title: Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) and transcutaneous electrical neural stimulation (TENS) on the improvement of mouth opening in patients with temporomandibular disorder (TMD).
  
  
  BACKGROUND
  TMDs are conditions that affect the form and/or function of the temporomandibular joint (TMJ), masticatory muscles, and dental apparatus. Often TMD is associated with pain localized in the TMJ and/or in the muscles of the face and neck.
  
  
  METHODS
  This clinical trial was performed in 10 patients, 18-56 years old, diagnosed with TMD of multiple causes. All patients received both methods of treatment in two consecutive weeks. LLLT was delivered via a 670-nm diode laser, output power 50 mW, fluence 3 J per site/4 sites (masseter muscle, temporal muscle, mandibular condyle, and intrauricular). TENS therapy was applied with a two-electrode machine at 20 W, maximum frequency of 60 Hz, adjusted by the patient according to their sensitivity. The amplitude of mouth opening was recorded before treatment and immediately after using a millimeter rule; the measurements were performed from the incisal of the upper incisors to the incisal of the lower incisors. A paired t-test was applied to verify the significance of the results.
  
  
  RESULTS
  A significant improvement in the range of motion for both therapies was observed immediately after treatment. Comparing the two methods, the values obtained after LLLT were significantly higher than those obtained after TENS (p < 0.01).
  
  
  CONCLUSIONS
  Both methods are effective to improve mouth opening. Comparing the two methods, LLLT was more effective than TENS applications.
authors.affiliation: Centro de Lasers e Aplicações, IPEN-CNEN/SP, Av. Lineu Prestes 2242, CEP: 05508-900 São Paulo, SP, Brazil. silnunez@aol.com
authors.forename: Silvia Cristina
authors.initials: SC
authors.lastname: Núñez
authors.forename: Aguinaldo Silva
authors.initials: AS
authors.lastname: Garcez
authors.forename: Selly Sayuri
authors.initials: SS
authors.lastname: Suzuki
authors.forename: Martha Simões
authors.initials: MS
authors.lastname: Ribeiro
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation