1
|
Desai AP, Roy SK, Semi RS, Balasundaram T. Efficacy of Low-Level Laser Therapy in Management of Temporomandibular Joint Pain: A Double Blind and Placebo Controlled Trial. J Maxillofac Oral Surg 2022; 21:948-956. [PMID: 36274894 PMCID: PMC9474957 DOI: 10.1007/s12663-021-01591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background Stomatognathic system is an interaction of the muscles of mastication, dentition, neural component, and temporomandibular joint. Any dysfunction in this system may lead to temporomandibular disorders (TMDs). Various non-surgical modalities have been employed for treating TMDs. Aim and objectives The aim of the study was to objectively evaluate the effects of low-level laser therapy (LLLT) in treatment of patients with TMDs. Materials and Methods Sixty individuals diagnosed with TMDs were divided randomly into two groups (Group I-placebo and Group II -LLLT). A series of 20 sessions of LLLT applied both in closed mouth and maximum mouth opening position were given over a period of 08 weeks. Assessment was done in terms of improvement in mouth opening, pain, clicking, and deviation of mandible. The data collected were analyzed statistically. Results The results showed improvement in the pain reduction, improvement in the maximum mouth opening, reduction in deviation, and clicking in both groups but better treatment outcome in the low-level laser group. Conclusion Though conservative measures improved the symptoms in TMD but LLLT has shown better results in comparison with the placebo group. Being non-surgical can be employed in combination with other modes for effectively treating such disorders. Keywords: Pain, Dysfunction, Temporomandibular joint disorders (TMDs), Low-level laser therapy (LLLT).
Collapse
Affiliation(s)
- Ajay Premanand Desai
- Oral and Maxillofacial Surgery, Army Dental Centre (Research & Referral), New Delhi, 110010 India
| | - S. K. Roy
- Oral and Maxillofacial Surgery, Army Dental Corps, New Delhi, 110010 India
| | | | - T. Balasundaram
- Oral and Maxillofacial Surgery, Military Dental Centre, Jabalpur, 482001 India
| |
Collapse
|
2
|
Evaluation the effects of low-level laser therapy on disc displacement with reduction. Turk J Phys Med Rehabil 2020; 66:24-30. [PMID: 32318671 DOI: 10.5606/tftrd.2020.3355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/04/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the effects of additional low-level laser therapy (940 nm GaAlAs) to the routine occlusal splint therapy on maximal mouth opening (MMO), visual analog scale (VAS) scores, and passive mouth opening (PMO). Patients and methods Between January 2016 and March 2018, a total of 40 patients (10 males, 30 females; mean age 22.35 years; range, 18 to 60 years) with disc displacement with reduction of the temporomandibular joint were included. The patients were divided into two groups. Group 1 (control group, n=20) received routine non-steroidal anti-inflammatory drug (NSAID) therapy and occlusal splint therapy for eight hours per day for a total of three months. Group 2 (laser group, n=20) received NSAID, occlusal splint therapy and 940 nm wavelength diode laser therapy for two sessions per week for a total of four weeks. The MMO, PMO, and VAS scores were recorded before and at one, two, three, four, and 12 weeks after treatment. The joint and muscle examinations were performed. Results A constant decrease was found in the VAS scores in both groups. At four (p=0.008) and 12 weeks (p=0.003), a statistically significant difference in the VAS scores was observed. At all time points, PMO and MMO scores increased in both groups. The MMO scores were statistically higher in the laser group at all time points (p<0.005). Conclusion Our study results suggest that short-term low-level laser therapy additional to conventional treatment may yield satisfactory outcomes.
Collapse
|
3
|
Graciele Carrasco T, Oliveira Mazzetto M, Galli Mazzetto R, Mestriner W. Low Intensity Laser Therapy in Temporomandibular Disorder: a Phase II Double-Blind Study. Cranio 2014; 26:274-81. [DOI: 10.1179/crn.2008.037] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
4
|
Antônio Moreira Rodrigues da Silva M, Luís Botelho A, Vogt Turim C, Maria Bettoni Rodrigues da Silva A. Low Level Laser Therapy as an Adjunctive Technique In the Management of Temporomandibular Disorders. Cranio 2014; 30:264-71. [DOI: 10.1179/crn.2012.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
| | - André Luís Botelho
- Faculdade de Odontologia de, Ribeirão Preto, Departamento de, Odontologia Restauradora (USP, Av. do Café, s/n, 14040-904 Ribeirão Preto, SP, Brazil,
| | - Carolina Vogt Turim
- Faculdade de Odontologia de, Ribeirão Preto, Departamento de, Odontologia Restauradora (USP, Av. do Café, s/n, 14040-904 Ribeirão Preto, SP, Brazil,
| | - Ana Maria Bettoni Rodrigues da Silva
- Faculdade de Odontologia de, Ribeirão Preto, Departamento de, Odontologia Restauradora (USP, Av. do Café, s/n, 14040-904 Ribeirão Preto, SP, Brazil,
| |
Collapse
|
5
|
Catão MHCDV, Oliveira PSD, Costa RDO, Carneiro VSM. Avaliação da eficácia do laser de baixa intensidade no tratamento das disfunções têmporo-mandibular: estudo clínico randomizado. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013005000052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBEJTIVO: avaliar a eficácia do laser de baixa intensidade no tratamento da dor em pacientes com desordens temporomandibulares. MÉTODO:consistiu de um ensaio clínico randomizado divididos em dois grupos: Grupo 1: laser AsGaAl, Grupo 2: laser InGaAlP, do qual participaram 20 pacientes entre 19 e 35 anos de idade, com diagnóstico de sinais e sintomas de DTM. Os pacientes tinham a amplitude de movimento para abertura máxima da boca e lateralidade registados no início e no final do tratamento a laser. O Laser foi aplicado em quatro pontos pré-auriculares, totalizando 12 sessões três vezes por semana, durante um mês. Dor dos pacientes foi registrado com base na utilização da escala analógica visual (EAV) e também por exame físico dos pontos álgicos. RESULTADOS: observou-se redução significante (p<0,028) do nível de dor em ambos os grupos, porém no G1 a significância foi maior. A evolução do limiar de sensibilidade muscular evidenciou diferença estatisticamente significante (p<0,05) para G1 e G2. A laserterapia no Grupo 1 melhorou a abertura bucal em média de 4,643 mm, enquanto no Grupo 2, a média foi de 3,71 mm por paciente. CONCLUSÃO: houve eficácia em ambos os lasers no controle da dor e abertura bucal dos pacientes.
Collapse
|
6
|
Pelegrini S, Venancio RC, Liebano RE. Efeitos local e sistêmico do laser de baixa potência no limiar de dor por pressão em indivíduos saudáveis. FISIOTERAPIA E PESQUISA 2012. [DOI: 10.1590/s1809-29502012000400009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O laser de baixa potência é utilizado como recurso terapêutico para controle da dor. Porém, ainda é questionado o real efeito como também a dosimetria mais eficaz para esse efeito analgésico. Assim, este estudo teve como objetivo avaliar os efeitos local e sistêmico do laser de baixa potência no limiar de dor por pressão, em indivíduos saudáveis. Cento e cinquenta indivíduos foram distribuídos aleatoriamente em cinco grupos: Controle, Laser Placebo, 3 J, 6 J e 12 J. Para avaliar o limiar de dor, utilizou-se um algômetro de pressão em cinco tempos distintos. Na região da mão dominante do indivíduo, foi realizado o laser e a algometria para verificar o efeito local. Já naquela da perna dominante, realizou-se somente a algometria para verificar efeito sistêmico do laser de baixa potência. Houve redução local do limiar de dor por pressão no Grupo 3 J em comparação com os grupos Controle (p=0,0016) e Placebo (p=0,004), e não houve alteração sistêmica do limiar de dor por pressão. O laser de baixa potência, quando utilizado com energia de 3 J, reduziu o limiar de dor por pressão local em indivíduos saudáveis, porém não houve alteração sistêmica.
Collapse
|
7
|
Kogawa EM, Kato MT, Santos CN, Conti PCR. Evaluation of the efficacy of low-level laser therapy (LLLT) and the microelectric neurostimulation (MENS) in the treatment of myogenic temporomandibular disorders: a randomized clinical trial. J Appl Oral Sci 2012; 13:280-5. [PMID: 20878031 DOI: 10.1590/s1678-77572005000300015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Accepted: 07/29/2005] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the efficacy of low-level laser therapy (LLLT) and the microelectric neurostimulation (MENS) in the treatment of patients with temporomandibular disorders (TMD). MATERIAL AND METHODS A sample of 19 individuals presenting with signs and symptoms of myogenic TMD was randomly divided into two groups (I - LLLT and II - MENS). Therapy was done in 10 sessions, three times a week, for one month. Patients were evaluated by the Visual Analogue Scale (VAS), measurement of active range of motion (AROM) and muscle palpation, performed immediately before and 5 minutes after each therapeutic session by a blinded TMD specialist. The ANOVA for repeated measurements and Mann-Whitney tests were used for the statistical analysis. RESULTS The results showed an increase in maximum mouth opening and a decrease in tenderness to palpation for both groups. The VAS reduced for both groups, although more evident for the laser group (p<0.05). CONCLUSION Authors concluded that both therapies were effective as part of the TMD treatment, and the cumulative effect may have been responsible for this fact. However, caution is recommended when judging the results due to the self-limiting aspect of musculoskeletal conditions such as TMD.
Collapse
|
8
|
Huang YF, Lin JC, Yang HW, Lee YH, Yu CH. Clinical effectiveness of laser acupuncture in the treatment of temporomandibular joint disorder. J Formos Med Assoc 2012; 113:535-9. [PMID: 25037758 DOI: 10.1016/j.jfma.2012.07.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 07/12/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND/PURPOSE Temporomandibular joint disorder (TMD) is a general term for diseases of the temporomandibular joint and orofacial muscles. In this study, we tested whether laser acupuncture was effective for the treatment of TMD. METHODS Twenty patients with TMD were treated with diode K-Laser (wavelength 800 nm, energy density 100.5 J/cm(2)) once a week at four acupuncture points including three standard ipsilateral local points (ST6, ST7, Ashi point) and one contralateral distal point (LI4). A 10-cm visual analogue scale (0 no pain and 10 the most severe pain) was used for measuring the pain intensity before and after the treatment. RESULTS Seventeen out of 20 patients (85%) showed various degrees of pain relief after laser acupuncture treatment. The average pain score was 6.3 ± 1.6 before treatment and 2.5 ± 2.2 after treatment. Significant pain relief after laser acupuncture treatment was achieved (p = 0.0003, Wilcoxon signed rank test). The 17 patients showed an average pain relief of 63 ± 31%. There were six patients who showed no TMD symptoms after an average of four treatments of laser acupuncture. The other 11 patients showed partial relief of TMD symptoms after treatment. Although the pain was still present, it was less and was acceptable. No side effects were reported in any patients during or after laser acupuncture treatments. CONCLUSION Laser acupuncture may be an alternative treatment modality for TMD because it is non-invasive, results in partial or total relief of pain, and has no side effects.
Collapse
Affiliation(s)
- Yu-Feng Huang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jung-Chih Lin
- Department of Integrated Chinese and Western Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hui-Wen Yang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsien Lee
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chuan-Hang Yu
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
9
|
Dostalová T, Hlinakova P, Kasparova M, Rehacek A, Vavrickova L, Navrátil L. Effectiveness of physiotherapy and GaAlAs laser in the management of temporomandibular joint disorders. Photomed Laser Surg 2012; 30:275-80. [PMID: 22551049 DOI: 10.1089/pho.2011.3171] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Low-level laser therapy (LLLT) is a treatment method commonly used in physiotherapy for musculoskeletal disorders. The aim of this study was to monitor the function of temporomandibular joint (TMJ) and surrounding tissues and compare the objective measurements of the effect of LLLT. BACKGROUND DATA LLLT has been considered effective in reducing pain and muscular tension; thus improving the quality of patients' lives. MATERIALS AND METHODS TMJ function was evaluated by cephalometric tracing analysis, orthopantomogram, TMJ tomogram, and computer face-bow record. Interalveolar space between central incisors before and after therapy was measured. Patients evaluated pain on the Visual Analog Scale. LLLT was performed in five treatment sessions (energy density of 15.4 J/cm(2)) by semiconductive GaAlAs laser with an output of 280 mW, emitting radiation wavelength of 830 mm. The laser supplied a spot of ~0.2 cm(2). RESULTS Baseline comparisons between the healthy patients and patients with low-level laser application show that TMJ pain during function is based on anatomical and function changes in TMJ areas. Significant differences were seen in the posterior and anterior face height. The results comparing healthy and impaired TMJ sagittal condyle paths showed that patients with TMJ pain during function had significantly flatter nonanatomical movement during function. After therapy, the unpleasant feeling was reduced from 27.5 to 4.16 on the pain Visual Analog Scale. The pain had reduced the ability to open the mouth from 34 to 42 mm. CONCLUSIONS The laser therapy was effective in the improvement of the range of temporomandibular disorders (TMD) and promoted a significant reduction of pain symptoms.
Collapse
Affiliation(s)
- Tatjana Dostalová
- Department of Paediatric Stomatology, 2nd Medical Faculty, Charles University, Prague, Czech Republic.
| | | | | | | | | | | |
Collapse
|
10
|
Kato MT, Kogawa EM, Santos CN, Conti PCR. TENS and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci 2009; 14:130-5. [PMID: 19089044 PMCID: PMC4327455 DOI: 10.1590/s1678-77572006000200012] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pain relief and reestablishment of normal jaw function are the main goals of conservative management of Temporomandibular Disorders (TMD). Transcutaneous electrical nerve stimulation (TENS) and laser therapy are part of these modalities, although little is known about their real efficacy in controlled studies. This research compared these two treatments in a sample of 18 patients with chronic TMD of muscular origin, divided into two groups (LASER and TENS). Treatment consisted of ten sessions, in a period of 30 days. Active range of motion (AROM), visual analogue scale (VAS) of pain and muscle (masseter and anterior temporalis) palpation were used for follow-up analysis. Data were analyzed by Friedman test and ANOVA for repeated measurements. Results showed decrease in pain and increase in AROM for both groups (p<0.05), and improvement in muscle tenderness for the LASER group. Authors concluded that both therapies are effective as part of TMD management and a cumulative effect may be responsible for the improvement. Caution is suggested when analyzing these results because of the self-limiting feature of musculoskeletal conditions like TMD.
Collapse
Affiliation(s)
- Melissa Thiemi Kato
- Public Health Department, Bauru Dental School - University of São Paulo, Bauru - SP, Brasil
| | | | | | | |
Collapse
|
11
|
Shirani AM, Gutknecht N, Taghizadeh M, Mir M. Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci 2008; 24:715-20. [PMID: 19002646 DOI: 10.1007/s10103-008-0624-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2008] [Accepted: 09/30/2008] [Indexed: 11/30/2022]
Abstract
Myofacial pain dysfunction syndrome (MPDS) is the most common reason for pain and limited function of the masticatory system. The effects of low-level lasers (LLLs) for controlling the discomfort of patients are investigated frequently. However, the aim of this study was to evaluate the efficacy of a particular source producing 660 nm and 890 nm wavelengths that was recommended to reduce of the pain in the masticatory muscles. This was a double-blind and placebo-controlled trial. Sixteen MPDS patients were randomly divided into two groups. For the laser group, two diode laser probes (660 nm (nanometers), 6.2 J/cm(2), 6 min, continuous wave, and 890 nm, 1 J/cm(2) (joules per square centimetre), 10 min, 1,500 Hz (Hertz)) were used on the painful muscles. For the control group, the treatment was similar, but the patients were not irradiated. Treatment was given twice a week for 3 weeks. The amount of patient pain was recorded at four time periods (before and immediately after treatment, 1 week after, and on the day of complete pain relief). A visual analog scale (VAS) was selected as the method of pain measurement. Repeated-measures analysis of variance (ANOVA), the t-test and the paired t-test were used to analyze the data. In each group the reduction of pain before and after the treatment was meaningful, but, between the two groups, low-level laser therapy (LLLT) was more effective (P = 0.031) According to this study, this type of LLLT was the effective treatment for pain reduction in MPDS patients.
Collapse
Affiliation(s)
- Amir Mansour Shirani
- Department of Oral Medicine, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | | | | |
Collapse
|
12
|
da Cunha LA, Firoozmand LM, da Silva AP, Camargo SEA, Esteves SA, Oliveira W. Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J 2008; 58:213-7. [PMID: 18783114 DOI: 10.1111/j.1875-595x.2008.tb00351.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS To evaluate the effectiveness of low-level laser therapy (LLLT) in patients presenting with temporomandibular disorder (TMD) in a random and placebo-controlled research design. METHODS The sample consisted of 40 patients, divided into an experimental group (G1) and a placebo group (G2). The treatment was done with an infrared laser (830nm, 500mW, 20s, 4J/point) at the painful points, once a week for four consecutive weeks. The patients were evaluated before and after the treatment through a Visual Analogue Scale (VAS) and the Craniomandibular Index (CMI). RESULTS The baseline and posttherapy values of VAS and CMI were compared by the paired T-test, separately for the placebo and laser groups. A significant difference was observed between initial and final values (p < 0.05) in both groups. Baseline and post-therapy values of pain and CMI were compared in the therapy groups by the two-sample T-test, yet no significant differences were observed regarding VAS and CMI (p > 0.05). CONCLUSION After either placebo or laser therapy, pain and temporomandibular symptoms were significantly lower, although there was no significant difference between groups. The low-level laser therapy was not effective in the treatment of TMD, when compared to the placebo.
Collapse
|
13
|
Fikácková H, Dostálová T, Navrátil L, Klaschka J. Effectiveness of Low-Level Laser Therapy in Temporomandibular Joint Disorders: A Placebo-Controlled Study. Photomed Laser Surg 2007; 25:297-303. [PMID: 17803388 DOI: 10.1089/pho.2007.2053] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Low-level laser therapy (LLLT) treatment for pain caused by temporomandibular joint disorders (TMD) was investigated in a controlled study comparing applied energy density, subgroups of TMD, and duration of disorders. BACKGROUND DATA Although LLLT is a physical therapy used in the treatment of musculoskeletal disorders, there is little evidence for its effectiveness in the treatment of TMD. METHODS The study group of 61 patients was treated with 10 J/cm(2) or 15 J/cm(2), and the control group of 19 patients was treated with 0.1 J/cm(2). LLLT was performed by a GaAlAs diode laser with output of 400 mW emitting radiation wavelength of 830 nm in 10 sessions. The probe with aperture 0.2 cm(2) was placed over the painful muscle spots in the patients with myofascial pain. In patients with TMD arthralgia the probe was placed behind, in front of, and above the mandibular condyle, and into the meatus acusticus externus. Changes in pain were evaluated by self-administered questionnaire. RESULTS Application of 10 J/cm(2) or 15 J/cm(2) was significantly more effective in reducing pain compared to placebo, but there were no significant differences between the energy densities used in the study group and between patients with myofascial pain and temporomandibular joint arthralgia. Results were marked in those with chronic pain. CONCLUSION The results suggest that LLLT (application of 10 J/cm(2) and 15 J/cm(2)) can be considered as a useful method for the treatment of TMD-related pain, especially long lasting pain.
Collapse
Affiliation(s)
- H Fikácková
- Institute of Biophysics and Informatics, 1st Medical Faculty, Charles University, Prague, Czech Republic
| | | | | | | |
Collapse
|
14
|
Cetiner S, Kahraman SA, Yücetaş S. Evaluation of Low-Level Laser Therapy in the Treatment of Temporomandibular Disorders. Photomed Laser Surg 2006; 24:637-41. [PMID: 17069496 DOI: 10.1089/pho.2006.24.637] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the effectiveness of low-level laser therapy (LLLT) in the treatment of myogenic originated temporomandibular disorders (TMD). BACKGROUND DATA Limited studies have demonstrated that LLLT may have a therapeutic effect on the treatment of TMD. METHODS Thirty-nine patients with myogenic TMD-associated orofacial pain, limited mandibular movements, chewing difficulties, and tender points were included in this study. Twenty-four of them were treated with LLLT for 10 sessions per day excluding weekends as test group, and 15 patients with the same protocol received placebo laser treatment as a control group. These parameters were assessed just before, just after, and 1 month after the treatment. RESULTS Maximal mouth-opening improvement, and reductions in pain and chewing difficulty were statistically significant in the test group when compared with the control group. Statistically significant improvements were also detected between two groups regarding reduction in the number of tender points. CONCLUSION Based on the results of this placebo-controlled report, LLLT is an appropriate treatment for TMD and should be considered as an alternative to other methods.
Collapse
Affiliation(s)
- Sedat Cetiner
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Gazi University, Ankara, Turkey.
| | | | | |
Collapse
|
15
|
Ferreira DM, Zângaro RA, Villaverde AB, Cury Y, Frigo L, Picolo G, Piccolo G, Longo I, Barbosa DG. Analgesic Effect of He-Ne (632.8 nm) Low-Level Laser Therapy on Acute Inflammatory Pain. Photomed Laser Surg 2005; 23:177-81. [PMID: 15910182 DOI: 10.1089/pho.2005.23.177] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the analgesic effect of the low level laser therapy (LLLT) with a He-Ne laser on acute inflammatory pain, verifying the contribution of the peripheral opioid receptors and the action of LLLT on the hyperalgesia produced by the release of hyperalgesic mediators of inflammation. BACKGROUND DATA All analgesic drugs have undesired effects. Because of that, other therapies are being investigated for treatment of the inflammatory pain. Among those, LLLT seems to be very promising. MATERIAL AND METHODS Male Wistar rats were used. Three complementary experiments were done. (1) The inflammatory reaction was induced by the injection of carrageenin into one of the hind paws. Pain threshold and volume increase of the edema were measured by a pressure gauge and plethysmography, respectively. (2) The involvement of peripheral opioid receptors on the analgesic effect of the laser was evaluated by simultaneous injection of carrageenin and naloxone into one hind paw. (3) Hyperalgesia was induced by injecting PGE2 for the study of the effect of the laser on the sensitization increase of nociceptors. A He-Ne laser (632.8 nm) of 2.5 J/cm2 was used for irradiation. RESULTS We found that He-Ne stimulation increased the pain threshold by a factor between 68% and 95% depending on the injected drug. We also observed a 54% reduction on the volume increase of the edema when it was irradiated. CONCLUSION He-Ne LLLT inhibits the sensitization increase of nociceptors on the inflammatory process. The analgesic effect seems to involve hyperalgesic mediators instead of peripheral opioid receptors.
Collapse
Affiliation(s)
- D M Ferreira
- Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, SP, Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Makihara E, Makihara M, Masumi SI, Sakamoto E. Evaluation of Facial Thermographic Changes Before and After Low-Level Laser Irradiation. Photomed Laser Surg 2005; 23:191-5. [PMID: 15910185 DOI: 10.1089/pho.2005.23.191] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the facial thermographic changes before and after low-level laser irradiation applied to the temporomandibular joint in normal subjects. BACKGROUND DATA Although this therapy has been reported to be effective in the pain management of patients with rheumatoid arthritis and degenerative joint disease, several researchers have stated that this therapy has no effect on pain of myogeneous origin. MATERIALS AND METHODS Nine healthy subjects underwent irradiation using the continuous wave setting of a CO2 laser with a power output of 1.0 W. The laser tip was positioned 10 cm above the skin over the right TMJ area for 10 min. The actual fluence on the facial surface was 7.64 J/cm2. Variation of the facial temperature was evaluated by using thermography. RESULTS The facial temperature 10 min after stopping irradiation was higher than that after 10 min of irradiation applied to the opposite side. The warmer area was found not only over the TMJ area but also over the temporal area, forehead area, and eyelid area on both sides. CONCLUSION These results suggested that low-level laser irradiation had a long-lasting effect on facial cutaneous tissues.
Collapse
Affiliation(s)
- Eri Makihara
- Division of Occlusion and Maxillofacial Reconstruction, Kyushu Dental College, Kitakyushu, Japan
| | | | | | | |
Collapse
|
17
|
Nes AG, Posso MBS. Patients with moderate chemotherapy-induced mucositis: pain therapy using low intensity lasers. Int Nurs Rev 2005; 52:68-72. [PMID: 15725279 DOI: 10.1111/j.1466-7657.2004.00401.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intensive cancer therapy normally affects malignant and normal cells with high replication rates. Cells in the gastrointestinal tract are therefore commonly affected by cytotoxins. This often results in the development of chemotherapy-induced oral mucositis (COM). COM is the inflammatory response of the oral mucous membrane to the chemotherapy drugs. Low level laser therapy (LLLT) has proved to be effective in treating and repairing biologically damaged tissue and to reduce pain. LLLT has also proven to be an efficient method for the prevention of oral mucositis. OBJECTIVE To investigate the effect of LLLT on pain relief among patients who have developed COM. METHOD The study was performed as a clinical test with a sample consisting of 13 adult patients receiving oncology treatment. The patients were treated during a 5-day period, and the pain was measured before and after each laser application. The laser used was an AsGaAl, with a wavelength of 830 nm and a potency of 250 mW. The energy given was 35 J cm(-2). ANALYSIS The results were analysed using the Wilcoxon test. RESULTS There was a significant (P = 0.007) 67% decrease in the daily average experience of pain felt before and after each treatment, confirming that LLLT can relieve pain among patients who have developed COM. STUDY LIMITATIONS The low number of COM patients at the hospital did not allow a control group to be included in the study, and therefore the results contain a potential placebo effect. IMPLICATIONS FOR NURSING CARE: The most important benefit the authors consider to be the value for the patients of better and quicker treatment with a drastic reduction in painful mucositis.
Collapse
Affiliation(s)
- A G Nes
- Buskerud University, Drammen, Norway.
| | | |
Collapse
|
18
|
Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol 2003; 32:114-8. [PMID: 12737331 DOI: 10.1080/03009740310000139] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the effectiveness of low-level laser therapy in the treatment of temporomandibular disorder and to compare treatment effects in myogenic and arthrogenic cases. METHODS Thirty-five patients were evaluated by magnetic resonance imaging and randomly allocated to active treatment (n=20) and placebo treatment (n= 15) groups. In addition to a daily exercise program, all patients were treated with fifteen sessions of low-level laser therapy. Pain, joint motion, number of joint sounds and tender points were assessed. RESULTS Significant reduction in pain was observed in both active and placebo treatment groups. Active and passive maximum mouth opening, lateral motion, number of tender points were significantly improved only in the active treatment group. Treatment effects in myogenic and arthrogenic cases were similar. CONCLUSION Low-level laser therapy can be considered as an alternative physical modality in the management of temporomandibular disorder.
Collapse
Affiliation(s)
- Sevinc Kulekcioglu
- Department of Physical Medicine and Rehabilitation, Uludag University School of Medicine, Bursa, Turkey
| | | | | | | |
Collapse
|
19
|
Pogrel MA, Chen JW, Zhang K. Effects of low-energy gallium-aluminum-arsenide laser irradiation on cultured fibroblasts and keratinocytes. Lasers Surg Med Suppl 2000; 20:426-32. [PMID: 9142682 DOI: 10.1002/(sici)1096-9101(1997)20:4<426::aid-lsm8>3.0.co;2-s] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE To assess whether the gallium-aluminum-arsenide low energy laser will increase cell proliferation, cell attachment, or cell migration in cultured fibroblasts and keratinocyte models. STUDY DESIGN/MATERIALS AND METHODS Monolayer cultures of fibroblasts and keratinocytes were subjected to gallium-aluminum-arsenide laser irradiation at varying power densities for varying time intervals. Cell proliferation was assessed by absorbent spectrophotometry while cell adhesion was assessed by a microcolorimetric assay for cells attached to bovine dermis collagen. Cell migration was assessed through a filter utilizing high power microscopic fields. RESULTS There were no differences in cell proliferation, adhesion, or migration in either the fibroblasts or keratinocyte culture treated with the gallium-aluminum-arsenide laser at any power density or time compared with nontreated controls. CONCLUSION The gallium-aluminum-arsenide laser, when utilized at powers 5-100 milliwatts and times of between 10-120 seconds has no biostimulatory effects on fibroblasts or keratinocyte cultures as assessed by cell proliferation, adhesion, or migration.
Collapse
Affiliation(s)
- M A Pogrel
- Department of Oral Surgery, School of Dentistry, University of California, San Francisco 94143-0440, USA
| | | | | |
Collapse
|
20
|
Fukuuchi A, Suzuki H, Inoue K. A DOUBLE-BLIND TRIAL OF LOW REACTIVE-LEVEL LASER THERAPY IN THE TREATMENT OF CHRONIC PAIN. Laser Ther 1998. [DOI: 10.5978/islsm.10.59] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
21
|
Takahashi T, Fukuda M, Ohnuki T, Ohtani M, Homma H, Calderhead RG. Nd:YAG LLLT IN THE TREATMENT OF TEMPOROMANDIBULAR DISORDERS: A TREATMENT PROTOCOL AND PRELIMINARY REPORT. Laser Ther 1998. [DOI: 10.5978/islsm.10.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
22
|
Conti PC. Low level laser therapy in the treatment of temporomandibular disorders (TMD): a double-blind pilot study. Cranio 1997; 15:144-9. [PMID: 9586517 DOI: 10.1080/08869634.1997.11746005] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this paper was to evaluate the efficacy of a Low-Level Laser therapy in patients with Temporomandibular Disorders (TMD) using a double-blind design. A sample of 20 patients with a chief complaint of pain was divided into myogenous and arthrogenous groups. The sample was also divided on the basis of the treatment rendered: real versus placebo treatment. An 830 nm Ga-Al-As Laser device with a energy power of 4 joules was used (OMNILASE, LASERDYNE PTY LTD.) in three treatment sessions. To evaluate the effectiveness of laser treatment, a Visual Analogue Scale (VAS) was used for pain and active range of motion (AROM) was used to measure changes in mandibular function. Using real laser treatment, the author found that there was a reported improvement in pain only for the myogenous pain patients (p < or = 0.02). For the arthrogenous pain patients, real laser treatment resulted in an improvement in Total Vertical Opening (TVO) (p < 0.05), Protrusive excursion (PROT) (p < 0.02) and Left lateral excursion (LATLEF) (p < 0.02). The placebo control group showed improvement in TVO and PROT for those patients having myogenous pain and LATLEF for those patients having arthrogenous pain. A repeated measurement one-way ANOVA demonstrated no significant differences between real and placebo groups. Considering the non-invasive and harmless characteristics of this modality, more research is recommended, using higher power and increased frequency of laser applications.
Collapse
Affiliation(s)
- P C Conti
- Bauru School of Dentistry, University of Sao Paulo, Brazil
| |
Collapse
|
23
|
McNamara DC, Rosenberg I, Jackson PA, Hogben J. Efficacy of arthroscopic surgery and midlaser treatments for chronic temporomandibular joint articular disc derangement following motor vehicle accident. Aust Dent J 1996; 41:377-87. [PMID: 9008994 DOI: 10.1111/j.1834-7819.1996.tb06023.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
As a result of motor vehicle accident soft-tissue injury, temporomandibular joint articular disc derangement may develop and persist despite symptomatic treatment and medication. This study reports the effectiveness of management directed at controlling the TMJ and masticatory neuromuscular pain dysfunction with a TMJ/interocclusal stabilization appliance, specific biofeedback and ultrasound therapy. Following these conservative measures residual articular disc derangement was present in some subjects who were offered arthroscopic surgery and infrared midlaser with TMJ/occlusal stabilization. Twenty subjects with residual disc derangement were randomly selected into two groups with and without arthroscopic surgery, and analyses of variance made before treatment, 12 months after conservative procedures, 3 months following arthroscopic surgery and midlaser therapy and 3 years since commencement of management. Dependent variables compared were pain-discomfort, Clinical Dysfunction Index, articular disc derangement and maximal voluntary jaw opening. Conservative management alone provided significant reduction of pain-discomfort and clinical dysfunction, while arthroscopic surgery resulted in significant reduction in articular disc derangement. The midlaser with TMJ/occlusal stabilization maintained significant improvement in the variables (p < 0.01) for both groups. The common articular deviations in form found at arthroscopy were soft tissue alteration with hyperaemia, synovitis, synovial membrane and posterior attachment folding with connective tissue hyperplasia, and disc displacement with fibrous adhesions. The Global Status Score of pain behaviour compared with residual function, confirmed the presence of greater pain before treatment commenced.
Collapse
Affiliation(s)
- D C McNamara
- Plastic Surgery and Maxillofacial Unit, Royal Perth Hospital
| | | | | | | |
Collapse
|
24
|
Skinner SM, Gage JP, Wilce PA, Shaw RM. A preliminary study of the effects of laser radiation on collagen metabolism in cell culture. Aust Dent J 1996; 41:188-92. [PMID: 8768644 DOI: 10.1111/j.1834-7819.1996.tb04854.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A low power Ga-As pulse laser was used to stimulate cultured human embryonic fibroblast cells. Energy fluencies varied from 0-1 J/cm2 over a period of 1-4 days. Fibroblast procollagen production was monitored by the synthesis of [3H] hydroxyproline, and DNA replication was assessed by [3H] thymidine incorporation. Following laser treatment, controlled pepsin digestion measured the increase in cell biostimulation. Maximum increase in collagen production and cell biostimulation occurred after 4 episodes of laser treatment at 24-hour intervals. Laser doses between 0.099 and 0.522 J/cm2 had the most significant stimulatory effects on fibroblast function. Clinical efficacy of the low power Ga-As pulse laser may be related to enhanced connective tissue repair.
Collapse
Affiliation(s)
- S M Skinner
- Department of Dentistry, Dental School, University of Queensland
| | | | | | | |
Collapse
|
25
|
Eckerdal A, Bastian L. CAN LOW REACTIVE-LEVEL LASER THERAPY BE USED IN THE TREATMENT OF NEUROGENIC FACIAL PAIN? A DOUBLE-BLIND, PLACEBO CONTROLLED INVESTIGATION OF PATIENTS WITH TRIGEMINAL NEURALGIA. Laser Ther 1996. [DOI: 10.5978/islsm.8.247] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
26
|
Lim HM, Lew KK, Tay DK. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 1995; 108:614-22. [PMID: 7503039 DOI: 10.1016/s0889-5406(95)70007-2] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Low level laser therapy (LLLT) has been shown to produce analgesic effects in many clinical applications. The aim of this clinical study was to test the efficacy of LLLT in controlling orthodontic postadjustment pain. Thirty-nine volunteers were selected for this study that used a double-blind design with placebo control. Elastomeric separators were placed at the proximal contacts of one premolar in each quadrant of the dentition to induce orthodontic pain. The tip of a 30 mW gallium-arsenide-aluminium (830 nm) diode laser probe was then placed at the buccal gingiva and directed at the middle third of the root. Three different treatment durations of 15, 30, and 60 seconds and one placebo treatment of 30 seconds were tested within each subject. The study was conducted over 5 days, and the visual analogue scale (VAS) was used to quantify the pain experienced by the subjects before and after laser applications for each day. Analysis of the VAS median scores showed that teeth exposed to laser treatment had lower levels of pain as compared with those with the placebo treatment. However, nonparametric statistical analysis of the data showed that the differences between treatments and placebo within each subject were not statistically significant.
Collapse
Affiliation(s)
- H M Lim
- Faculty of Dentistry, National University of Singapore
| | | | | |
Collapse
|
27
|
Bertolucci LE, Grey T. Clinical comparative study of microcurrent electrical stimulation to mid-laser and placebo treatment in degenerative joint disease of the temporomandibular joint. Cranio 1995; 13:116-20. [PMID: 8697497 DOI: 10.1080/08869634.1995.11678054] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Mid-laser and microcurrent stimulation (MENS) have been found to be effective in the reduction of painful temporomandibular joints (TMJ) with internal derangement. There was significant improvement in mobility with the reduction of pain. Mid-laser was superior to MENS in its application and effect, and both were significantly better than the placebo treatment.
Collapse
Affiliation(s)
- L E Bertolucci
- Bertolucci Physical Therapy, Citrus Heights, California 95621, USA
| | | |
Collapse
|
28
|
Bertolucci LE, Grey T. Clinical analysis of mid-laser versus placebo treatment of arthralgic TMJ degenerative joints. Cranio 1995; 13:26-9. [PMID: 7585998 DOI: 10.1080/08869634.1995.11678038] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Laser therapy has been found effective in the management of pain associated with rheumatoid and degenerative joint arthritis and disease. The efficacy of mid-laser therapy has been tested specifically on patients with degenerative joint disease (DJD) involving the temporomandibular joint (TMJ). The following controlled clinical study was designed to test the efficacy of mid-laser therapy to placebo therapy in the reduction of pain associated with TMJ disorders specific to arthralgic DJD.
Collapse
|
29
|
Pogrel M. The Role of Lasers in Pediatric Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am 1994. [DOI: 10.1016/s1042-3699(20)30741-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
30
|
Abstract
Articles from the English literature concerning lasers and articular cartilage were reviewed. Different experimental methods and laser systems were analyzed. Many studies lacked scientific validity. Future investigations with sound biologic foundations are recommended.
Collapse
Affiliation(s)
- C T Vangsness
- University of Southern California School of Medicine, Department of Orthopedics, Los Angeles
| | | |
Collapse
|
31
|
Abstract
This article offers a revised physical therapy treatment approach for rehabilitating a temporomandibular joint (TMJ) following arthroplastic surgical intervention. Surgical repair is only advised in those chronic cases where refractory symptoms affect the quality of the patient's life and prevent patients from carrying out their normal daily activities. Previous nonsurgical and surgical management usually fails to correct the problem in these types of cases. Rehabilitation guidelines discussed include plication, diskectomy (with or without interpositional implant), costochondral graft, fossa implant, and total joint replacement.
Collapse
|
32
|
Phillips RW, Jendresen MD, Klooster J, McNeil C, Preston JD, Schallhorn RG. Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 1990; 64:74-110. [PMID: 2200881 DOI: 10.1016/0022-3913(90)90155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The growth in the dental literature continues to escalate, as evidenced by the publication of at least 326 new books in 1988 and 1989 and more than 20 new journals in 1989. There still appears to be undue emphasis on quantity instead of quality of research. This proliferation in the literature poses ever increasing difficulties to this Committee in filtering out the articles that are of particular interest to the members of the Academy and identifying those that are most likely to have a major impact on dental practice and service. The subjects covered include periodontics, caries and preventive dentistry, craniomandibular disorders, occlusion, pulp biology, ceramics, and restorative dental materials.
Collapse
|
33
|
Clark GT, Adachi NY, Dornan MR. Physical medicine procedures affect temporomandibular disorders: a review. J Am Dent Assoc 1990; 121:151-62. [PMID: 2196298 DOI: 10.14219/jada.archive.1990.0140] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This article reviews the literature on the effectiveness of physical medicine procedures for treatment of temporomandibular disorders (TMD). Brief descriptions of some commonly used dental appliances, and pharmacological and surgical treatment methods are provided.
Collapse
Affiliation(s)
- G T Clark
- Dental Research Institute, UCLA School of Dentistry 90024
| | | | | |
Collapse
|