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Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and Placebo-Controlled Clinical Trial.

Abstract
Objective: We aimed to evaluate the efficacy of photobiomodulation (PBM), using an 635 nm diode laser, to provide pain relief for temporomandibular disorder (TMD). Background data: TMD involves a set of multiple clinical manifestations where pain is prevalent. Treatment ideally should be noninvasive and innocuous such as PBM. Methods: A randomized, placebo-controlled, clinically blinded trial was performed on 42 patients with painful TMD diagnosed according the Research Diagnostic Criteria for Temporomandibular Disorders. They were randomly placed into two groups: an intervention group (n = 22) subjected to the application of a 635 nm wavelength diode laser (using a 8-mm diameter handpiece in contact mode, delivering 8 J/cm2 over a period of 20 sec applied over the sensitive points where the pain was reported by the participants) and a placebo group (n = 20) following the same protocol but without laser activation. All patients received four sessions of treatment over 4 weeks. Personal pain perception, nonassisted pain-free maximum mouth opening and tenderness elicited during palpation of muscles were used as primary outcomes, evaluated at baseline and at follow-up 1 month later by blinded, calibrated evaluators. Results: There was a significant reduction in the degree of pain recorded in the laser group after treatment (0.63 ± 0.36) compared with the baseline evaluation (4.59 ± 2.36; p < 0.001), which was not observed in the placebo group. Reduction of pain during palpation of most masticatory muscles was significant following treatment in the intervention group. A significant increase in the nonassisted painless mouth opening was observed after treatment (42.14 ± 5.8 mm) compared with baseline values (36.73 ± 9.91 mm) only among the laser group (p = 0.007). There were no reported adverse events or side effects among the patients in the intervention group. Conclusions: Our results suggest that PBM using a 635 nm laser was effective on the remission of painful TMD, without complications.
AuthorsLuís Monteiro, Raquel Ferreira, Tiago Resende, José Júlio Pacheco, Filomena Salazar
JournalPhotobiomodulation, photomedicine, and laser surgery (Photobiomodul Photomed Laser Surg) Vol. 38 Issue 5 Pg. 280-288 (May 2020) ISSN: 2578-5478 [Electronic] United States
PMID32427553 (Publication Type: Journal Article, Randomized Controlled Trial)
Topics
  • Adolescent
  • Adult
  • Facial Pain (diagnosis, etiology, radiotherapy)
  • Female
  • Humans
  • Lasers, Semiconductor (therapeutic use)
  • Low-Level Light Therapy
  • Male
  • Pain Measurement
  • Patient Satisfaction
  • Single-Blind Method
  • Temporomandibular Joint Disorders (complications, therapy)
  • Treatment Outcome
  • Young Adult

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