Rodrigues Jeniffer Holley, Marques Márcia Martins, Biasotto-Gonzalez Daniela Aparecida, Moreira Maria Stella Nunes Araújo, Bussadori Sandra Kalil, Mesquita-Ferrari Raquel Agnelli, Martins Manoela Domingues
Universidade Nove de Julho - UNINOVE, 612, Avenida Francisco Matarazzo, São Paulo, SP, CEP 05001-100, Brazil,
Lasers Med Sci. 2015 Apr;30(3):953-9. doi: 10.1007/s10103-013-1514-z. Epub 2013 Dec 24.
Few studies have been carried out on the application of laser phototherapy (LPT) for treating painful temporomandibular disorder (TMD) in elderly population that is growing worldwide. The aim of the present study was to evaluate the pain, jaw movements, and psychosocial factors in ten elderly patients with painful TMD before and after LPT. All patients were evaluated before and after LPT by using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) axes I and II. For pain assessment, a visual analogue scale (VAS) was used. The LPT was carried out with an GaAlAs diode laser (780 nm; spot size 0.04 cm(2)) in punctual and contact mode. Two settings of irradiations were applied as follows: in patients presenting myofascial pain, 10 mW, 5 J/cm(2), 20 s, 0.2 J per application point; and in patients with joint TMD, 70 mW, 105 J/cm(2), 60 s on five points, 4.2 J per point. Two sessions of LPT were carried out per week over four consecutive weeks, in the total of eight sessions. Data was statistically analyzed (p < 0.05). Significant pain reduction was found in all patients. There were increase in maximum mouth opening without pain and reduction in muscle pain during right and left lateral excursion. A significant reduction in chronic pain severity (p = 0.02) and significant improvements in depression (p = 0.038) and nonspecific physical symptoms with pain (p = 0.0167) were observed. The present findings indicate that LPT is able to promote pain relief and improvement of jaw movements in elderly patients with TMD, with a positive effect on psychosocial aspects.
在全球老年人口不断增长的情况下，针对激光光疗法（LPT）用于治疗疼痛性颞下颌关节紊乱病（TMD）的研究较少。本研究的目的是评估10例患有疼痛性TMD的老年患者在LPT治疗前后的疼痛、下颌运动及社会心理因素。所有患者在LPT治疗前后均使用颞下颌关节紊乱病研究诊断标准（RDC/TMD）轴I和轴II进行评估。疼痛评估采用视觉模拟量表（VAS）。LPT采用GaAlAs二极管激光器（780 nm；光斑尺寸0.04 cm²）以点状和接触模式进行。应用了两种照射设置如下：对于出现肌筋膜疼痛的患者，10 mW，5 J/cm²，20秒，每个照射点0.2 J；对于患有关节TMD的患者，70 mW，105 J/cm²，在五个点上照射60秒，每个点4.2 J。连续四周每周进行两次LPT治疗，共八次。对数据进行统计学分析（p < 0.05）。发现所有患者的疼痛均显著减轻。无痛时最大张口度增加，左右侧方运动时肌肉疼痛减轻。观察到慢性疼痛严重程度显著降低（p = 0.02），抑郁（p = 0.038）和伴有疼痛的非特异性躯体症状显著改善（p = 0.0167）。目前的研究结果表明，LPT能够促进患有TMD的老年患者的疼痛缓解和下颌运动改善，对社会心理方面有积极影响。
