Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Oral Rehabil. 2013 Mar;40(3):171-8. doi: 10.1111/joor.12022. Epub 2012 Dec 17.
This study aimed to evaluate the efficacy of piroxicam associated with low-level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double-blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm(-2) ) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow-up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0·05) and showed the lowest temporal pain (P = 0·02) at the 30-day follow-up. The combination of low-level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days.
本研究旨在评估吡罗昔康联合低水平激光治疗与单一疗法治疗 32 例颞下颌关节关节炎患者的疗效，采用随机双盲研究设计。将样本分为激光+吡罗昔康、激光+安慰剂吡罗昔康和安慰剂激光+吡罗昔康组，在 4 个疗程中，对每侧 10 个颞下颌关节和肌肉点进行红外激光（830nm，100mW，28s，100J/cm2）治疗，同时每天服用 1 片 20mg 吡罗昔康，持续 10 天。在 4 个疗程和 30 天的随访中，通过视觉模拟评分（VAS）、最大张口度以及关节和肌肉（颞肌和咬肌）触诊疼痛评估治疗效果。结果表明，所有研究组的 VAS 评分均显著改善（P<0·05），且组间无显著差异。吡罗昔康对触诊时关节和肌肉疼痛的缓解作用有效（P<0·05），在 30 天随访时颞部疼痛最低（P=0·02）。低水平激光治疗联合吡罗昔康治疗颞下颌关节关节炎的效果并不优于单一疗法，吡罗昔康在接下来的 30 天内更有效。
