Low Level Laser Therapy for the Treatment of Temporomandibular Disorders: A Systematic Review of the Literature

ArticleinCranio: the journal of craniomandibular practice 30(4):304-12 · October 2012with6 Reads
DOI: 10.1179/crn.2012.045 · Source: PubMed
Abstract
The authors performed a review of the literature to evaluate the efficacy of low level laser therapy (LLLT) for the treatment of temporomandibular disorders (TMD). Selection criteria included: 1) human subjects, 2) articles written in English, and 3) randomized placebo-controlled trials. Evaluation was performed according to the CONSORT 2010 criteria. A total of 14 articles were included in the review. Studies varied considerably in terms of methodological design, particularly regarding the site of application of the laser beam, the number of applications performed, their duration, the laser beam features (wavelength, frequency, output, dosage), and outcome measures. The outcome of the trials was controversial and not particularly related to any features of the laser beam, to the number of laser applications, and their duration. Based on the results of this review no definitive conclusions can be drawn on the efficacy of LLLT for the treatment of TMD. Many methodological differences among the studies, especially regarding the number and duration of laser applications and characteristics of the laser beam (wavelength, frequency, output), do not allow for standardized guidelines for effective treatment with LLLT. The only indication seems to be that LLLT is probably more effective for the treatment of TMJ disorders, and less effective for the treatment of masticatory muscle disorders.
    • "Early diagnosis may avoid complex treatments, such as surgery and invasive occlusal therapy [6,7]. Several treatments are suggested for TMD. "
    [Show abstract] [Hide abstract] ABSTRACT: This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.
    Full-text · Article · Mar 2016
    • "LLLT not only affects the blood microcirculation but also increases ATP production. LLLT gives an increase of lymphatic flow that reduces edema and causes decrease of prostaglandin E2 and cyclooxygenase-2 levels [3]. Under the surface of the skin at 1 cm depth the intensity of a laser is reduced to 10% of its value. "
    [Show abstract] [Hide abstract] ABSTRACT: Light amplification by stimulated emission of radiation (laser) is one of the most recent treatment modalities in dentistry. Low-level laser therapy (LLLT) is suggested to have biostimulating and analgesic effects through direct irradiation without causing thermal response. There are few studies that have investigated the efficacy of laser therapy in temporomandibular disorders (TMD), especially in reduced mouth opening. The case report here evaluates performance of LLLT with a diode laser for temporomandibular clicking and postoperative findings were evaluated in two cases of TMD patients. First patient had a history of limited mouth opening and pain in temporomandibular joint (TMJ) region since nine months. Second patient’s main complaint was his restricted mouth opening, which was progressed in one year. LLLT was performed with a 685 nm red probed diode laser that has an energy density of 6.2 J/cm 2 , three times a week for one month, and application time was 30 seconds (685 nm, 25 mW, 30 s, 0.02 Hz, and 6.2 J/cm 2 ) (BTL-2000, Portative Laser Therapy Device). The treatment protocol was decided according to the literature. One year later patients were evaluated and there were no changes. This application suggested that LLLT is an appropriate treatment for TMD related pain and limited mouth opening and should be considered as an alternative to other methods.
    Full-text · Article · Nov 2015
    • "Although a number of studies in the literature have addressed different forms of treatment for TMD24252627 including phototherapy [28,29], gaps in knowledge remain in clinical practice regarding the use of different light sources (LLLT and LED), as well as the most effective, evidenced-based doses. In a systematic review, Melis et al. [30] found considerable methodological differences among studies, especially with regard to the number of applications, duration and characteristics (wavelength and frequency) of LLLT, demonstrating the lack of standardized guidelines for effective treatment. Thus, there is a need for further in-depth investigations regarding the use of phototherapy for the treatment of myogenous TMD24252627. "
    Full-text · Article · Aug 2015
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