The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature

Abstract

Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles. Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs. Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations. Key words:Low level laser therapy; phototherapy; temporomandibular joint disorders.

Low Level Laser Therapy Versus Pharmacotherapy in Improving Myofascial Pain Disorder Syndrome

“…Laser therapy has been shown to increase angiogenesis and blood flow by promoting new blood vessel capillary budding and increased collateral circulation. [23][24][25][26] Regarding tenderness (pain on palpation) of masticatory muscles there was a significant reduction in pain symptoms in laser group. While in the naproxen group there was no significant reduction in pain symptoms, nor in maximum painless mouth opening.…”

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“…Hipoksik hasar ve stres azalırken büyüme faktör salınımı da artmaktadır (23). DDLT analjezik, antiinflamatuar ve rejeneratif etkilerinden dolayı iskelet kas rahatsızlıklarında kolay uygulanabilen ve kısa sürede sonuç alınan bir tedavi seçeneğidir (24). DDLT'nin servikal dentin hassasiyeti, trigeminal nevralji, baş ağrısı ve özellikle TMR'de analjezik bir etki gösterdiği bildirilmiştir.…”

The use of low-level laser therapy in temporomandibular joint disordersers

“…DDLT, TMR'de yararlı olan noninvaziv, hızlı, güvenilir ve non-farmasötik bir uygulamadır. Fakat, DDLT'nin klinik etkinliği ve uygulama prosedürü üzerine literatürde hala tam bir fikir birliği bulunmamaktadır (24). Lazer uygulamasında hastanın bu tedaviye cevabı sadece lazerin tipine bağlı olmamakta, aynı zamanda …”