Photobiomodulation Therapy for Myofascial Pain in Temporomandibular Joint Dysfunction: A Double-Blinded Randomized Clinical Trial

  • Mohammed Nadershah
  • Hala M. Abdel-Alim
  • Amr M. Bayoumi
  • Ahmed M. Jan
  • Ali Elatrouni
  • Fatima M. JaduEmail author
Original Article



Temporomandibular disorder (TMD) is a complex process that affects the temporomandibular joint (TMJ). The multifactorial process is of unknown etiology and has many manifestations and thus many management options. Photobiomodulation therapy has been suggested for management of TMD, despite the lack of understanding of its exact mechanism. The aim of this study is to examine the effectiveness of photobiomodulation in the treatment of myofascial type TMD.


Patients with unilateral TMJ and masticatory muscles pain during function were recruited and divided into two groups: a control group that received a sham laser treatment every 48 h for 10 days and a test group that received the same frequency of treatment to deliver a dose of 257 J per treatment and a total dose of 1285 J for the entire treatment. Pain was assessed using the visual analog scale (VAS).


There was a significant difference in VAS scores between the test and control groups with the test group scoring lower.


Photobiomodulation therapy proved to be an effective short-term therapeutic modality for myofascial TMD pain. It is non-invasive, easy to apply with no systemic side effects. Its long-term effect and its effect on different subtypes of TMD need further investigation.


Low-level light therapy Temporomandibular joint Temporomandibular joint disorders Photomodulation therapy Laser therapy 


Compliance with Ethical Standards

Conflict of interest

All authors declare no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP et al (2014) Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache 28(1):6–27. CrossRefGoogle Scholar
  2. 2.
    Okeso J (2007) Management of temporomandibular disorders and occlusion, 7th edn. Elsevier, St. LouisGoogle Scholar
  3. 3.
    Suenaga S, Abeyama K, Indo H, Shigeta K, Noikura T (2001) Temporomandibular disorders: MR assessment of inflammatory changes in the posterior disk attachment during the menstrual cycle. J Comput Assist Tomogr 25(3):476–481CrossRefGoogle Scholar
  4. 4.
    Hosgor H, Bas B, Celenk C (2017) A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg 46(11):1403–1410. CrossRefGoogle Scholar
  5. 5.
    Sakurai Y, Yamaguchi M, Abiko Y (2000) Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci 108(1):29–34CrossRefGoogle Scholar
  6. 6.
    Carvalho CM, Lacerda JA, dos Santos Neto FP, de Castro IC, Ramos TA, de Lima FO et al (2011) Evaluation of laser phototherapy in the inflammatory process of the rat’s TMJ induced by carrageenan. Photomed Laser Surg 29(4):245–254. CrossRefGoogle Scholar
  7. 7.
    Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Moradi Abbasabadi F (2016) Low level laser therapy versus pharmacotherapy in improving myofascial pain disorder syndrome. J Lasers Med Sci 7(1):45–50. CrossRefGoogle Scholar
  8. 8.
    Chen J, Huang Z, Ge M, Gao M (2015) Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 42(4):291–299. CrossRefGoogle Scholar
  9. 9.
    Carrasco TG, Mazzetto MO, Mazzetto RG, Mestriner W Jr (2008) Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio 26(4):274–281. CrossRefGoogle Scholar
  10. 10.
    Mazzetto MO, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, Mazzetto RG (2007) Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio 25(3):186–192. CrossRefGoogle Scholar
  11. 11.
    Venancio Rde A, Camparis CM, Lizarelli Rde F (2005) Low intensity laser therapy in the treatment of temporomandibular disorders: a double-blind study. J Oral Rehabil 32(11):800–807. CrossRefGoogle Scholar
  12. 12.
    Demirkol N, Sari F, Bulbul M, Demirkol M, Simsek I, Usumez A (2015) Effectiveness of occlusal splints and low-level laser therapy on myofascial pain. Lasers Med Sci 30(3):1007–1012. CrossRefGoogle Scholar
  13. 13.
    Marini I, Bartolucci ML, Bortolotti F, Innocenti G, Gatto MR, Alessandri Bonetti G (2015) The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial. Lasers Med Sci 30(1):35–41. CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  • Mohammed Nadershah
    • 1
  • Hala M. Abdel-Alim
    • 1
    • 2
  • Amr M. Bayoumi
    • 1
    • 2
  • Ahmed M. Jan
    • 1
  • Ali Elatrouni
    • 3
  • Fatima M. Jadu
    • 4
    Email author
  1. 1.Oral and Maxillofacial Surgery, Faculty of DentistryKing Abdulaziz UniversityJeddahSaudi Arabia
  2. 2.Alexandria UniversityAlexandriaEgypt
  3. 3.Oral and Maxillofacial SurgeryDr. Solaiman Fakeeh HospitalJeddahSaudi Arabia
  4. 4.Oral and Maxillofacial Radiology, Faculty of DentistryKing Abdulaziz UniversityJeddahSaudi Arabia

Personalised recommendations