title: Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders.
abstract: The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.
authors.affiliation: Dental School, University of Pernambuco, Pernambuco, Brazil. janainasalmos@hotmail.com
authors.forename: Janaina Andrade Lima
authors.initials: JA
authors.lastname: Salmos-Brito
authors.forename: Rebeca Ferraz
authors.initials: RF
authors.lastname: de Menezes
authors.forename: Camila Epitácio Cravo
authors.initials: CE
authors.lastname: Teixeira
authors.forename: Raphaella Karlla Machado
authors.initials: RK
authors.lastname: Gonzaga
authors.forename: Breno Henrique Mara
authors.initials: BH
authors.lastname: Rodrigues
authors.forename: Rodivan
authors.initials: R
authors.lastname: Braz
authors.forename: Ricardo Viana
authors.initials: RV
authors.lastname: Bessa-Nogueira
authors.forename: Marleny Elizabeth Márquez de Martínez
authors.initials: ME
authors.lastname: Gerbi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005157:Facial Pain / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D013705:Temporomandibular Joint Disorders / Q000532:radiotherapy*; D016896:Treatment Outcome