Abstract
Low-level laser therapy (LLLT) has been commonly used for the treatment of painful musculoskeletal conditions, but the results of previous studies on this subject are controversial. The aim of this study was to evaluate the efficacy of LLLT in the management of patients with myogenic temporomandibular joint disorders (TMDs). In this randomized, double-blind clinical trial, 20 patients with myogenic TMD were randomly divided into laser and placebo groups. In the laser group, a pulsed 810-nm low-level laser (average power 50 mW, peak power 80 W, 1,500 Hz, 120 s, 6 J, and 3.4 J/cm2 per point) was used on painful muscles three times a week for 4 weeks. In the placebo group, the treatment was the same as that in the laser group, but without energy output. The patients were evaluated before laser therapy (T1), after six sessions of laser application (T2), at the end of treatment (T3), and 1 month after the last application (T4), and the level of pain and the amount of mouth opening were measured. There was a significant increase in mouth opening and a significant reduction of pain symptoms in the laser group (p < 0.05). A similar improvement was not observed in the placebo group (p > 0.05). Between-group comparisons revealed no significant difference in pain intensity and mouth opening measurement at any of the evaluation time points (p > 0.05). LLLT can produce a significant improvement in pain level and mouth opening in patients affected with myogenic TMD.
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References
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
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
Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6(4):301–355
Dias FJ, Issa JP, Barbosa AP, de Vasconcelos PB, Watanabe IS, Mizusakiiyomasa M (2012) Effects of low-level laser irradiation in ultrastructural morphology, and immunoexpression of VEGF and VEGFR-2 of rat masseter muscle. Micron 43(2–3):237–244. doi:10.1016/j.micron.2011.08.005
Hawkins D, Abrahamse H (2007) Phototherapy—a treatment modality for wound healing and pain relief. Afr J Biomed Res 10(2):99–109
Mester E, Mester AF, Mester A (1985) The biomedical effects of laser application. Lasers Surg Med 5(1):31–39
Skinner SM, Gage JP, Wilce PA, Shaw RM (1996) A preliminary study of the effects of laser radiation on collagen metabolism in cell culture. Aust Dent J 41(3):188–192
Carvalho CM, Lacerda JA, dos Santos Neto FP, de Castro IC, Ramos TA, de Lima FO, de Cerqueira Luz JG, Ramalho MJ, dos Santos JN, Pinheiro 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. doi:10.1089/pho.2009.2685
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):29–34
Shimizu N, Yamaguchi M, Goseki T, Shibata Y, Takiguchi H, Iwasawa T, Abiko Y (1995) Inhibition of prostaglandin E2 and interleukin 1-beta production by low-power laser irradiation in stretched human periodontal ligament cells. J Dent Res 74(7):1382–1388
Cetiner S, Kahraman SA, Yucetas S (2006) Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg 24(5):637–641. doi:10.1089/pho.2006.24.637
Nunez SC, Garcez AS, Suzuki SS, Ribeiro MS (2006) Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation. Photomed Laser Surg 24(1):45–49. doi:10.1089/pho.2006.24.45
Kato MT, Kogawa EM, Santos CN, Conti PC (2006) TENS and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci 14(2):130–135
Bertolucci LE, Grey T (1995) Clinical comparative study of microcurrent electrical stimulation to mid-laser and placebo treatment in degenerative joint disease of the temporomandibular joint. Cranio 13(2):116–120
Kogawa EM, Kato MT, Santos CN, Conti PC (2005) Evaluation of the efficacy of low-level laser therapy (LLLT) and the microelectric neurostimulation (MENS) in the treatment of myogenic temporomandibular disorders: a randomized clinical trial. J Appl Oral Sci 13(3):280–285
Oz S, Gokcen-Rohlig B, Saruhanoglu A, Tuncer EB (2010) Management of myofascial pain: low-level laser therapy versus occlusal splints. J Craniofac Surg 21(6):1722–1728. doi:10.1097/SCS.0b013e3181f3c76c
da Cunha LA, Firoozmand LM, da Silva AP, Esteves SA, Oliveira W (2008) Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J 58(4):213–217
Emshoff R, Bosch R, Pumpel E, Schoning H, Strobl H (2008) Low-level laser therapy for treatment of temporomandibular joint pain: a double-blind and placebo-controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105(4):452–456. doi:10.1016/j.tripleo.2007.09.012
Gam AN, Thorsen H, Lonnberg F (1993) The effect of low-level laser therapy on musculoskeletal pain: a meta-analysis. Pain 52(1):63–66
McNeely ML, Armijo Olivo S, Magee DJ (2006) A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther 86(5):710–725
Petrucci A, Sgolastra F, Gatto R, Mattei A, Monaco A (2011) Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain 25(4):298–307
Carvalho CM, de Lacerda JA, dos Santos Neto FP, Cangussu MC, Marques AM, Pinheiro AL (2010) Wavelength effect in temporomandibular joint pain: a clinical experience. Lasers Med Sci 25(2):229–232. doi:10.1007/s10103-009-0695-y
Mazzetto MO, Hotta TH, Pizzo RC (2010) Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser. Braz Dent J 21(4):356–360
Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, Manzi CT (1997) Low-level laser therapy in the management of disorders of the maxillofacial region. J Clin Laser Med Surg 15(4):181–183
Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, Miranda ER, De Quevedo AS, Manzi CT, Vieira AL, Rolim AB (1998) Low-level laser therapy is an important tool to treat disorders of the maxillofacial region. J Clin Laser Med Surg 16(4):223–226
Santos Tde S, Piva MR, Ribeiro MH, Antunes AA, Melo AR, Silva ED (2010) Laser therapy efficacy in temporomandibular disorders: control study. Braz J Otorhinolaryngol 76(3):294–299
Conti PC (1997) Low level laser therapy in the treatment of temporomandibular disorders (TMD): a double-blind pilot study. Cranio 15(2):144–149
Fikackova H, Dostalova T, Navratil L, Klaschka J (2007) Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomed Laser Surg 25(4):297–303. doi:10.1089/pho.2007.2053
Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M (2003) Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol 32(2):114–118
Shirani AM, Gutknecht N, Taghizadeh M, Mir M (2009) Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci 24(5):715–720. doi:10.1007/s10103-008-0624-5
Venezian GC, da Silva MA, Mazzetto RG, Mazzetto MO (2010) Low level laser effects on pain to palpation and electromyographic activity in TMD patients: a double-blind, randomized, placebo-controlled study. Cranio 28(2):84–91
Ilbuldu E, Cakmak A, Disci R, Aydin R (2004) Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. Photomed Laser Surg 22(4):306–311. doi:10.1089/1549541041797878
Marini I, Gatto MR, Bonetti GA (2010) Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain 26(7):611–616. doi:10.1097/AJP.0b013e3181e0190d
Gray RJ, Quayle AA, Hall CA, Schofield MA (1994) Physiotherapy in the treatment of temporomandibular joint disorders: a comparative study of four treatment methods. Br Dent J 176(7):257–261
Hotta PT, Hotta TH, Bataglion C, Bataglion SA, de Souza Coronatto EA, Siessere S, Regalo SC (2010) Emg analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice. Complement Ther Clin Pract 16(3):158–160. doi:10.1016/j.ctcp.2010.01.002
Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA (2003) A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Aust J Physiother 49(2):107–116
Acknowledgments
The authors would like to thank the Vice-Chancellor for Research of Mashhad University of Medical Sciences for the financial support of this project (grant no. 88563). The results presented in this work were part of a DDS student thesis proposal.
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Ahrari, F., Madani, A.S., Ghafouri, Z.S. et al. The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci 29, 551–557 (2014). https://doi.org/10.1007/s10103-012-1253-6
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DOI: https://doi.org/10.1007/s10103-012-1253-6
Keywords
- Temporomandibular disorder
- Low level laser therapy
- Low intensity laser therapy
- Myofacial pain
- Myogenic pain
- Temporomandibular joint
- LLLT
- TMD
- TMJ