title: Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up.
abstract: This study investigated the efficacy of combining low-level laser therapy (LLLT) with oral motor exercises (OM-exercises) for rehabilitation of patients with chronic temporomandibular disorders (TMDs). Eighty-two patients with chronic TMD and 20 healthy subjects (control group) participated in the study. Patients were randomly assigned to treatment groups: GI (LLLT + OM exercises), GII (orofacial myofunctional therapy-OMT-which contains pain relief strategies and OM-exercises), and GIII (LLLT placebo + OM-exercises) and GIV (LLLT). LLLT (AsGaAl; 780-nm wavelength; average power of 60 mW, 40 s, and 60 ± 1.0 J/cm²) was used to promote analgesia, while OM-exercises were used to reestablish the orofacial functions. Evaluations at baseline (T1), after treatment immediate (T2), and at follow-up (T3) were muscle and joint tenderness to palpation, TMD severity, and orofacial myofunctional status. There was a significant improvement in outcome measures in all treated groups with stability at follow-up (Friedman test, P < 0.05), but GIV did not show difference in orofacial functions after LLLT (P > 0.05). Intergroup comparisons showed that all treated groups had no difference in tenderness to palpation of temporal muscle compared to GC at follow-up (Kruskal-Wallis test, P < 0.01). Moreover, GI, GII, and GIII showed no difference from GC in orofacial functional condition (T2 and T3) while they differed significantly from GIV (P < 0.01). In conclusion, LLLT combined with OM-exercises was more effective in promoting TMD rehabilitation than LLLT alone was. Similar treatment results were verified with the OMT protocol.
authors.affiliation: Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.|Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.
authors.forename: Barbara Cristina Zanandréa
authors.initials: BC
authors.lastname: Machado
authors.affiliation: Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo Oliveira
authors.initials: MO
authors.lastname: Mazzetto
authors.affiliation: Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.|Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Marco Antonio M Rodrigues
authors.initials: MA
authors.lastname: Da Silva
authors.affiliation: Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. cfelicio@fmrp.usp.br.|Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil. cfelicio@fmrp.usp.br.
authors.forename: Cláudia Maria
authors.initials: CM
authors.lastname: de Felício
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000534:rehabilitation; D059408:Pain Management; D010147:Pain Measurement; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Low-level laser therapy; Oral motor therapy; Orofacial functions; Rehabilitation; Temporomandibular disorders