Tunér Jan, Hosseinpour Sepanta, Fekrazad Reza
Private Practice, Swedish Laser Medical Society (SLMS), Stockholm, Sweden.
School of Dentistry, The University of Queensland, Brisbane, Australia.
Photobiomodul Photomed Laser Surg. 2019 Dec;37(12):826-836. doi: 10.1089/photob.2019.4705. Epub 2019 Nov 26.
This systematic review aimed to comprehensively review all available documents regarding photobiomodulation therapy (PBMT) application in temporomandibular disorder (TMD) patients and to suggest an evidence-based protocol for therapeutic PBM administration for these patients. The existence of temporomandibular joint and/or pain and dysfunction in masticatory muscles is characterized in TMDs. PBMT is, due to its impact on biological processes, especially inflammation, considered as an adjuvant treatment modality in TMD cases. All original articles related to PBMT for TMDs in EMBASE, MEDLINE (NCBI PubMed and PMC), Cochrane library, Scopus, Web of Science, and Google Scholar were reviewed until December 2018. The energy density ranging from 0.75 to 112.5 J/cm with 0.9-500 mW power was found to be a window protocol for light application. The best results for pain relief and mandibular movement enhancement were reported after application of GaAlAs diode laser, 800-900 nm, 100-500 mW, and <10 J/cm, twice a week for 30 days on trigger points. The session of light applications varied from 1 to 20. Although most articles showed that PBMT is effective in reducing pain and contributed to functional enhancement in TMD patients, the heterogenic parameters that have been reported in various studies made the standardization of PBMT complicated. However, such evidence-based consensus can be beneficial for both future research and for clinical applications.
本系统评价旨在全面回顾所有关于光生物调节疗法(PBMT)在颞下颌关节紊乱病(TMD)患者中应用的现有文献,并为这些患者的PBMT治疗提出基于证据的方案。颞下颌关节紊乱病的特征是存在颞下颌关节和/或咀嚼肌疼痛及功能障碍。由于PBMT对生物过程尤其是炎症有影响,它被视为TMD病例的一种辅助治疗方式。检索了截至2018年12月EMBASE、MEDLINE(NCBI PubMed和PMC)、Cochrane图书馆、Scopus、科学网和谷歌学术中所有与PBMT治疗TMD相关的原始文章。发现能量密度范围为0.75至112.5 J/cm²、功率为0.9至500 mW是光照射的一个窗口方案。在触发点应用波长800 - 900 nm、功率100 - 500 mW、能量密度<10 J/cm²的GaAlAs二极管激光,每周两次,持续30天,报告显示在缓解疼痛和增强下颌运动方面取得了最佳效果。光照射疗程从1次到20次不等。尽管大多数文章表明PBMT在减轻TMD患者疼痛和促进功能改善方面有效,但不同研究报告的参数存在异质性,使得PBMT的标准化变得复杂。然而,这种基于证据的共识对未来研究和临床应用都有益处。