Low level laser therapy as an adjunctive technique in the management of temporomandibular disorders

Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Brazil.
Cranio: the journal of craniomandibular practice (Impact Factor: 0.68). 10/2012; 30(4):264-71. DOI: 10.1179/crn.2012.040
Source: PubMed


The purpose of this study was to assess the effect of low level laser therapy on subjects with intra-articular temporomandibular disorders (IA-TMD), and to quantify and compare severity of signs and symptoms before, during, and after the laser applications. The sample consisted of 45 subjects randomly divided into three groups (G) of 15 subjects each: G-I: 15 individuals with IA-TMD submitted to an energy dose of 52.5 J/cm2; G-II: dose of 105.0 J/cm2; and G-III: placebo group (0 J/cm2). In all groups, the applications were performed on condylar points on the masseter and anterior temporalis muscles. Two weekly sessions were held for five weeks, totaling 10 applications. The assessed variables were: mandibular movements and painful symptoms evoked by muscle palpation. These variables were measured before starting the study, then immediately after the first, fifth, and tenth laser application, and finally, 32 days after completing the applications. The results showed that there were statistically significant differences for G-I and G-II at the level of 1% between the doses, as well as between assessments. Therefore, it was concluded that the use of low level laser increased the mean mandibular range of motion and reduced painful symptoms in the groups that received effective treatment, which did not occur in the placebo group.

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    • "With different media and wavelengths, the laser would also have different penetration depths. Appropriate parameters that influence the therapeutic effects for TMJ pain remain controversial at present12). Various clinical doses, methods, and modes of LLLT could also result in different treatment effects. "
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    ABSTRACT: [Purpose] Temporomandibular joint (TMJ) pain is a symptom of TMJ disease. Low-level laser therapy (LLLT) is often used in the clinical treatment of TMJ pain. The aim of this study was to review the effective parameters of LLLT for TMJ pain. [Methods] This study was a systematic review in which electronic databases were searched for the period of January 2005 to January 2010. We selected reports of randomized controlled trials and calculated the effect size (ES) of the pain relief to evaluate the effect of LLLT. [Results] Seven reports are found to meet the inclusion criteria and discussed. Based on the calculation results, the pooled ES was -0.6, indicating a moderate effect of pain relief. In addition, the dosages and treatments with wavelengths of 780 and 830 nm can cause moderate and large pain relief effects. [Conclusion] Use of LLLT on the masticatory muscle or joint capsule for TMJ pain had a moderate analgesic effect. The optimal parameters for LLLT to treat TMJ pain have not been confirmed. However, our results can be a vital clinical reference for clinical physicians in treatment of patients with TMJ pain.
    Journal of Physical Therapy Science 08/2014; 26(8):1297-300. DOI:10.1589/jpts.26.1297 · 0.39 Impact Factor
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    • "The LLLT protocol used in this study was effective in reducing the pain in both phases of the inflammatory induction elicited by formalin. Significant reduction of the painful symptoms and recovery of the mandibular movements of patients treated with phototherapy was previously reported using the same equipment and protocol employed in the current study [33]. However, comparisons between these two studies must be analyzed parsimoniously, since the rats received considerably higher dose per body weight than humans. "
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    ABSTRACT: The aim of this study was to investigate the analgesic and anti-inflammatory activity of low-level laser therapy (LLLT) on the nociceptive behavioral as well as histomorphological aspects induced by injection of formalin and carrageenan into the rat temporomandibular joint. The 2.5% formalin injection (FRG group) induced behavioral responses characterized by rubbing the orofacial region and flinching the head quickly, which were quantified for 45min. The pretreatment with systemic administration of diclofenac sodium-DFN group (10mg/kg i.p.) as well as the irradiation with LLLT infrared (LST group, 780nm, 70mW, 30s, 2.1J, 52.5J/cm(2), GaAlAs) significantly reduced the formalin-induced nociceptive responses. The 1% carrageenan injection (CRG group) induced inflammatory responses over the time-course of the study (24h, and 3 and 7days) characterized by the presence of intense inflammatory infiltrate rich in neutrophils, scanty areas of liquefactive necrosis and intense interstitial edema, extensive hemorrhagic areas, and enlargement of the joint space on the region. The DFN and LST groups showed an intensity of inflammatory response that was significantly lower than in CRG group over the time-course of the study, especially in the LST group, which showed exuberant granulation tissue with intense vascularization, and deposition of newly formed collagen fibers (3 and 7days). It was concluded that the LLLT presented an anti-nociceptive and anti-inflammatory response on the inflammation induced in the temporomandibular joint of rodents.
    Journal of photochemistry and photobiology. B, Biology 10/2013; 129C:135-142. DOI:10.1016/j.jphotobiol.2013.10.002 · 2.96 Impact Factor
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    ABSTRACT: whiplash is a frequent post traumatic pathology caused by muscle, tendon and capsular elements over stretching. The authors conducted a short term prospective randomised study to test the effectiveness of a multi wave High Power Laser Therapy (HPLT) versus conventional simple segmental physical rehabilitation (PT) included in Italian tariff nomenclature performance physiotherapy Study Design: prospective randomised study (Level II). the authors identified 135 homogeneous patients with whiplash grade 1 - 2 of the Quebec Task Force classification (QTFC). INAIL, the Italian National Workers Insurance, based in Milan, was reliable source for identifying patients. All patients with whiplash injuries grade 1 or 2 QTFC, were eligible for the study, starting from April 28 2010 to September 30 2010. Patients referred to a Coordinator (C.M.) who applied the inclusion and exclusion criteria. Patients who agreed to participate were randomly assigned to one of the two treatment groups. Dates for initial treatment session were arranged, including cervical spine X-ray, and assessment. Each patient gave informed consent for participation and agreed to adopt only the study treatment for 6 weeks. Group A (84 patients) was treated with High Power Laser Therapy (HPLT), Group B (51 patients) received conventional simple segmental physical rehabilitation (PT). During the treatment period, no other electro-medical therapy, analgesics or anti-inflammatory drugs were allowed. All patients were assessed at baseline (T0) and at the end of the treatment period (T1) using a Visual Analogical Scale (VAS), (T2) the date of return to work was registered afterwards. there was a reduction in VAS pain scores at T1. Group A (VAS = 20) Group B (VAS = 34,8) (p =0.0048). Laser treatment allowed quick recovery and return to work (T2). Group A after 48 days against 66 days of Group B (p=0.0005). results suggest that High Power Laser Therapy - is an effective treatment in patients with whiplash injury, compared to conventional simple segmental physical rehabilitation.
    Muscles 04/2013; 3(2):106-11. DOI:10.11138/mltj/2013.3.2.106
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