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Abufoul R, Gavish L, Haddad M. Photobiomodulation self-treatment at home after rotator cuff arthroscopic repair accelerates improvement in pain, functionality, and quality of life: A double-blind, sham-controlled, randomized clinical trial. Lasers Surg Med 2023; 55:662-673. [PMID: 37288499 DOI: 10.1002/lsm.23692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To determine whether self-applied photobiomodulation (PBM) therapy at home, following rotator cuff arthroscopic surgery (RCAS) can accelerate improvement in patient-reported outcomes within the first 6 months postsurgery. METHODS This study was a prospective, double-blind, sham-controlled, randomized clinical trial (NCT04593342). Patients (n = 50, age 55 ± 7 years, male:female 29:21) who underwent primary RCAS were randomized to receive active (n = 22) or sham (n = 28) PBM devices (B-Cure Laser Pro, Erica B-Cure LASER Ltd., Haifa, Israel) in addition to standard care. Patients self-applied the treatments (808 nm, 15 min, 16.5 J/cm2 ) at home for 3 months postsurgery. Evaluations were conducted before the surgery (baseline) and at 1-3 and 6 months post-RCAS (FU-1M, FU-3M, FU-6M), and included Constant-Murley score (CMS), range of motion (ROM), subjective pain by visual analogue scale (VAS), disability by QuickDASH, and quality of life (QOL) by SF-12. The difference from baseline to follow-up (ΔFU), %patients achieving minimal clinical important difference (MCID), and patient acceptable symptom score (PASS) were calculated. Comparisons were conducted with superiority 2-sample t test and χ2 . RESULTS Baseline values were not significantly different between groups. Both groups had similar improvements in CMS and ROM. However, compared to Sham, PBM significantly accelerated subjective pain reduction at 3 and 6 months (VAS mean ± SD, PBM-vs-Sham: ΔFU-3M 32 ± 33 vs. 16 ± 27, p = 0.040; ΔFU-6M: 41 ± 36 vs. 23 ± 26, p = 0.038), with a significantly higher proportion of patients achieving MCID at 3 months (76% vs. 48%, p = 0.027) and PASS at 6 months (48% vs. 23%, p = 0.044). PBM also significantly accelerated improvement in functionality and QOL at 6 months (QuickDASH ΔFU-6M: 30 ± 24 vs. 18 ± 14, p = 0.029; SF-12 physical component 6.8 ± 12.5 vs. 0.4 ± 8.6, p = 0.031; SF-12 mental component 8.5 ± 9.1 vs. 2.2 ± 12, p = 0.032). CONCLUSIONS Self-applied photobiomodulation following RCAS significantly accelerates decrease in pain and disability, and improves QOL. This nonpharmacologic add-on therapeutic modality is easy to use and encourages active patient involvement. Its potential use in rehabilitation following other surgeries should be considered. LEVEL OF EVIDENCE Level I, high-quality RCT.
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Affiliation(s)
- Rabie Abufoul
- Orthopedic Department, The Holy Family Hospital, Nazareth, Israel
| | - Lilach Gavish
- Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, Jerusalem, Israel
- The Saul and Joyce Brandman Hub for Cardiovascular Research and the Department of Medical Neurobiology, Institute for Medical Research (IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Marwan Haddad
- Orthopedic Department, The Holy Family Hospital, Nazareth, Israel
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Kim H, Shim JW, Shin WC, Lee YJ, Ha IH, Kim KW, Cho JH. Korean Medicine Clinical Practice Guideline Update for Temporomandibular Disorders: An Evidence-Based Approach. Healthcare (Basel) 2023; 11:2364. [PMID: 37628561 PMCID: PMC10454242 DOI: 10.3390/healthcare11162364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Many updated clinical research results have been published since the Korean Medicine Clinical Practice Guidelines (KMCPGs) for temporomandibular disorders (TMDs) were published in 2018. Therefore, it is necessary to update the existing clinical practice guidelines (CPGs). This study presents updated recommendations for TMD treatment based on current research data published up to February 2020. The draft version of the level of evidence and grade of recommendation was determined through an assessment of the risk of bias and a meta-analysis of selected literature based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The final guidelines were derived using the Delphi method. Eighteen recommendations were derived for eight items of Korean medicine treatment for TMDs. Compared with previous Korean medicine CPGs for TMDs, the grades of seven recommendations, including acupuncture, pharmacopuncture, and Chuna manual therapy, were increased. The grades of the two recommendations have been changed. Six new recommendations were added to fully reflect clinical reality. Acupuncture, pharmacopuncture, and Chuna manual therapy are recommended for TMD patients in clinical practice. Concurrent conventional conservative therapy with Korean medicine or a combination of Korean medicines should be considered in clinical practice in patients with temporomandibular disorders.
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Affiliation(s)
- Hyungsuk Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae Woo Shim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Woo-Chul Shin
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea; (Y.J.L.); (I.-H.H.)
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.K.); (J.W.S.); (W.-C.S.); (K.-W.K.)
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Farshidfar N, Farzinnia G, Samiraninezhad N, Assar S, Firoozi P, Rezazadeh F, Hakimiha N. The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials. J Lasers Med Sci 2023; 14:e24. [PMID: 37744015 PMCID: PMC10517581 DOI: 10.34172/jlms.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/27/2023] [Indexed: 09/26/2023]
Abstract
Introduction: Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. Methods: A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. Results: A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. Conclusion: This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm2, and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.
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Affiliation(s)
- Nima Farshidfar
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnoush Farzinnia
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sahar Assar
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Parsa Firoozi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Rezazadeh
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Hakimiha
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang Y, Qian Y, Huo K, Liu J, Huang X, Bao J. Efficacy of laser therapy for temporomandibular disorders: A systematic review and meta-analysis. Complement Ther Med 2023; 74:102945. [PMID: 36997006 DOI: 10.1016/j.ctim.2023.102945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the efficacy of laser therapy in temporomandibular disorders (TMD). METHODS Randomized controlled trials (RCTs) in regard to this issue were searched in electronic databases. Three investigators independently screened the eligible studies, and the quality of the included studies was assessed according to the risk of bias tool recommended by the Cochrane handbook. The primary outcome measure was the degree of pain, reported on a visual analog scale (VAS), and the secondary outcome measures were TMJ function, including maximum active vertical opening (MAVO), maximum passive vertical opening (MPVO), left and right lateral movement (LLE, RLE). Pooled effect sizes were calculated using random effects models and 95% confidence interval (95% CI). RESULTS A total of 28 randomized controlled trials were included. Laser therapy had a more significant effect in terms of VAS (SMD=﹣1.88; 95% CI=﹣2.46 to﹣1.30; P<0.00001; I2 =93%), MAVO (MD = 4.90; 95% CI= 3.29 to 6.50; P < 0.00001; I2 =72%), MPVO (MD=5.82; 95% CI= 4.62 to 7.01; P<0.00001; I2 =40%) and RLE (MD = 0.73; 95% CI= 0.23 to 1.22; P = 0.004; I2 = 0%) as compared to placebo group. However, there was no significant difference in LLE between two groups (MD= 0.35; 95% CI=﹣0.31 to 1.01; P=0.30; I2 =0%). CONCLUSIONS Laser therapy can effectively reduce pain but have small effect on improving mandibular movement of TMD patients. More well-designed RCTs with large sample sizes are needed for further validation. And these studies should report detailed laser parameters and provide complete outcome measure data. PROSPERO CRD42022349719.
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Affiliation(s)
- Yan Zhang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Yingqiu Qian
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Kangxin Huo
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Jingxin Liu
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Xi Huang
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Jie Bao
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China; Children's Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Ningbo, China.
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Ren H, Liu J, Liu Y, Yu C, Bao G, Kang H. Comparative effectiveness of low-level laser therapy with different wavelengths and transcutaneous electric nerve stimulation in the treatment of pain caused by temporomandibular disorders: A systematic review and network meta-analysis. J Oral Rehabil 2021; 49:138-149. [PMID: 34289157 DOI: 10.1111/joor.13230] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/28/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To assess the efficacy of low-level laser therapy (LLLT) with different wavelengths and transcutaneous electric nerve stimulation (TENS) and explore the optimal wavelength range of laser application in the treatment of pain caused by temporomandibular disorders (TMD). METHODS An electronic search on PubMed, Cochrane Library, Embase, Scopus and Web of Science was undertaken to identify the randomised clinical trials (RCTs) published from database inception to 16 April 2021, aiming to compare the effects of LLLT with different wavelengths (632.8-672 nm, 780-904 nm, and 910-1100 nm) or TENS or placebo group on TMD patients pain reduction. In addition, manual search of the studies was performed. The reviewers assessed the risk of bias of individual studies with the Cochrane risk of bias tool and excluded the RCTs with a high risk of bias in any field. Meanwhile, the reviewers, after performing the network meta-analysis, assessed the quality of evidence, which contributed to network estimate via the GRADE framework. RESULTS Twenty-seven RCTs with 969 patients with TMD were included. In the meta-analysis, all treatment groups showed an overall improvement in pain scores, when compared with the placebo group. LLLT with wavelength ranging from 910 nm to 1100 nm produced more pain relief in the visual analogue scale (VAS) immediately after treatment [mean difference (MD) = 4.68, 95% confidence interval (CI):(3.08,6.28)]. After one-month follow-up, LLLT with wavelength ranging from 910 nm to 1100 nm also showed superior pain-relieving effects [MD = 3.61, 95% CI: (-1.77, 8.99)]. However, no significant difference was observed. Based on the SUCRA ranking, L3 ranked first immediately after treatment and 1 month later. CONCLUSION The results of the meta-analysis showed the LLLT had better short-term efficacy than TENS in the treatment of pain caused by TMD. Better results can be achieved with higher wavelengths. Therefore, we recommended to treat TMD using LLLT with wavelength ranging from 910 nm to 1100 nm.
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Affiliation(s)
- Hui Ren
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Jingying Liu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Yang Liu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Caiyun Yu
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Guangjie Bao
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, China
| | - Hong Kang
- Department of Temporomandibular joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
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Abstract
Temporomandibular joint disorders (TMDs) encompass a wide array of ailments affecting the temporomandibular joint (TMJ), muscles of mastication, and the allied structural framework. Myofascial pain, internal derangement of the joint, and degenerative joint diseases constitute the majority of TMDs. TMDs usually have a multifactorial etiology, and treatment modalities range from conservative therapies to surgical interventions. Low-level laser therapy (LLLT) has evolved as an efficient non-invasive therapeutic modality in TMDs. Previously conducted systematic reviews and meta-analyses have shown variable results regarding the efficiency of LLLT in TMJ disorder patients. Hence, this systematic review was carried out as an attempt to evaluate the efficacy of LLLT in the treatment of temporomandibular joint disorder patients.
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Affiliation(s)
- Syed Ansar Ahmad
- Department of Oral Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shazina Saeed
- Laboratory of Disease Dynamics and Molecular Epidemiology, Amity Institute of Public Health, Amity university, Noida, Uttar Pradesh, India
| | - Ateeba Khan
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Munna Khan
- Department of Electrical Engineering, Jamia Millia Islamia, New Delhi, India
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Alves GÂDS, Gondim YRDR, Lima JASD, Silva MAPD, Florêncio DSF, Almeida LNAD, Silva HJD. Effects of photobiomodulation associated with orofacial myofactional therapy on temporomandibular joint dysfunction. Codas 2021; 33:e20200193. [PMID: 34105614 DOI: 10.1590/2317-1782/20202020193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/26/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate the influence of photobiomodulation associated with orofacial myofunctional therapy (OMT) in patients with temporomandibular muscle disorders (TMD). METHODS Randomized, blinded trial clinical study with a sample of eleven women with muscle TMD divided into two groups. The experimental group (EG) consisted of five women submitted to orofacial myofunctional therapy associated with photobiomodulation, and the control group (CG) consisted of six women submitted to orofacial myofunctional therapy associated with inactive photobiomodulation (placebo). The intervention was performed in the following twelve sessions: one evaluation, ten speech therapy sessions associated with photobiomodulation, and one reevaluation. For outcomes, investigation on pain perception using the visual analogue scale (VAS), investigation of palpation sensitivity with the research diagnostic criteria for temporomandibular disorders (RDC/TMD), and quality of life (QOL) verification through oral health impact profile - short form (OHIP-14) were considered. RESULTS The EG increased measurements of mandibular movements of opening and protrusion and improved in the evaluation of QOL. CONCLUSION Orofacial myofunctional therapy, when associated with photobiomodulation, contributed to increase the range of mandibular movements, with important improvements in the perception of quality of life and with significant improvement in the painful conditions of volunteers with TMD.
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Affiliation(s)
- Giorvan Ânderson Dos Santos Alves
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.,Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Yanne Rabelo da Rocha Gondim
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Jully Anne Soares de Lima
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Mayze Azevedo Pereira da Silva
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - David Sildes Fidelis Florêncio
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Larissa Nadjara Alves de Almeida
- Núcleo de Estudos em Linguagem e Funções Estomatognáticas - NELF, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Hilton Justino da Silva
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
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Haze A, Gavish L, Elishoov O, Shorka D, Tsohar T, Gellman YN, Liebergall M. Treatment of diabetic foot ulcers in a frail population with severe co-morbidities using at-home photobiomodulation laser therapy: a double-blind, randomized, sham-controlled pilot clinical study. Lasers Med Sci 2021; 37:919-928. [PMID: 34052927 DOI: 10.1007/s10103-021-03335-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of an at-home photobiomodulation (PBM) device for the treatment of diabetic foot ulcers (DFUs) in a frail population with severe comorbidities. METHODS Prospective, randomized, double-blind, sham-controlled pilot study. Patients (age = 63 ± 11 years, male:female 13:7) with insulin-dependent diabetes type 2, neuropathy, peripheral artery disease, significant co-morbidities, and large osteomyelitis-associated DFUs (University of Texas grade ≥ III) were randomized to receive active (n = 10) or sham (n = 10) at-home daily PBM treatments (pulsed near-infrared 808 nm Ga-Al-As laser, 250 mW, 8.8 J/cm2) for up to 12 weeks in addition to standard care. The primary outcome was the %wound size reduction. The secondary was adverse events. RESULTS With the numbers available, PBM-treated group had significantly greater %reduction compared to sham (area [cm2], baseline vs endpoint: PBM 10[20.3] cm2 vs 0.2[2.4] cm2; sham, 7.9 [12.0] cm2 vs 4.6 [13.8] cm2, p = 0.018 by Mann-Whitney U test). Wound closure > 90% occurred in 7 of 10 PBM-treated patients but in only 1 of 10 sham patients (p = 0.006). No adverse device effects were observed. CONCLUSIONS Photobiomodulation at home, in addition to standard care, may be effective for the treatment of severe DFUs in frail patients with co-morbidities and is particularly relevant at these times of social distancing. Our preliminary results justify the conduction of a larger clinical trial. ClinicalTrials.gov: NCT01493895.
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Affiliation(s)
- Amir Haze
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
| | - Lilach Gavish
- Institute for Research in Military Medicine (IRMM) of the Faculty of Medicine, The Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112001, Israel.
| | - Ofer Elishoov
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
| | - Dorit Shorka
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
| | - Tamir Tsohar
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
| | - Yechiel N Gellman
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
| | - Meir Liebergall
- Orthopedic Department, Hadassah-Hebrew University Medical Center, POB 12000, 9112001, Jerusalem, Israel
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Fornaini C, Merigo E, Huffer KW, Arany P. At-Home Photobiomodulation Treatments for Supportive Cancer Care During the COVID-19 Pandemic. Photobiomodul Photomed Laser Surg 2020; 39:81-82. [PMID: 32905736 DOI: 10.1089/photob.2020.4923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Carlo Fornaini
- UFR Odontologie, UPR Micoralis, University Côte d'Azur, Nice Cedex, France
| | - Elisabetta Merigo
- UFR Odontologie, UPR Micoralis, University Côte d'Azur, Nice Cedex, France
| | | | - Praveen Arany
- Department of Oral Biology & Biomedical Engineering, University of Buffalo, Buffalo, New York, USA
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Merigo E, Tan L, Zhao Z, Rocca JP, Fornaini C. Auto-Administered Photobiomodulation on Diabetic Leg Ulcers Treatment: A New Way to Manage It? Case Rep Med 2020; 2020:7428472. [PMID: 32518562 DOI: 10.1155/2020/7428472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/15/2020] [Accepted: 05/01/2020] [Indexed: 12/22/2022] Open
Abstract
Background Peripheral arterial disease is a dramatic consequence of an uncontrolled diabetic condition causing an increase of morbidity and mortality and its treatment is currently medical or surgical, finally requiring, in the 7–20% of cases, major or minor amputation. Photobiomodulation therapy (PBM) is a laser treatment used in medicine, thanks to its ability to stimulate the wound healing, the acceleration of inflammatory process, and the modulation of pain. Recently, the self-administration of the treatment has been suggested for different purposes in medicine and dentistry with a great number of advantages and no side effects. Methods A 84-year-old woman affected by diabetes type 2 and positive for diabetes complications had diagnosis for an ulcerative lesion of 1 cm diameter on her right leg and started a treatment of the lesion applying the B-Cure Laser Pro (Erika Carmel, Haifa, Israel) on her own with a fluence per minute of 3.2 J/cm2 for 2 sessions of 15 minutes by cutaneous application. Results After a week of treatment, the ulcer dried and crusted, finally providing complete healing after 30 days of treatment. Conclusion With this short case report, we think to add a further contribution by suggesting this kind of treatment for successful management of the leg ulcers in diabetic patients.
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Gavish L, Houreld NN. Therapeutic Efficacy of Home-Use Photobiomodulation Devices: A Systematic Literature Review. Photobiomodul Photomed Laser Surg 2020; 37:4-16. [PMID: 31050938 DOI: 10.1089/photob.2018.4512] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Perform systematic literature review on photobiomodulation (PBM) devices used at home for nonesthetic applications. Background: Home-use PBM devices have been marketed for cosmetic and therapeutic purposes. This is the first systematic literature review for nonesthetic applications. Methods: A systematic literature search was conducted for PBM devices self-applied at home at least thrice a week. Two independent reviewers screened the articles and extracted the data. Treatment dosage appropriateness was compared to the World Association for Laser Therapy (WALT) recommendations. The efficacy was evaluated according to the relevant primary end-point for the specific indication. Results: Eleven studies were suitable. Devices were applied for a range of indications, including pain, cognitive dysfunction, wound healing, diabetic macular edema, and postprocedural side effects, and were mostly based on near-infrared, pulsed light-emitting diodes with dosages within WALT recommendations. Regarding efficacy, studies reported mostly positive results. Conclusions: Home-use PBM devices appear to mediate effective, safe treatments in a variety of conditions that require frequent applications. Conclusive evaluation of their efficacy requires additional, randomized controlled studies.
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Affiliation(s)
- Lilach Gavish
- 1 Department of Medical Neurobiology, Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nicolette Nadene Houreld
- 2 Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Merigo E, Rocca JP, Pinheiro ALB, Fornaini C. Photobiomodulation Therapy in Oral Medicine: A Guide for the Practitioner with Focus on New Possible Protocols. Photobiomodul Photomed Laser Surg 2019; 37:669-680. [PMID: 31589560 DOI: 10.1089/photob.2019.4624] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Photobiomodulation (PBM) is the term to define the wide range of laser applications using low-energy densities and based on photochemical mechanisms where the energy is transferred to the intracellular mitochondrial chromophores and respiratory chain components. In literature, a great number of works are reported showing the advantages of PBM use in many oral diseases such as recurrent aphthous stomatitis, herpes infections, mucositis, and burning mouth syndrome. Different factors may explain the increasing reported use of PBM in oral medicine: the absence of side effects, the possibility of safely treating compromised patients such as oncologic patients, the possibility of a noninvasive approach not associated with pain or discomfort, and the possibility of performing short sessions. The review's aim is to describe the possible applications of PBM in oral medicine, giving practitioners simple guide for practice together with the information of a new treatment possibility "at home" performed by the patient himself under supervision.
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Affiliation(s)
- Elisabetta Merigo
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France.,Dentistry, Special Needs and Maxillo-Facial Surgery Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy
| | - Jean-Paul Rocca
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France
| | | | - Carlo Fornaini
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France.,Dentistry, Special Needs and Maxillo-Facial Surgery Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy.,GAEM, Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
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Abstract
OBJECTIVE Perform systematic literature review on photobiomodulation (PBM) devices used at home for nonesthetic applications. BACKGROUND Home-use PBM devices have been marketed for cosmetic and therapeutic purposes. This is the first systematic literature review for nonesthetic applications. METHODS A systematic literature search was conducted for PBM devices self-applied at home at least thrice a week. Two independent reviewers screened the articles and extracted the data. Treatment dosage appropriateness was compared to the World Association for Laser Therapy (WALT) recommendations. The efficacy was evaluated according to the relevant primary end-point for the specific indication. RESULTS Eleven studies were suitable. Devices were applied for a range of indications, including pain, cognitive dysfunction, wound healing, diabetic macular edema, and postprocedural side effects, and were mostly based on near-infrared, pulsed light-emitting diodes with dosages within WALT recommendations. Regarding efficacy, studies reported mostly positive results. CONCLUSIONS Home-use PBM devices appear to mediate effective, safe treatments in a variety of conditions that require frequent applications. Conclusive evaluation of their efficacy requires additional, randomized controlled studies.
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Affiliation(s)
- Lilach Gavish
- 1 Department of Medical Neurobiology, Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem , Jerusalem, Israel
| | - Nicolette Nadene Houreld
- 2 Laser Research Centre, Faculty of Health Sciences, University of Johannesburg , Johannesburg, South Africa
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Nandhini J, Ramasamy S, Ramya K, Kaul RN, Felix AJW, Austin RD. Is nonsurgical management effective in temporomandibular joint disorders? - A systematic review and meta-analysis. Dent Res J (Isfahan) 2018; 15:231-241. [PMID: 30123299 PMCID: PMC6073942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Various nonsurgical interventions have been used for the management of patients with temporomandibular joint (TMJ) disorders, but their clinical effectiveness remains unclear. Hence, the purpose of this systematic review and meta-analyses was to assess the evidence of the effectiveness of nonsurgical interventions in the management of TMJ disorders. MATERIALS AND METHODS A literature search on five databases such as PubMed, PubMed Central Cochrane, TRIP, NGCH databases and hand searching was conducted for a period from October 1995 to 2015. Randomized control trials (RCTs) on the nonsurgical management of TMJ disorders were included and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the articles was assessed by JADAD scoring. Finally, out of 23 RCTs, 11 articles having any of the primary outcomes (pain pressure threshold [PPT], pain, maximal pain-free mouth opening, and level of dysfunction) were selected. The extracted data were analyzed using NCSS software. RESULTS The results showed the evidence of pain reduction (P = 0.00), maximal pain-free mouth opening (P = 0.0138), and decrease in level of dysfunction (P = 0.0007) but no improvement in PPT to a significant level (P = 0.6600). CONCLUSION Our results suggest that the simplest, cost-effective nonsurgical treatments have a positive therapeutic effect on the initial management of TMJ disorders. However, a consistent methodology recording both the objective and subjective outcomes would be a better choice for added reliability.
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Affiliation(s)
- J. Nandhini
- Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, India
| | - S. Ramasamy
- Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, India
| | - K. Ramya
- Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, India
| | - Ronak Nazir Kaul
- Department of Oral and Maxillofacial Surgery, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - A. John William Felix
- Department of Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, India
| | - Ravi David Austin
- Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, India
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Xu GZ, Jia J, Jin L, Li JH, Wang ZY, Cao DY. Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis. Pain Res Manag 2018; 2018:4230583. [PMID: 29861802 DOI: 10.1155/2018/4230583] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/03/2018] [Indexed: 12/25/2022]
Abstract
Objectives We systematically reviewed randomized controlled trials (RCTs) of the effect of low-level laser therapy (LLLT) versus placebo in patients with temporomandibular disorder (TMD). Methods A systematic search of multiple online sources electronic databases was undertaken. The methodological quality of each included study was assessed using the modified Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results A total of 31 RCTs were included. Total modified Jadad scale scores showed that the methodological quality was high in 30 studies and low in 1 study. Combining data from all clinically heterogeneous studies revealed positive effects of LLLT on pain relief, regardless of the visual analogue scale (VAS) score or the change of VAS score between the baseline and the final follow-up time point, while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD. Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up. Temporomandibular joint function outcomes indicated that the overall effect favored LLLT over placebo. Conclusion This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD.
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Merigo E, Rocca JP, Oppici A, Cella L, Fornaini C. At-home laser treatment of oral neuronal disorders: Case reports. J Clin Exp Dent 2017; 9:e595-e598. [PMID: 28469830 PMCID: PMC5410685 DOI: 10.4317/jced.53373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 12/02/2016] [Indexed: 01/28/2023] Open
Abstract
The neuronal disorders occurring in the oral district are mainly anaesthesia, paraesthesia, hypoesthesia and hyperaesthesia and they may occur frequently after surgical procedures. Medical treatment depends on degree of severity of the nerve injury but, in every case, it must be immediately carried out to reduce immune inflammatory reaction. The aim of this report is to investigate the effectiveness in the recovery of the peripheral nerve lesions of a new laser device recently proposed by the commerce that, due to its reduced size and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Three different cases were treated with this "at-home approach": complete resolution of symptomatology was obtained after laser treatment with a good compliance for the patient and without reporting any side effect. Key words:Laser, biomodulation, low level laser therapy, oral neuronal disorders, at-home treatment, paresthesia.
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Affiliation(s)
- Elisabetta Merigo
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France.,"Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Jean-Paul Rocca
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France
| | - Aldo Oppici
- "Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Luigi Cella
- "Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Carlo Fornaini
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France.,"Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
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Merigo E, Fornaini C, Meleti M, Manfredi M, Vescovi P. Low-Level Laser Therapy in odontostomatologia: istruzioni per l’uso. Dental Cadmos 2015. [DOI: 10.1016/s0011-8524(15)30064-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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