Effect of photobiomodulation therapy on painful temporomandibular disorders

Abstract

To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm2, 3 regions, 60 s) or TMJ region (6 J/cm2, 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0–10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P < 0.001) for both types of interventions, however, PBMT caused greater reduction in pain scores than placebo (P = 0.014). For myalgia patients, pain intensity decreased over time (P < 0.001) but without difference between interventions (P = 0.074). PPTs increased in both myalgia (P < 0.001) and TMJ arthralgia patients over time (P < 0.001) but without difference between interventions (P ≥ 0.614). Overall, PBMT was associated with marginally better improvements in range of motion compared to placebo in both myalgia and arthralgia patients. Pain intensity, sensory function and jaw movements improve after both PBMT and placebo treatments in myalgia and arthralgia patients indicating a substantial non-specific effect of PBMT.

Effect of Photobiomodulation Therapy Dosage on Orthodontic Movement, Temporomandibular Dysfunction and Third Molar Surgery Outcomes: A Five-Year Systematic Review

“…As for the treatment outcomes observed, 12/20 studies (60%) [59][60][61][62][63][64]66,67,70,[73][74][75]] presented a positive result, while 8/20 (40%) [65,68,69,71,72,[76][77][78] showed no difference from the control group.…”

The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials

“…All of the included studies provided information on pain intensity except one. 48 Fifteen RCTs evaluated MMO, 1,25,34,36,38,40,41,44,46,[50][51][52]54,57,61 two evaluated AMMO and PMMO, 35,60 ten evaluated LM, 1,24,25,34,36,38,46,54,60,61 four evaluated PM, 1,25,38,46 nine evaluated PPT, 25,39,40,42,46,50,52,53,60,6 4 five evaluated EMG activity, 37,39,40,48,52 and five evaluated sounds of TMJ. 24,31,34,44,51 Twenty-seven studies out of 39 showed a reduction in pain intensity in the PBMT groups in comparison with the control groups.…”

“…24,31,34,44,51 Twenty-seven studies out of 39 showed a reduction in pain intensity in the PBMT groups in comparison with the control groups. 1,24,26,[29][30][31][33][34][35][36][37][38][40][41][42][43][45][46][47]49,52,[55][56][57][58]60,61 Among the RCTs that reported MMO, seven studies 34,36,38,41,46,54,61 showed a greater MMO in the PBMT groups compared to the placebo groups; while others showed no difference. Also, AMMO and PMMO were reported to be greater in the PBMT groups.…”

“…Thirty-six studies used diode lasers 1,[24][25][26][27][29][30][31][32][33][34][35][36][37][39][40][41][42][44][45][46][48][49][50][51][52][53][55][56][57][58][59][60]63,64 with different wavelengths, including 635 nm, 56 640 nm, 52,57 660 nm, 33,65 780 nm, 25,26,30,32,37,38,48,50,53,59 795 nm, 40 808 nm, 42,45,54,58 810 nm,…”

“…Energy/Energy Density Among the studies, laser energy density ranged from 0.9 J/cm 2 to 300 J/cm 2 . Energy density in twenty studies 24,25,28,29,33,36,40,41,43,44,46,47,[49][50][51]56,[58][59][60]62 -In-vitro studies, ex-vivo studies, in-vivo studies, case reports/series, letters to the editor, short communications, non-comparative studies, narrative reviews, and systematic reviews with or without meta-analysis below 10 J/cm 2 in 13 studies 1,26,27,32,34,[37][38][39]42,48,53,54,57 were between 19 to 100 J/cm 2 , and in five studies 30,32,38,39,55 was over 100 J/cm 2 . Moreover, laser energy in eight studies 27,29,31,39,41,42,44,52 was reported below 10 J, and in three studies 39,…”