The study aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) on bilateral masseter muscle thickness and amplitude of mouth opening in children with spastic cerebral palsy (CP), and the impact on their oral health-related quality of life (OHRQOL). Three groups were included: experimental CP group (EG: n = 26 with oral complaints), positive control CP group (PCG: n = 26 without complaints), and negative control group (NCG: n = 26 without CP). In the EG, the masseter muscles on both sides were irradiated with an infrared low-level Ga-Al-As laser (λ = 808 ± 3 nm, 120 mW) using a 3 J/cm energy dose per site, with a 20 s exposure time per site (spot area: 4 mm; irradiance: 3 W/cm; energy delivery per point: 2.4 J) six times over six consecutive weeks. Masseter thickness, assessed through ultrasonography, and the amplitude of mouth opening were measured in the EG before and after six applications of PBMT and once in the PCG and NCG. The Parental-Caregiver Perception Questionnaire (P-CPQ) was used to evaluate OHRQOL. ANOVA, chi-square, t tests, and multilevel linear regression were used for statistical analysis. In the EG, the study results revealed average increments of 0.77 (0.08) millimeter in masseter thickness (P < 0.05) and 7.39 (0.58) millimeter for mouth opening (P < 0.05) and reduction in all P-CPQ domains (P < 0.001), except for social well-being. The six applications of PBMT increased masseter thickness and mouth opening amplitude and reduced the impact of spastic CP on OHRQOL.
Spasticity causes stiffness in the masticatory muscles of individuals with cerebral palsy (CP), affecting the amplitude of mouth opening, making oral hygiene conditions difficult and predisposing these individuals to the risk of developing oral diseases. Objective: To evaluate the effect of a low-intensity photobiomodulation diode laser on the thick part of the masseter muscle in a child with spastic type CP. Method: The caregiver reported that the child had great difficulty in performing the oral hygiene, making avoidance movements of the head when the toothbrush touched the mucosa of the upper molar region in the mouth. The mother described the child’s discomfort as extreme. The first ultrasound evaluation was performed at the first appointment, and the second evaluation after 6 sessions of photobiostimulation. The low-intensity Infrared Laser Diode, Ga-As-Al, was employed (λ = 808 ± 3 nm, 120 mW; Twin Flex Evolution Laser MMOptics São Paulo, Brazil), using 5.0 J/cm2 dose energy/location, with 20 seconds exposure/site. The area of the masseter muscle was bilaterally irradiated towards the midpoint of its length and width. Six sessions were performed, with an interval of 7 days between them. Results: At the end of the sixth session of photobiostimulation, the mother reported that the child slept better, had reduction in involuntary movements performed by the jaw, and oral hygiene was possible now with no painful expression of the child. During palpation there was less stiffness in the bilateral masseter and an increased masseter thickness and increase in the amplitude of the mouth opening of 7 mm. Conclusion: The diode laser photobiostimulation appears to be effective in reducing spasticity in the masseter muscle of children with spastic type CP.
Spasticity causes stiffness in the masticatory muscles of individuals with cerebral palsy (CP), affecting the amplitude of mouth opening, making oral hygiene conditions difficult and predisposing these individuals to the risk of developing oral diseases. Objective: To evaluate the effect of a low-intensity photobiomodulation diode laser on the thick part of the masseter muscle in a child with spastic type CP. Method: The caregiver reported that the child had great difficulty in performing the oral hygiene, making avoidance movements of the head when the toothbrush touched the mucosa of the upper molar region in the mouth. The mother described the child's discomfort as extreme. The first ultrasound evaluation was performed at the first appointment, and the second evaluation after 6 sessions of photobiostimulation. The low-intensity Infrared Laser Diode, Ga-As-Al, was employed (λ = 808 ± 3 nm, 120 mW; Twin Flex Evolution Laser MMOptics São Paulo, Brazil), using 5.0 J/cm 2 dose energy/location, with 20 seconds exposure/site. The area of the masseter muscle was bilaterally irradiated towards the midpoint of its length and width. Six sessions were performed, with an interval of 7 days between them. Results: At the end of the sixth session of photobiostimulation, the mother reported that the child slept better, had reduction in involuntary movements performed by the jaw, and oral hygiene was possible now with no painful expression of the child. During palpation there was less stiffness in the bilateral masseter and an increased masseter thickness and increase in the amplitude of the mouth opening of 7 mm. Conclusion: The diode laser photobiostimulation appears to be effective in reducing spasticity in the masseter muscle of children with spastic type CP.
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