Temporomandibular Joint Disorder
Conditions
Keywords
Temporomandibular disorders, low- level laser- photobiomodulation therapy, TMD, myofascial TMD
Brief summary
The objective of this preliminary research was to identify the effect of low-level laser photobiomodulation therapy (LLLT-PBMT) in patients with myofascial temporomandibular disorders (TMDs), refractory to botulinum toxin (BTX) treatment. Specifically, the hypothesis of LLLT-PBMT as a safe, low-cost, painless, and minimally invasive alternative therapy was proposed to improve complete muscle recovery and significantly reduce muscle paralysis in patients with masticatory muscle disorders previously treated with BTX. Additionally, different treatment alternatives were investigated, and a protocol was suggested for the application of LLLT-PBMT in myofascial TMDs and the pain associated with masticatory muscles, also analyzing its complications and negative effects
Interventions
DEVICELow- level laser- photobiomodulation therapy
Three patients (30%) received treatment on the left side and seven (70%) on the right side. The treatment was carried out using the EPIC X laser (BIOLASE®), which uses a solid-state diode as a semiconductor source of invisible infrared radiation. The therapy was applied to the masticatory muscles (temporal, masseter, internal pterygoid), to trigger points discovered on palpation and to the intra-articular area of the TMJ (posterior portion through the external ear, superior portion and anterior portion). All patients included in the study underwent four sessions of PBMT-LLL for four consecutive weeks. T
Sponsors
University of Salamanca
University of Coimbra
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female patients diagnosed with TMDs. Presence of unilateral or bilateral painful symptoms. Associated conditions: Bruxism, hypertrophy of the masticatory muscles, headaches * Previous treatment with BTX: Minimum of 3 doses (100 IU) Applied in masticatory muscles and intracapsular area No favorable results obtained
Exclusion criteria
* Patients without prior treatment of this type. * Patients receiving treatment in the Pain Unit. * Patients undergoing invasive treatments: Open surgery in the cervicofacial region or TMJ arthrocentesis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Severity and frequency of the symptoms | Baseline and four weeks after the treatment | To evaluate both the severity and the frequency of the symptoms associated with TMJ disorders, the anamnestic index of Fonseca was used, considered a valid tool for diagnostic confirmation. |
| Pain Intensity | Baseline and four weeks after the treatment | For the evaluation of pain, the visual analog scale (VAS) was used, which provides a subjective evaluation of pain, with a scale of values from 0 to 10 representing the intensity of pain in an ascending manner. |
| Pressure pain threshold | Baseline and four weeks after the treatment | Pressure pain (PP) was measured using a pressure algometer (Wagner FPI 10®) that shows its strength during manual therapy on pressure points (tip of the algometer perpendicular to the muscle, maintaining the pressure which is progressively increased up to 1 kg/sec). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Depression and anxiety | Baseline and four weeks after the treatment | The Depression Anxiety Stress Scales-21 (DASS-21) questionnaire was used to assess affective states through the 21 questions that make up the tool. Scores are reported as a total score (ranging from 0 to 63) and individual scores for three subscales (ranging from 0 to 21). Additionally, percentiles are calculated based on community samples. Each subscale score is classified into five severity levels: normal, mild, moderate, severe, and extremely severe. |
| Maximum mouth opening | Baseline and four weeks after the treatment | To measure the maximum mouth opening (MMO), a digital gauge (Ubermann®) was used, taking two measurements, and the average was used for statistical analysis. |
| Satisfaction with the treatment | Four weeks after the treatment | The degree of satisfaction with the treatment received was evaluated in the patients. For this purpose, the Likert scale was used, a validated scale consisting of 5 items that evaluates attitudes, perceptions or levels of satisfaction. |
Countries
Spain
Outcome results
None listed