Sobral Ana-Paula-Taboada, Sobral Sergio-de Sousa, Campos Thalita-Molinos, Horliana Anna-Carolina-Ratto-Tempestini, Fernandes Kristianne-Porta-Santos, Bussadori Sandra-Kalil, Motta Lara-Jansiski
Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil.
Postgraduate Program.
J Clin Exp Dent. 2021 Jul 1;13(7):e724-e732. doi: 10.4317/jced.58084. eCollection 2021 Jul.
Photobiomodulation (PBM) is a non-invasive and non-pharmacological treatment, which, has shown beneficial results in the treatment of temporomandibular disorders (TMD) related pain. This systematic review and meta-analysis study aimed to evaluate the efficacy of photobiomodulation in the treatment of myofascial pain associated with (TMD by analyzing randomized clinical trials published from 2007 to February 2019. The secondary objective of the study was to perform a cost-effectiveness analysis of TMD treatment with photobiomodulation in patients with myofascial pain.
International databases were used: Pubmed, Medline and Web of Science; the initial search raised 316 papers, and only 17 papers met the inclusion criteria for the systematic review (SR). Of these, only 04 papers met the inclusion criteria for meta-analysis: VAS data represented by numerical scores and placebo control group.
As for the wavelength, the most used value was 780nm (followed by 830nm. The most used treatment time was 4 offered treatments for 4 weeks; followed by 10 sessions. Regarding periodicity, 9 studies used 2 times a week. The meta-analysis showed that laser-treated groups had painful symptoms improvement that was superior to the control group (mean difference 1.49;95% CI = -1.67; -1.32). Laser therapy showed a cost-effectiveness of $1,464.28 by controlled pain intensity and placebo showed $2,866.20 by controlled pain intensity.
The studies were considered to have moderate quality of evidence. Laser-treated groups had painful symptoms improvement that was superior to the control group and photobiomodulation was more cost-effective than placebo in patients with TMD and myofascial pain. Temporomandibular disorder, Myofascial pain, Photobiomodulation, Placebo, Cost-effectiveness.
光生物调节（PBM）是一种非侵入性、非药物治疗方法，已显示出在治疗颞下颌关节紊乱病（TMD）相关疼痛方面有有益效果。本系统评价和荟萃分析旨在通过分析2007年至2019年2月发表的随机临床试验，评估光生物调节治疗与TMD相关的肌筋膜疼痛的疗效。该研究的次要目的是对肌筋膜疼痛患者采用光生物调节治疗TMD进行成本效益分析。
使用国际数据库：PubMed、Medline和科学网；初步检索得到316篇论文，只有17篇论文符合系统评价（SR）的纳入标准。其中，只有4篇论文符合荟萃分析的纳入标准：以数字评分表示的视觉模拟量表（VAS）数据和安慰剂对照组。
至于波长，最常用的值是780nm（其次是830nm）。最常用的治疗时间是4周内进行4次治疗；其次是10次治疗。关于治疗频率，9项研究使用每周2次。荟萃分析表明，激光治疗组的疼痛症状改善优于对照组（平均差值1.49；95%置信区间=-1.67；-1.32）。激光治疗通过控制疼痛强度显示出成本效益为1464.28美元，安慰剂通过控制疼痛强度显示为2866.20美元。
这些研究被认为证据质量中等。激光治疗组的疼痛症状改善优于对照组，在TMD和肌筋膜疼痛患者中，光生物调节比安慰剂更具成本效益。颞下颌关节紊乱病、肌筋膜疼痛、光生物调节、安慰剂、成本效益。
