Skip to main content

Advertisement

SpringerLink
Log in

A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

This study compared the efficacy of low-level laser therapy (LLLT) versus laser acupuncture therapy (LAT) in patients with temporomandibular disorders (TMDs). In this randomized, double-blind clinical trial, 45 TMD patients were randomly divided into three groups. In group 1 (LLLT), a GaAlAs laser was applied on painful masticatory muscles and TMJs (810 nm, 200 mW, 30 s per point, Gaussian beam, spot size 0.28 cm2, 21 J/cm2) two times a week for 5 weeks. In group 2 (LAT), the laser was emitted bilaterally on acupuncture points (ST6, ST7, LI4) with the same settings as the LLLT group. Group 3 (placebo) underwent treatment with sham laser. The patients were evaluated before treatment (T1), after 5 (T2) and 10 (T3) laser applications, and 1 month later (T4). The mandibular range of motion as well as pain intensity in masticatory system was recorded at each interval. There was no significant difference in mouth opening between the groups (p > 0.05), but the amount of lateral excursive and protrusive movements was significantly greater in LLLT and LAT groups than the placebo group at some intervals (p < 0.05). The overall pain intensity and pain degree at masticatory muscles (except temporal muscle) and TMJs were significantly lower in both experimental groups than the placebo group at most intervals after therapy (p < 0.05). Both LLLT and LAT were effective in reducing pain and increasing excursive and protrusive mandibular motion in TMD patients. LAT could be suggested as a suitable alternative to LLLT, as it provided effective results while taking less chair time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8(3):291–305

    Article  CAS  Google Scholar 

  2. 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

    Article  Google Scholar 

  3. Sayed N, Murugavel C, Gnanam A (2014) Management of temporomandibular disorders with low level laser therapy. J Maxillofac Oral Surg 13(4):444–450. https://doi.org/10.1007/s12663-013-0544-1

    Article  PubMed  Google Scholar 

  4. Eshghpour M, Shaban B, Ahrari F, Erfanian M, Shadkam E (2017) Is low-level laser therapy effective for treatment of neurosensory deficits arising from sagittal split ramus osteotomy? J Oral Maxillofac Surg 75(10):2085–2090. https://doi.org/10.1016/j.joms.2017.04.004

    Article  PubMed  Google Scholar 

  5. Bayani S, Rostami S, Ahrari F, Saeedipouya I (2016) A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement. Laser Ther 25(2):121–129. https://doi.org/10.5978/islsm.16-OR-10

    Article  PubMed  PubMed Central  Google Scholar 

  6. Eshghpour M, Ahrari F, Takallu M (2016) Is low-level laser therapy effective in the management of pain and swelling after mandibular third molar surgery? J Oral Maxillofac Surg 74(7):1322.e1321–1322.e1328. https://doi.org/10.1016/j.joms.2016.02.030

    Article  Google Scholar 

  7. Sardari F, Ahrari F (2016) The effect of low-level helium-neon laser on oral wound healing. Dent Res J (Isfahan) 13(1):24–29. https://doi.org/10.4103/1735-3327.174693

    Article  Google Scholar 

  8. Heravi F, Moradi A, Ahrari F (2014) The effect of low level laser therapy on the rate of tooth movement and pain perception during canine retraction. Oral Health Dent Manag 13(2):183–188

    PubMed  Google Scholar 

  9. Ahrari F, Madani AS, Ghafouri ZS, Tuner J (2014) The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci 29(2):551–557. https://doi.org/10.1007/s10103-012-1253-6

    Article  PubMed  Google Scholar 

  10. Moosavi H, Maleknejad F, Sharifi M, Ahrari F (2015) A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations. Lasers Med Sci 30(4):1245–1249. https://doi.org/10.1007/s10103-014-1565-9

    Article  PubMed  Google Scholar 

  11. Moosavi H, Arjmand N, Ahrari F, Zakeri M, Maleknejad F (2016) Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching. Lasers Med Sci 31(4):713–719. https://doi.org/10.1007/s10103-016-1913-z

    Article  PubMed  Google Scholar 

  12. Huang YF, Lin JC, Yang HW, Lee YH, Yu CH (2014) Clinical effectiveness of laser acupuncture in the treatment of temporomandibular joint disorder. J Formos Med Assoc 113(8):535–539. https://doi.org/10.1016/j.jfma.2012.07.039

    Article  PubMed  Google Scholar 

  13. Baxter GD, Bleakley C, McDonough S (2008) Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud 1(2):65–82. https://doi.org/10.1016/s2005-2901(09)60026-1

    Article  PubMed  Google Scholar 

  14. Law D, McDonough S, Bleakley C, Baxter GD, Tumilty S (2015) Laser acupuncture for treating musculoskeletal pain: a systematic review with meta-analysis. J Acupunct Meridian Stud 8(1):2–16. https://doi.org/10.1016/j.jams.2014.06.015

    Article  PubMed  Google Scholar 

  15. 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. https://doi.org/10.1089/pho.2006.24.637

    Article  PubMed  Google Scholar 

  16. 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

    Article  Google Scholar 

  17. 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. https://doi.org/10.1089/pho.2007.2053

    Article  CAS  PubMed  Google Scholar 

  18. da Cunha LA, Firoozmand LM, da Silva AP, Camargo SE, Oliveira W (2008) Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J 58(4):213–217

    Article  Google Scholar 

  19. Madani AS, Ahrari F, Nasiri F, Abtahi M, Tuner J (2014) Low-level laser therapy for management of TMJ osteoarthritis. Cranio 32(1):38–44. https://doi.org/10.1179/0886963413z.0000000004

    Article  PubMed  Google Scholar 

  20. 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. https://doi.org/10.1016/j.tripleo.2007.09.012

    Article  PubMed  Google Scholar 

  21. Hotta PT, Hotta TH, Bataglion C, Bataglion SA, de Souza Coronatto EA, Siessere S, Regalo SCH (2010) Emg analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice. Complement Ther Clin Pract 16(3):158–160. https://doi.org/10.1016/j.ctcp.2010.01.002

    Article  PubMed  Google Scholar 

  22. Hu WL, Chang CH, Hung YC, Tseng YJ, Hung IL, Hsu SF (2014) Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One 9(10):e110528. https://doi.org/10.1371/journal.pone.0110528

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Seifi M, Ebadifar A, Kabiri S, Badiee MR, Abdolazimi Z, Amdjadi P (2017) Comparative effectiveness of low level laser therapy and transcutaneous electric nerve stimulation on temporomandibular joint disorders. J Lasers Med Sci 8(Suppl 1):S27–s31. https://doi.org/10.1007/s10103-017-2406-410.15171/jlms.2017.s6

  24. Peimani A, Sardary F (2014) Effect of low-level laser on healing of temporomandibular joint osteoarthritis in rats. J Dent (Tehran) 11(3):319–327

    Google Scholar 

  25. Wang SM, Kain ZN, White P (2008) Acupuncture analgesia: I. The scientific basis. Anesth Analg 106(2):602–610. https://doi.org/10.1213/01.ane.0000277493.42335.7b

    Article  PubMed  Google Scholar 

  26. Han JS (2004) Acupuncture and endorphins. Neurosci Lett 361(1–3):258–261. https://doi.org/10.1016/j.neulet.2003.12.019

    Article  CAS  PubMed  Google Scholar 

  27. Pomeranz B (1996) Scientific research into acupuncture for the relief of pain. J Altern Complement Med 2(1):53–60

    Article  CAS  Google Scholar 

  28. Shukla D, Muthusekhar MR (2016) Efficacy of low-level laser therapy in temporomandibular disorders: a systematic review. Natl J Maxillofac Surg 7(1):62–66. https://doi.org/10.4103/0975-5950.196127

    Article  PubMed  PubMed Central  Google Scholar 

  29. 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. https://doi.org/10.1179/crn.2008.037

    Article  PubMed  Google Scholar 

  30. Basili M, Barlattani A Jr, Venditti A, Bollero P (2017) Low-level laser therapy in the treatment of muscle-skelet pain in patients affected by temporo-mandibular disorders. Oral Implantol (Rome) 10(4):406–411. https://doi.org/10.4103/0975-5950.19612710.11138/orl/2017.10.4.406

  31. Ferreira LA, de Oliveira RG, Guimaraes JP, Carvalho AC, De Paula MV (2013) Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci 28(6):1549–1558. https://doi.org/10.1007/s10103-013-1273-x

    Article  PubMed  Google Scholar 

  32. Wu JY, Zhang C, Xu YP, Yu YY, Peng L, Leng WD, Niu YM, Deng MH (2017) Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders: a PRISMA-compliant meta-analysis. Medicine (Baltimore) 96(9):e6064. https://doi.org/10.1097/md.0000000000006064

    Article  Google Scholar 

  33. Fernandes AC, Duarte Moura DM, Da Silva LGD, De Almeida EO, Barbosa GAS (2017) Acupuncture in temporomandibular disorder myofascial pain treatment: a systematic review. J Oral Facial Pain Headache 31(3):225–232. https://doi.org/10.11607/ofph.1719

    Article  PubMed  Google Scholar 

  34. Jung A, Shin BC, Lee MS, Sim H, Ernst E (2011) Acupuncture for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized, sham-controlled trials. J Dent 39(5):341–350. https://doi.org/10.1016/j.jdent.2011.02.006

    Article  PubMed  Google Scholar 

  35. Borges RMM, Cardoso DS, Flores BC, da Luz RD, Machado CR, Cerveira GP, Daitx RB, Dohnert MB (2018) Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci 33(9):1859–1866. https://doi.org/10.1007/s10103-018-2533-6

    Article  Google Scholar 

  36. Jahanbin A, Ramazanzadeh B, Ahrari F, Forouzanfar A, Beidokhti M (2014) Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors. Am J Orthod Dentofacial Orthop 146(5):565–572. https://doi.org/10.1016/j.ajodo.2014.07.006

    Article  PubMed  Google Scholar 

  37. Rodrigues CA, Melchior MO, Valencise Magri L, Mazzetto MO (2018) Can the severity of orofacial myofunctional conditions interfere with the response of analgesia promoted by active or placebo low-level laser therapy? Cranio:1–8. https://doi.org/10.1080/08869634.2018.1520950

Download references

Funding source

This project received financial support from the Vice-Chancellor for research of Mashhad University of Medical Sciences [grant no. 951115]. The results presented in this work were part of a DDS student thesis [thesis number 2890].

Author information

Authors and Affiliations

  1. Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Azamsadat Madani, Farzaneh Ahrari & Amir Fallahrastegar

  2. Resident of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran

    Naeemeh Daghestani

Authors
  1. Azamsadat Madani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Farzaneh Ahrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amir Fallahrastegar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naeemeh Daghestani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Farzaneh Ahrari or Naeemeh Daghestani.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The protocol of the study was reviewed and approved by the Ethics committee of Mashhad University of Medical Sciences (IR. Mums.sd.REC.1394.191) and was recorded in Iranian Registry of Clinical Trials with IRCT number IRCT2017010131770N1.

Informed consent

The procedure was explained in detail for all the patients and signed consent documents were taken before the study commencement.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Madani, A., Ahrari, F., Fallahrastegar, A. et al. A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci 35, 181–192 (2020). https://doi.org/10.1007/s10103-019-02837-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-019-02837-x

Keywords

Search

Navigation