Federal University of Sergipe, Aracaju, SE, Brazil.
J Appl Oral Sci. 2012 Nov-Dec;20(6):594-602. doi: 10.1590/s1678-77572012000600002.
Temporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected.
To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD.
The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events.
After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm², while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo.
Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol for pain relief in patients with TMD.
颞下颌关节紊乱(TMD)的特征为存在颞下颌关节(TMJ)和/或咀嚼肌疼痛和功能障碍。低水平激光被作为一种辅助治疗方式用于 TMD 的治疗,特别是当怀疑存在炎症性疼痛时。
系统地评价研究低水平激光治疗(LLLT)对 TMD 患者疼痛程度的影响。
从 2003 年 1 月至 2010 年 10 月检索 Scopus、embase、ebsco 和 PubMed 数据库,使用以下关键词:激光治疗、低水平激光治疗、颞下颌关节紊乱、颞下颌关节功能紊乱综合征、颞下颌关节、下颌、面部疼痛和关节痛,并纳入人类干预研究,排除动物研究、非英文、西班牙文或葡萄牙文文献、学位论文、专论和科学会议摘要。
仔细审查后,有 14 项研究符合纳入标准,其中 12 项研究使用了安慰剂组。至于激光应用方案,使用的能量密度为 0.9 至 105 J/cm²,功率密度为 9.8 至 500 mW。治疗次数从 1 次到 20 次不等,应用频率从每天 1 次持续 10 天到每周 1 次持续 4 周不等。有 13 项研究报道疼痛减轻,其中 9 项仅出现在实验组,4 项研究报道实验组和安慰剂组均有疼痛缓解。
大多数研究表明 LLLT 似乎能有效减轻 TMD 疼痛。然而,激光参数标准化的异质性要求对这些结果的解释需谨慎。因此,有必要开展进一步的研究,以便就 TMD 患者缓解疼痛的最佳应用方案达成共识。