Low level laser therapy as an adjunctive technique in the management of temporomandibular disorders.
ABSTRACT 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.
- SourceAvailable from: Lucindo José Quintans-Júnior
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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 . However, comparisons between these two studies must be analyzed parsimoniously, since the rats received considerably higher dose per body weight than humans. "
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 · 2.80 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.04/2013; 3(2):106-11. DOI:10.11138/mltj/2013.3.2.106
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ABSTRACT: The present study was designed to evaluate the effects of low-level laser (Nd:YAG) therapy and occlusal splints in patients with signs and symptoms of temporomandibular disorders (TMD) characterized with myofascial pain (MP). A total of 30 patients were selected after being diagnosed with MP according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TDM). The patients were divided into three groups. The first group was occlusal splint (OS) group A (n = 10), the second was low-level laser therapy (LLLT) group B (n = 10), and the last group C was placebo (n = 10). LLLT (1,064 nm, 8 j/cm(2), 250 mW, Fotona) was applied to the patients in the study group once a day for 10 days, for a total of ten sessions. The same parameters and application times were used for placebo group, but the patients were not irradiated. The application was on the trigger points. The patients in the OS group were instructed to wear occlusal splints 12 h/day for 3 weeks. Functional examination was based on RDC/TDM, and pressure pain values were obtained with the Visual Analog Scale. Comparisons were made between the groups before and after the treatment according to Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests. The pain score values decreased significantly after both LLLT (p < 0.05) and occlusal splint therapy (p < 0.05) compared to placebo group (p < 0.05). There was no significant difference between LLLT and OS groups after treatment (p > 0.05). OS and LLLT are effective for decreasing MP. In addition, this particular type of LLLT is as effective as occlusal splint for pain relief.Lasers in Medical Science 02/2014; 30(3). DOI:10.1007/s10103-014-1522-7 · 2.42 Impact Factor