Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial

Abstract

A prospective, double-blind, randomized, and placebo-controlled trial was conducted in patients with chronic temporomandibular disorder (TMD) to check the analgesic efficacy of infrared low-power GaAlAs diode laser applied to acupuncture points. Forty female subjects, ranging in age from 20 to 40 years, with diagnoses of chronic myofascial pain and arthralgia were randomly allocated to two groups: an experimental group (EG) who received the laser acupuncture as adjunct to reversible occlusal splint therapy and a control group (CG) who received a placebo laser associated with occlusal splint therapy. Both approaches were applied once a week for 3 months. Laser acupuncture was defined by the following parameters: 50-mW continuous radiation for 90 s to acupoints ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3; defining 4.5-J energy; 1250-W/cm(2) density point; and 112.5-J/cm(2) total density. The outcome measurements included a symptom evolution assessment carried out by checking spontaneous and palpation pain intensity, which was indicated on a visual analog scale (VAS). All evaluations were made by an assessor who was blind to the treatment. The symptom reduction was significant in both groups (EG: VAS = 0, n = 20; CG: VAS between 2 and 4, n = 18). The measurements showed significantly faster and lower pain intensity values in the EG (p ≤ 0.002), where there was a higher proportion of patients with remission of symptoms related to the action of laser acupuncture. For patients in whom conservative treatment was adopted, the laser acupuncture is a secure, noninvasive, and effective treatment modality because it improves the chronic pain associated with TMD and has no side effects.

Managing Pain with Laser Acupuncture

“…In our literature search, all four RCTs suggested a positive treatment effect for LA in treating the pain associated with TMD [4,[38][39][40]. Occlusal splinting is the nonsurgical standard treatment for this condition in dental clinics.…”

“…Moreover, it is a relatively safe procedure with minimal adverse effects [3]. Even though acupuncture has been proven to be effective for many therapeutic applications, metal needling is not widely accepted owing to fear of possible contamination or transcutaneous lesions [4]. Consequently, following the theory of TCM, the use of low-level laser on acupuncture points has been developed as a new therapeutic approach called laser acupuncture (LA) [5,6].…”

Efectos del Láser de Baja Intensidad (As-Ga-Al 904 nm) sobre el Cóndilo Mandibular de Conejos: Análisis a través de Tomografía Computadorizada Cone Beam

“…En el tratamiento de los TTMs los autores utilizan dosis de irradiación en un rango que va desde 3 J/cm 2 hasta 112,5 J/cm 2 por sesión de tratamiento (Emshoff et al;Ferreira et al, 2013). En la literatura no hay ninguna evidencia precisa con respecto a la dosis efectiva para el tratamiento de los TTMs (Chen et al).…”

Influência da eletroacupuntura e laser-acupuntura no tratamento de parestesia em pacientes submetidos à cirurgia ortognática combinada e mentoplastia

“…Outras terapias atualmente utilizadas para o tratamento das parestesias da região orofacial do tipo neuropraxia e axonotmese de diversas etiologias são: fisioterapia neurológica, que busca a restauração ou readaptação dos processos sensoriais e da função motora (Machado et al, 2012); eletroacupuntura, que apresenta a mesma base da acupuntura, porém com agulhas ligadas a aparelhos elétricos que, ao serem acionados, produzem estímulos elétricos que geram uma ação analgésica ; e laser-acupuntura, que é o uso do laser de baixa potência aplicado nos pontos de acupuntura, seguindo os princípios da medicina tradicional chinesa (Baxter et al, 2008;Ferreira et al, 2013;Round et al, 2013). No entanto, ainda não existem na literatura cientifica estudos clínicos longitudinais que comprovem a eficácia destas três terapias.…”

“…Além da estimulação dos pontos de acupuntura com agulhas, estudos têm sido conduzidos para que novas técnicas de estimulação possam ser empregadas, como eletroacupuntura (Tavares et al, 2007;Kavoussi;Ross, 2007;Zhou, 2008;Cheng et al, 2011) e a laser-acupuntura, que é a estimulação dos pontos tradicionais de acupuntura com laser de baixa potência, mas as pesquisas ainda são muito recentes (Zhou, 1984;Whittaker, 2004;Pohodenko-Chudakova;Scarsella, 2008;Pulido et al, 2009;Sari;Sari, 2010;Hotta et al, 2010;Katsoulis et al, 2010;Ferreira et al, 2013).…”