The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: “temporomandibular joint laser therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD.

IntroductionTemporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism.MethodsSixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD.ResultsThe inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups.ConclusionMassage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and symptoms among individuals with severe TMD and sleep bruxism.Trial registrationThis study is registered in August, 2014 in the ClinicalTrials.gov (NCT01874041).Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-014-0043-6) contains supplementary material, which is available to authorized users.

A single session of combined phototherapy was capable of reducing pain intensity in individuals patients with TMD. ClinicalTrials.gov (NCT02018770). Implications for Rehabilitation Phototherapy device combining two light sources (LED and laser), and different densities in the same device is a novelty in the rehabilitation market, and has proved to be a useful intervention for people with temporomandibular disorders. This mode of phototherapy is another option that assists in the rapid intervention in pain symptoms, promoting a considerable degree of comfort to the patient moments after its application.

| Background: Temporomandibular disorder (TMD) is considered multifactorial and is defined as a group of pain conditions characterized by functional stomatognathic system alterations, which may be affected by or related disrupted postural control. Objective: Assess the immediate effect of nonspecific mandibular mobilization (NMM) on the postural control of subjects diagnosed or not with TMD. Method: A simple-blind, randomized, controlled clinical trial was performed involving 50 subjects of both genders assigned to two groups: the TMD group and the control group. TMD was diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A stabilometric assessment was performed by testing subjects in a quiet stance on a dual force platform under two visual conditions (eyes open and eyes closed). The Center of Pressure (CoP)-related variables analyzed were displacement, amplitude, speed of anterior-posterior (AP) and medial-lateral (ML) displacements and CoP sway area. The mean values of each variable were compared, considering the accepted significance value of p<0.05. Results: A significant difference between the pre-and post-NMM means could be observed in subjects diagnosed with TMD under the closed-eyes visual condition. There was a statistically significant difference in the CoP sway area (p<0.03) in the ML displacement COP ML (p<0.006) and ML amplitude COP ML (p<0.01) and in the variable speed in the AP COP AP (p<0.03) and ML COP ML (p<0.03) directions, simultaneously. Conclusion: These results indicate that nonspecific temporomandibular joint mobilization contributes to the immediate improvement of postural control in patients with TMD.Keywords: physical therapy; temporomandibular joint; temporomandibular joint disorders; equilibrioception. Article registered in the Brazilian Registry of Clinical Trials (Registro de Ensaio Clinico Brasileiro, REBEC): RBR-63gdgg HOW TO CITE THIS ARTICLEAmaral AP, Politti F, Hage YE, Arruda EEC, Amorin CF, Biasotto-Gonzalez DA. Immediate effect of nonspecific mandibular mobilization on postural control in subjects with temporomandibular disorder: a single-blind, randomized, controlled clinical trial. Braz J Phys Ther.

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