Low Intensity Laser Therapy in Disc Derangement Disorders of Temporomandibular Joint: A Review Article

Abstract

Temporomandibular disorders embrace a number of clinical conditions that involves the masticatory musculature, temporomandibular joint (TMJ) and associated structures. The most frequent cause of TMJ disorders are disc derangement disorders which involve progressive slipping or displacement of articular disc. Various conservative treatment strategies for disc derangement disorders includes pharmacologic therapy, psychological counselling, treatment of parafunctional habits, use of occlusal splints and acupuncture which gives short term relief only. Recently, a non traumatic introduction to dentistry can be represented by low level laser therapy or soft laser therapy. It has proved to be an effective treatment modality in management of disc derangement disorders through its analgesic and anti-inflammatory effect. Therefore, the goal of this review article is to explore the use of low level laser therapy as an emerging trend in the management of disc derangement disorders of TMJ. KEY WORDS: low level laser, disc derangement disorders, orofacial pain.

The Effect of Low Level Laser with Repositioning Appliance in the Management of Temporomandibular Joint Disc Displacement with Reduction

“…[1] The three most common TMDs are myofascial pain, internal derangement (ID) of the condyle-disc complex, and degenerative joint disease. [2] Internal derangements are the most common noninflammatory disorder of the TMJ and are defined as an abnormal relationship between the articular disc and the condyle.…”

“…[3] Numerous factors have been proposed including traumatic events, bruxism, changes in the composition of synovial fluid, an improper activity of the lateral pterygoid muscle, and psychological stress. [1], [4], [5) Anterior DDwR is a commonly seen subgroup of ID, in which the intra-articular disc is positioned more anteriorly due to elongation of the inferior retrodiscal lamina and discal collateral ligament. The condyle rests on a more posterior portion of the disc resulting in abnormal translatory shift of the condyle over the disc during opening.…”

“…[6], [7] Various cardinal signs and symptoms are associated with DDwR as joint pain, clicking of joint, tenderness in masticatory muscles, and limitation in mandibular movements. [1] During the last 35 years, the dental profession's attitude toward management of Disc Displacements (DDs) has changed greatly. [8] A wide consensus has been reached through the years on considering conservative and reversible approaches as first-line therapy of symptomatic DD including physical therapy, pharmacologic therapy, psychological counseling, cognitive behavioral therapy, treatment of parafunctional habits, occlusal appliances and acupuncture.…”

Internal Derangement of Temporomandibular Joint - A Review

“…Disadvantage has been the high cost compared to the conventional therapies and the fast development in the field. [46] …”

“…Similarly, Bertolucci & Grey in 1995 reported significant improvement in articular noise, limitation of oral opening and also in the masticatory function through reduction of muscle contraction and of intra articular inflammation by LLLT. [46]The main effects of laser light used in LLLT on tissue include: Analgesic, Biostimulating , Anti-inflammatory .Advantages includes aseptic, noninvasive, painless, nonpharmaceutical and reversible therapy, if used properly has no side effects.It has no postoperative discomfort. Disadvantage has been the high cost compared to the conventional therapies and the fast development in the field.…”