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

Abstract

This systematic review and meta-analysis (PROSPERO registration; ref CRD 42020198921) aimed to govern photobiomodulation therapy (PBMT) efficacy in temporomandibular disorder (TMD). PRISMA guidelines and Cochrane Collaboration recommendations were followed. Differences in pain reduction assessment by qualitative measurement with visual analogue scale pain (VAS), pressure threshold (PPT) and maximum mouth opening (MMO) were calculated with 95% confidence intervals and pooled in a random effects model with a subgroup analysis, evaluating the role of follow-up duration. Heterogeneity was analysed using Q and I2 tests. Publication bias was assessed by visual examination of funnel plot symmetry. Qualitative analysis revealed 46% of the 44 included studies showed a high risk of bias. Meta-analysis on 32 out of 44 studies revealed statistically significant intergroup differences (SSID) for VAS (SMD = −0.55; 95% CI = −0.82 to −0.27; Z = 3.90 (p < 0.001)), PPT (SMD = −0.45; 95% CI = −0.89 to 0.00; Z = 1.97 (p = 0.05)) and MMO (SMD = −0.45; 95% CI = −0.89 to 0.00; Z = 1.97 (p = 0.05)), favouring PBMT compared to control treatment strategies. Sensitivity analysis revealed SSID (SMD = −0.53; 95% CI = −0.73 to −0.32; Z = 5.02 (p < 0.0001)) with low heterogeneity (T2 = 0.02; χ2 = 16.03 (p = 0.31); I2 = 13%). Hence, this review, for first time, proposed suggested recommendations for PBMT protocols and methodology for future extensive TMD research.

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

“…TMD occurs in all age groups, especially in young adults, and the highest prevalence rate is between 20 and 40 years old [ 4 ]. Muscle pain and articular disc displacement are common in adolescents, while degenerative osteoarthropathy has a high incidence in middle-aged and elderly people [ 5 ]. MRI is regarded as the first choice because of its nonradiation and high soft tissue resolution.…”

Therapeutic Potential of Photobiomodulation for Chronic Kidney Disease

“…Although the action mechanisms underlying the beneficial effect of PBM are not fully understood, the most widely accepted mechanism is that PBM improves mitochondrial function, leading to increased ATP production, inhibiting oxidative stress, and reducing inflammation [ 15 , 80 , 81 ]. Furthermore, recent studies have demonstrated that PBM can modulate the gut microbiota and may be a novel gut microbiota intervention in different animal disease models, including Alzheimer’s disease and osteoporosis [ 17 , 82 , 83 ] and, more recently, in patients with Parkinson’s disease [ 84 , 85 ].…”

“…PBM has been used clinically for more than 50 years and studied in various diseases and conditions, such as muscle [ 5 ], wound healing [ 6 ], pain relief [ 7 ], arthritis [ 8 ], hair loss [ 9 ], orthodontic mini-implant stability [ 10 ], neurodegenerative diseases [ 11 ] and most recently in COVID-19 patients [ 12 ]. PBM has been shown over decades to be a patient-directed, adjunctive, effective, non-invasive, and safe treatment option to mitigate mitochondrial dysfunction [ 13 ], oxidative stress [ 14 , 15 ], inflammatory conditions [ 16 ], and, more recently, gut microbiota dysbiosis [ 17 ], which are all primary contributors to CKD. Notably, several studies have demonstrated a positive effect of PBM in different models of kidney diseases, including acute kidney injury, glomerulonephritis, and metabolic syndrome-related kidney injury [ 18 ].…”

Photobiomodulation Therapy in the Treatment of Temporomandibular Disorders

“…Temporomandibular disorders (TMDs) are classified as degenerative musculoskeletal disorders that cause structural and functional abnormalities (AHMAD, 2021). They are a set of clinical conditions with signs and symptoms in the masticatory muscles, temporomandibular joint (TMJ) and associated structures and pain on palpation of the masticatory muscles (HANNA, 2021). As it is a multifactorial disease, it requires a complex therapeutic approach, with noninvasive therapies being the first option for most patients (BROCHADO, 2019).…”