Photobiomodulation in Temporomandibular Disorders

Abstract

Objective: This systematic review aimed to comprehensively review all available documents regarding photobiomodulation therapy (PBMT) application in temporomandibular disorder (TMD) patients and to suggest an evidence-based protocol for therapeutic PBM administration for these patients. Background data: The existence of temporomandibular joint and/or pain and dysfunction in masticatory muscles is characterized in TMDs. PBMT is, due to its impact on biological processes, especially inflammation, considered as an adjuvant treatment modality in TMD cases. Materials and methods: All original articles related to PBMT for TMDs in EMBASE, MEDLINE (NCBI PubMed and PMC), Cochrane library, Scopus, Web of Science, and Google Scholar were reviewed until December 2018. Results: The energy density ranging from 0.75 to 112.5 J/cm 2 with 0.9-500 mW power was found to be a window protocol for light application. The best results for pain relief and mandibular movement enhancement were reported after application of GaAlAs diode laser, 800-900 nm, 100-500 mW, and <10 J/cm 2 , twice a week for 30 days on trigger points. The session of light applications varied from 1 to 20. Conclusions: Although most articles showed that PBMT is effective in reducing pain and contributed to functional enhancement in TMD patients, the heterogenic parameters that have been reported in various studies made the standardization of PBMT complicated. However, such evidence-based consensus can be beneficial for both future research and for clinical applications.

Role of Photobiomodulation Therapy in Modulating Oxidative Stress in Temporomandibular Disorders. A Systematic Review and Meta-Analysis of Human Randomised Controlled Trials

“…Twelve studies were conducted on patients with a mean age in the range of 25 to 35 years [13,17,29,30,32,[34][35][36][37]39,42,44]. Eleven studies were conducted on patients with a mean age ranging from 35 to 45 years [6,9,12,15,18,21,[24][25][26][27]40], two studies had patient age groups in the range of 18 to 25 years [38,41] and one study included patients more than 45 years old [33]. Additionally, 13 studies failed to provide a mean age in their respective studies [4,5,7,8,10,16,19,20,22,23,28,31,43] with a variation in the range of 18 to 60 years.…”

“…However, its clinical efficacy has been controversial due to the diversity of the reported results. Many systematic reviews and meta-analyses have analysed PBMT effectiveness in musculoskeletal disorders [29,30], but only three relatively focused on TMDs in which effective dosage and power density were analysed to evaluate the reduction in TMD-induced pain [31][32][33]. Additionally, the use of LED PBM has captured the interest of many investigators, due to its easy administration over a large surface area [34].…”

Laser‐Induced Differentiation of Human Adipose‐Derived Stem Cells to Temporomandibular Joint Disc Cells

“…To confirm the seriousness of this disorder, the worldwide Research Diagnosis Criteria for TMD (RDC/TMD) was developed [20–22]. Photobiomodulation has been introduced as a new method for the treatment of TMD patients [23]. Additionally, photobiomodulation increases stem cell migration and stimulate the proliferation and regeneration [24,25].…”

The Path to an Evidence-Based Treatment Protocol for Extraoral Photobiomodulation Therapy for the Prevention of Oral Mucositis

“…The highest peak is in the near infrared window at 812.0-846 nm. Additionally, PBMT in the near infrared window has shown efficacy for several other inflammatory/painful indications, such as osteoarthritis, colitis, and temporomandibular disorders [29][30][31][32][33][34][35][36]. Longer wavelengths beyond the near-infrared range lack evidence of efficacy [37].…”