Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis

Abstract

Objectives We systematically reviewed randomized controlled trials (RCTs) of the effect of low-level laser therapy (LLLT) versus placebo in patients with temporomandibular disorder (TMD). Methods A systematic search of multiple online sources electronic databases was undertaken. The methodological quality of each included study was assessed using the modified Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results A total of 31 RCTs were included. Total modified Jadad scale scores showed that the methodological quality was high in 30 studies and low in 1 study. Combining data from all clinically heterogeneous studies revealed positive effects of LLLT on pain relief, regardless of the visual analogue scale (VAS) score or the change of VAS score between the baseline and the final follow-up time point, while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD. Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up. Temporomandibular joint function outcomes indicated that the overall effect favored LLLT over placebo. Conclusion This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD.

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

“…13,14 LLLT has recently been put under the spotlight because it's safe, non-invasive, easy to use, fast, and aseptic and has few contraindications. 15 It is almost well tolerated at any age. The basic effects of LLLT are biostimulative, regenerative, analgesic, and anti-inflammatory.…”

“…8,9 Other modalities include pharmaceutical therapy, occlusal splints, and biofeedback. [10][11][12][13][14][15][16][17] Since pain is typically the reason for the patients with TMDs to seek medical care, pharmacological therapy is most often indicated as the first line of treatment. 10 A wide variety of drugs ranging from short-term treatment with non-steroidal anti-inflammatory drugs and muscle relaxants to the long-term administration of antidepressants for less well-characterized pain have been used.…”

“…18 Literature reviews usually indicate that LLLT is effective in reducing pain in TMDs mostly through its anti-inflammatory effects. 15,16,19 However, a systematic review in 2012 concluded no definitive results could be drawn on the efficacy of LLLT in the treatment of TMDs except that it was probably more effective in the treatment of TMJ disorders and less effective in masticatory muscle disorders. 20 Therefore, the relative clinical efficacy of LLLT in the treatment of TMD is controversial and sufficient evidence is lacking regarding its benefits in MPDS.…”

“…It is believed that combining various types of treatments in TMDs could result in not only a better treatment outcome but also a reduction in the dosage and duration of pharmacotherapy and therefore their side effects. 8,9,15 The purpose of this study was to compare the efficacy of pharmaceutical therapy only with its use in combination with the laser and the occlusal appliance in the treatment of MPDS.…”

Nonsurgical Strategies for the Treatment of Temporomandibular Joint Disorders

“…In any case, a mixed approach of therapies has impact on reducing pain, increasing range of motion, but lacks a significant impact for functional improvement [27,28]. The effect of lowlevel laser therapy in patients with TMD seems to relieve pain and improves functional outcomes [29] or dysfunctional TMJ [30]. And in comparing the effects of different methods, low intensity ultrasound and traditional exercise therapy were more effective that laser therapy reduced TMJ pain and trismus after oncologic surgery [31].…”