy. All participants diagnosed with painful TMD and Muscle Temporomandibular and/or Joint Dysfunction were included. Two independent reviewers selected the articles, then the data were organized by the researcher responsible for the project, and later the data were analyzed according to the information previously collected and organized. After excluding articles by reading their title and abstract and removing duplicates, 33 of those articles related to the topic were selected and, finally, five of those were chosen. The number of participants in the study ranged from 18 to 74 subjects. Amongst the five studies analyzed, three of them were conducted in Brazil. Two studies had more than one experimental group with different dosimetry in the laser application, and only one article presented another associated therapy. Regarding the TMD diagnosis, three articles used the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) as the assessment tool. The total number of sessions ranged from three to ten, with a weekly frequency of two to four times a week, which lasted from one to five weeks. Both device and dosimetry of the studies were different, but most studies presented continuous-wave laser. Only one article did not disclose such information. Application time in the experimental and placebo groups ranged from ten to sixty seconds. Four of the five articles used GaAlAs laser and one used GaAs laser. We could identify that, out of the five studies selected, four presented improvement in the painful symptoms through laser therapy and one showed results that were similar to the placebo group. However, due to the limited number of studies and variabilities in how results were assessed and presented, it was not possible to apply the statistical treatment (meta-analysis) to prove the effectiveness of laser therapy in adults with painful TMD.

Controle da disfunção temporomandibular utilizando laserterapia: Uma revisão integrativa

“…A diminuição da dor também foi um aspecto unânime em todos os artigos. Pereira (2019), ao contrário dos demais autores abordados, publicou um artigo apresentando evidências científicas sobre a Laserterapia no controle das DTMs dolorosas. No entanto, a autora chega à conclusão de que não foi possível verificar a eficácia do uso do LASER nos casos de DTM, pois existiam poucos estudos publicados no momento e os que já haviam sido publicados possuíam grande variabilidade de metodologias de avaliação e apresentação de resultados.…”

“…As intra-articulares ocorrem devido às lesões e deslocamentos do disco articular. Já as disfunções musculares comprometem os músculos responsáveis pela mastigação, podendo ser percebidas através de: espasmo muscular, miosite, contração muscular de proteção e síndrome de dor miofascial, sendo a última mais frequente em relação às outras condições (Pereira, 2019).…”

Laserterapia como recurso terapêutico na fonoaudiologia

“…A laserterapia é uma medida indicada para várias modalidades de tratamentos, de forma isolada ou associada ou como uma espécie de complemento de uma terapia que devido sua intensidade menor proporciona ao organismo do ser humano energia suficiente em prol da promoção de transformações biológicas e químicas no meio intracelular, aumentando consideravelmente a produção de Adnosina trifosfato (ATP), considerada uma molécula fundamental, no que se refere a liberação energética para as células (Pereira, 2019).…”