Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders
Lasers in Medical Science
Abstract
The
purpose of this study was to address the following question: among
patients with acute or chronic temporomandibular disorders
(TMD), does low-level laser therapy (LLLT) reduce pain
intensity and improve maximal mouth opening? The sample comprised
myogenic
TMD patients (according Research Diagnostic Criteria for
TMD). Inclusion criteria were: male/female, no age limit, orofacial
pain, tender points, limited jaw movements and chewing
difficulties. Patients with other TMD subtypes or associated
musculoskeletal/rheumatologic
disease, missing incisors teeth, LLLT contra-indication, and
previous TMD treatment were excluded. According to disease duration,
patients were allocated into two groups, acute
(<6 months) and chronic TMD (≥6 months). For each patient, 12 LLLT
sessions
were performed (gallium–aluminum–arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm2).
Pain intensity was recorded using a 10-cm visual analog scale and
maximal mouth opening using a digital ruler (both recorded
before/after LLLT). The investigators were previously
calibrated and blinded to the groups (double-blind study) and level
of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain
intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann–Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann–Whitney test, p
= 0.011). Low-level laser therapy can be considered as an alternative
physical modality or supplementary approach for management
of acute and chronic myogenic temporomandibular disorder;
however, patients with acute disease are likely to have a better
outcome.
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