Farshidfar Nima, Farzinnia Golnoush, Samiraninezhad Nazafarin, Assar Sahar, Firoozi Parsa, Rezazadeh Fahimeh, Hakimiha Neda
Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
J Lasers Med Sci. 2023 Aug 5;14:e24. doi: 10.34172/jlms.2023.24. eCollection 2023.
Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm, and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.
颞下颌关节紊乱病（TMDs）是影响颞下颌关节（TMJs）和/或口面部肌肉的最常见的非牙源性口面部疼痛病症。光生物调节疗法（PBMT）是改善TMD患者功能和减轻症状的一种保守方法。进行这项系统评价是为了更新关于PBMT对TMD患者疼痛强度、TMJ运动、肌电图（EMG）活动、压痛阈值（PPT）和TMJ弹响影响的证据。2000年1月至2022年9月期间，在Web of Science、PubMed/Medline和Scopus数据库中使用适当的关键词和特定策略进行了系统的文献检索。根据纳入/排除标准进行数据提取。共纳入40项研究。除一项研究外，所有纳入研究均提供了疼痛强度信息；27项研究表明，与对照组相比，PBMT组的疼痛强度有所降低。在报告最大开口度（MMO）的15项研究中，有7项显示PBMT组的MMO大于安慰剂组。此外，在所有报告被动最大开口度（PMMO）和主动最大开口度（AMMO）的研究中，PBMT组的PMMO和AMMO数值更高。在十项研究中的八项中，PBMT组的侧向运动（LM）更大。此外，在四项研究中的三项中，报告PBMT组的前伸运动（PM）更大。在九项研究中的四项中，PBMT组的PPT更高。在五项研究中的两项中，报告PBMT组的TMJ弹响减少。此外，在大多数研究中，两组之间未检测到EMG活动的差异。这项更新的系统评价显示了PBMT在减轻疼痛和改善MMO方面的良好效果。根据先前报道的结果，使用波长在780 - 980 nm之间、能量密度<100 J/cm且输出功率≤500 mW的红外二极管激光进行至少六次治疗，似乎是治疗上述TMD体征和症状的一个有前景的选择。
