Comparative effectiveness of Low Level Laser therapy and Transcutaneous Electric Nerve Stimulation on Temporomandibular Joint Disorders

Massoud Seifi--- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,
Asghar Ebadifar--- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran- Iran,
Sattar Kabiri--- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Mohammad Reza Badiee--- Dentofacial Deformities Research Center, Research institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran,
Zahra Abdolazimi--- Pediatric Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Parisa Amdjadi--- Department of Dental Materials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract


445

Background: Temporomandibular joint disorders are the most common source of pain on the face. There are multiple etiologies, and several types of treatment have been reported. The use of non-invasive and reversible therapies in the treatment of such problems is recommended. The present study evaluated the effect of low level laser (LLL) therapy and transcutaneous electric nerve stimulation (TENS) on temporomandibular joint disorders.

 

Methods: In this single-blind study, 40 patients with temporomandibular disorders were randomly divided into four groups: TENS (TENSTem dental), LLL (diode 810 nm CW), sham-TENS, and sham-LLL. All subjects were examined and data on pain and tenderness in the temporomandibular joint (TMJ) and masticatory muscles (using the visual analogue scale) and mouth-opening (distance between incisal edges before feeling pain; mm) were collected before baseline (T1), after each session (T2-T5) and one month after the end of the sessions (T6)), and analyzed using repeated measure ANOVA and Boneferronie statistical tests. A p-value < 0.05 was considered significant.

 

Results: The decrease in pain (p = 0.000), tenderness (p = 0.000) and increase in mouth-opening ability (p = 0.002) was greater in the TENS and LLL groups than in the placebo groups. At the one-month follow-up, significant decrease in pain and tenderness was recorded in the TENS and LLL groups (p = 0.000). There was no significant differences between TENS and LLL and the placebo groups for maximum mouth-opening at the end of the study (p = 0.692).

 

Conclusion: Using TENS or LLL therapy can improve TMD symptoms at least for the short term. Although the effects of the placebo played a role in improving symptoms, their effects were less important

Keywords


Temporomandibular disorders; Low Level Laser Therapy; Transcutaneous Electrical Nerve Stimulation.

Full Text:

PDF

135

References


Randhawa K, Bohay R, Côté P, van der Velde G, Sutton D, Wong JJ, et al. The effectiveness of non-invasive interventions for temporomandibular disorders: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Clin J Pain. 2015 ;32(3):260-78

Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc. 1990;120(3):273-81.

Emshoff R, Bösch R, Pümpel E, Schöning H, Strobl H. Low-level laser therapy for treatment of temporomandibular joint pain: a double-blind and placebo-controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2008;105(4):452-6.

Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low‐level laser therapy in temporomandibular disorder. Scand J Rheumatol. 2003;32(2):114-8.

Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clinf North Am. 2013;57(3):465-79.

Koray O, Küçük B, Edebeoglu B. Etiology of temporomandibular disorder pain. J Orofac Pain. 2009;21(3):89-94.

McNeely ML, Olivo SA, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther. 2006;86(5):710-25.

Grossmann E, Tambara JS, Grossmann TK, Siqueira JTTd. Transcutaneous electrical nerve stimulation for temporomandibular joint dysfunction. Revista Dor. 2012;13(3):271-6.

Abreu Venancio R, Camparis CM, Fátima Zanirato Lizarelli R. Low intensity laser therapy in the treatment of temporomandibular disorders: a double‐blind study. J Oral Rehabil. 2005;32(11):800-7.

Carvalho CM, de Lacerda JA, dos Santos Neto FP, Cangussu MCT, Marques AM, Pinheiro AL. Wavelength effect in temporomandibular joint pain: a clinical experience. Lasers Med Sci. 2010;25(2):229-32.

Mazzetto MO, Hotta TH, Pizzo RCdA. Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser. Braz Dent J. 2010;21(4):356-60.

De Medeiros JS, Vieira GF, Nishimura PY. Laser application effects on the bite strength of the masseter muscle, as an orofacial pain treatment. Photomed Laser Ther. 2005;23(4):373-6.

Kamyszek G, Ketcham R, Garcia Jr R, Radke J. Electromyographic evidence of reduced muscle activity when ULF-TENS is applied to the Vth and VIIth cranial nerves. Cranio. 2001;19(3):162-8.

Treacy K. Awareness/relaxation training and transcutaneous electrical neural stimulation in the treatment of bruxism. J Oral Rehabil. 1999;26(4):280-7.

Núñez SC, Garcez AS, Suzuki SS, Ribeiro MS. Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation. Photomed Laser Surg. 2006;24(1):45-9.

Dworkin SF, LeResche L, DeRouen T, Von Korff M. Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners. J Prosthet Dent. 1990;63(5):574-9.

Wessberg GA, Carroll WL, Dinham R, Wolford LM. Transcutaneous electrical stimulation as an adjunct in the management of myofascial pain-dysfunction syndrome. J Prosthet Dent. 1981;45(3):307-14.

Geissler P, McPhee P. Electrostimulation in the treatment of pain in the mandibular dysfunction syndrome. J Dent. 1986;14(2):62-4.

Schiffman E, Look J, Hodges J, Swift J, Decker K, Hathaway K, et al. Randomized effectiveness study of four therapeutic strategies for TMJ closed lock. J Dent Res. 2007;86(1):58-63.

Wright EF, North SL. Management and treatment of temporomandibular disorders: a clinical perspective. J Man Manip Ther. 2009;17(4):247-54.

Cooper B. The role of bioelectronic instruments in the management of TMD. N Y State Dent J. 1995;61(9):48-53.

Çetiner S, Kahraman SA, Yücetas S. Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Ther. 2006;24(5):637-41.

Dimitroulis G. Temporomandibular disorders: a clinical update. Bmj. 1998;317(7152):190-4.

Møystad A, Krogstad BS, Larheim TA. Transcutaneous nerve stimulation in a group of patients with rheumatic disease involving the temporomandibular joint. J Prosthet Dent. 1990;64(5):596-600.

Hansson P, Ekblom A. Transcutaneous electrical nerve stimulation (TENS) as compared to placebo TENS for the relief of acute oro-facial pain. Pain. 1983;15(1):157-65.

Wieselmann‐Penkner K, Janda M, Lorenzoni M, Polansky R. A comparison of the muscular relaxation effect of TENS and EMG‐biofeedback in patients with bruxism. J Oral Rehabil. 2001;28(9):849-53.

Lewis D, Lewis B, Sturrock RD. Transcutaneous electrical nerve stimulation in osteoarthrosis: a therapeutic alternative? Ann Rheum Dis. 1984;43(1):47-9.

Marchand S, Charest J, Li J, Chenard J-R, Lavignolle B, Laurencelle L. Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain. 1993;54(1):99-106.

Fikácková H, Dostálová T, Navrátil L, Klaschka J. Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomed Laser Surg. 2007;25(4):297-303.

Shirani AM, Gutknecht N, Taghizadeh M, Mir M. Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci. 2009;24(5):715-20.

Hotta PT, Hotta TH, Bataglion C, Bataglion SA, de Souza Coronatto EA, Siéssere S, et al. Emg analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice. Complement Ther Clin Pract. 2010;16(3):158-60.

Khalighi HR, Mortazavi H, Mojahedi SM, Marhabi SA, Abbasabadi FM. Low Level Laser Therapy Versus Pharmacotherapy in Improving Myofascial Pain Disorder Syndrome. J Lasers Med Sci. 2016 1;7(1):45.

Ahrari F, Madani AS, Ghafouri ZS, Tunér J. The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. Lasers Med Sci. 2014;29(2):551-7.

Salmos-Brito JA, de Menezes RF, Teixeira CE, Gonzaga RK, Rodrigues BH, Braz R, Bessa-Nogueira RV, Gerbi ME. Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders. Lasers Med Sci. 2013; 28(1):57-64.

Marini I, Gatto MR, Bonetti GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain. 2010;26(7):611-6.

Gray R, Quayle A, Hall C, Schofield M. Physiotherapy in the treatment of temporomandibular joint disorders: a comparative study of four treatment methods. Br Dent J. 1994;176(7):257-61.

Kato MT, Kogawa EM, Santos CN, Conti PCR. TENS and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci. 2006;14(2):130-5.




Copyright © 2012 J Lasers Med Sci "Powered by Open Journal Systems"

 

Site Map | Privacy Statement | About JLMS | Contact | Search| Current | Archives | Open Access

ISSN: 2008-9783/E.ISSN: 2228-6721. Published quarterly by: Laser Application in Medical Sciences Research Center