Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study.

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.

[1]  T. Hansson.  Infrared laser in the treatment of craniomandibular disorders, arthrogenous pain. , 1989, The Journal of prosthetic dentistry.

[2]  S. Kahraman,et al.  Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. , 2006, Photomedicine and laser surgery.

[3]  R. J. M. Gray,et al.  Temporomandibular disorders : a clinical approach , 1995 .

[4]  B. Goldstein.  Temporomandibular disorders: a review of current understanding. , 1999, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[5]  H. J. Hansen,et al.  Low power laser biostimulation of chronic oro-facial pain. A double-blind placebo controlled cross-over study in 40 patients , 1990, Pain.

[6]  H. Thorsen,et al.  The effect of low-level laser therapy on musculoskeletal pain: A meta-analysis , 1993, Pain.

[7]  M. Ribeiro,et al.  Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation. , 2006, Photomedicine and laser surgery.

[8]  L E Bertolucci,et al.  Clinical analysis of mid-laser versus placebo treatment of arthralgic TMJ degenerative joints. , 1995, Cranio : the journal of craniomandibular practice.

[9]  M. Parlak,et al.  Effectiveness of low‐level laser therapy in temporomandibular disorder , 2003, Scandinavian journal of rheumatology.

[10]  C. McNeill,et al.  History and evolution of TMD concepts. , 1997, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[11]  L. Navratil,et al.  Arthralgia of the temporomandibular joint and low-level laser therapy. , 2006, Photomedicine and laser surgery.

[12]  S. Dworkin,et al.  Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. , 1992, Journal of craniomandibular disorders : facial & oral pain.

[13]  P. Conti.  Low level laser therapy in the treatment of temporomandibular disorders (TMD): a double-blind pilot study. , 1997, Cranio : the journal of craniomandibular practice.

[14]  S. Harris,et al.  A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. , 2006, Physical therapy.

[15]  R A Oostendorp,et al.  The efficacy of laser therapy for musculoskeletal and skin disorders: a criteria-based meta-analysis of randomized clinical trials. , 1992, Physical therapy.

[16]  Lars Hode,et al.  Low level laser therapy : clinical practice and scientific background : aguide for research scientists, doctors, dentists, veterinarians, and other interested parties within the medical field. , 1999 .

[17]  B. Stegenga,et al.  Epidemiology and natural progression of articular temporomandibular disorders. , 1997, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.