Chen J, Huang Z, Ge M, Gao M
West China School of Stomatology, Sichuan University, Chengdu, China.
J Oral Rehabil. 2015 Apr;42(4):291-9. doi: 10.1111/joor.12258. Epub 2014 Dec 9.
This study was designed to evaluate the efficacy of low-level laser therapy (LLLT) in the treatment of temporomandibular disorders (TMDs). We searched electronic databases and references lists of relevant articles, retrieved all of the published randomised controlled trials in regard to these issues and then performed a meta-analysis. Fourteen highly qualified RCTs reporting on a total of 454 patients, which evaluated the effectiveness of LLLT for patients suffering from TMDs were retrieved. The results indicated that LLLT was not better than placebo in reducing chronic TMD pain (weighted mean difference = -19·39; 95% confidence interval = -40·80-2·03; P < 0·00001; I(2) = 99%). However, the LLLT provided significant better functional outcomes in terms of maximum active vertical opening (MAVO) (weighted mean difference = 4·18; 95% confidence interval = 0·73-7·63; P = 0·006; I(2) = 73%), maximum passive vertical opening (MPVO) (weighted mean difference = 6·73; 95% confidence interval = 01·34-12·13; P = 0·06; I(2) = 73%), protrusion excursion (PE) (weighted mean difference = 1·81; 95% confidence interval = 0·79-2·83; P = 0·59; I(2) = 0%) and right lateral excursion (RLE) (weighted mean difference = 2·86; 95% confidence interval = 1·27-4·45; P = 0·01; I(2) = 73%). The results of our meta-analysis have provided the best evidence on the efficacy of LLLT in the treatment of TMDs. This study indicates that using LLLT has limited efficacy in reducing pain in patients with TMDs. However, LLLT can significantly improve the functional outcomes of patients with TMDs.
本研究旨在评估低强度激光疗法(LLLT)治疗颞下颌关节紊乱病(TMDs)的疗效。我们检索了电子数据库及相关文章的参考文献列表,获取了所有已发表的关于这些问题的随机对照试验,然后进行荟萃分析。共检索到14项高质量随机对照试验,涉及454例患者,评估了LLLT对TMDs患者的有效性。结果表明,在减轻慢性TMD疼痛方面,LLLT并不优于安慰剂(加权平均差=-19.39;95%置信区间=-40.80至2.03;P<0.00001;I²=99%)。然而,在最大主动垂直开口度(MAVO)方面,LLLT能显著改善功能结局(加权平均差=4.18;95%置信区间=0.73至7.63;P=0.006;I²=73%),最大被动垂直开口度(MPVO)(加权平均差=6.73;95%置信区间=1.34至12.13;P=0.06;I²=73%),前伸运动范围(PE)(加权平均差=1.81;95%置信区间=0.79至2.83;P=0.59;I²=0%)以及右侧侧方运动范围(RLE)(加权平均差=2.86;95%置信区间=1.27至4.45;P=0.01;I²=73%)。我们的荟萃分析结果为LLLT治疗TMDs的疗效提供了最佳证据。本研究表明,使用LLLT减轻TMDs患者疼痛的疗效有限。然而,LLLT可显著改善TMDs患者的功能结局。