Siqueira Letícia da Costa, Brant Camila Freire, Bento Guilherme Ferreira, Soares Lélio Fernando Ferreira, Danziger Marcela Filié Haddad, Soares Carlos José, Almeida Daniel Augusto de Faria
School of Dentistry, Alfenas Federal University (Unifal-MG), Gabriel Monteiro da Silva, 700 - Centro, Alfenas, Minas Gerais, 37131-001, Brazil.
Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State of University (FOAR/UNESP), São Paulo, Brazil.
Lasers Med Sci. 2025 Jul 11;40(1):310. doi: 10.1007/s10103-025-04565-x.
This study aimed to assess the impact of photobiomodulation therapy (PBMT) using low-level laser therapy, an occlusal splint (OS), and their combined application (OSL) on symptoms of muscular temporomandibular disorder (TMD) through a randomized clinical trial. Participants diagnosed with muscular TMD following the Diagnostic Criteria for TMD guidelines were allocated to three groups: OS, L, and OSL. The OS and OSL groups utilized the device during sleep, while PBMT (3 J/cm² per point) was applied to the L and OSL groups in 5 weekly sessions employing infrared light (808 nm). Pain levels were evaluated using the visual analogue scale (VAS), mandibular mobility was assessed via maximum unassisted mouth opening, and quality of life was measured using the Oral Health Impact Profile (OHIP-14). A total of 99 participants (OS: n = 34, L: n = 32, OSL: n = 33), including 80 women and 19 men with an average age of 31.54 ± 10.39 years, were enrolled. Significant pain reduction occurred in the L and OSL groups (p < 0.05), with the OSL group demonstrating higher effectiveness compared to the OS group within the initial two weeks (p < 0.05). Post-treatment, the L and OSL groups exhibited notable improvements in mandibular mobility, except during the final session (p < 0.05). All groups reported enhanced quality of life, with the L group achieving higher scores than the OS and OSL groups during reassessment (p < 0.05). Laser therapy effectively treated muscular TMD, both as a standalone therapy and in combination with the OS, particularly for immediate pain relief. The combination of therapies was important for maintaining stable symptom control over time.
本研究旨在通过一项随机临床试验，评估使用低强度激光疗法的光生物调节疗法（PBMT）、咬合板（OS）及其联合应用（OSL）对肌肉性颞下颌关节紊乱病（TMD）症状的影响。根据TMD诊断标准指南被诊断为肌肉性TMD的参与者被分为三组：OS组、L组和OSL组。OS组和OSL组在睡眠期间使用该装置，而PBMT（每点3 J/cm²）以每周5次的频率应用于L组和OSL组，采用红外光（808 nm）。使用视觉模拟量表（VAS）评估疼痛程度，通过最大自主开口度评估下颌运动度，并使用口腔健康影响量表（OHIP-14）测量生活质量。共招募了99名参与者（OS组：n = 34，L组：n = 32，OSL组：n = 33），包括80名女性和19名男性，平均年龄为31.54±10.39岁。L组和OSL组疼痛显著减轻（p < 0.05），OSL组在最初两周内显示出比OS组更高的疗效（p < 0.05）。治疗后，L组和OSL组下颌运动度有显著改善，但最后一次治疗期间除外（p < 0.05）。所有组的生活质量均有所提高，在重新评估时，L组的得分高于OS组和OSL组（p < 0.05）。激光疗法作为单独疗法或与OS联合应用，均能有效治疗肌肉性TMD，尤其是在立即缓解疼痛方面。联合治疗对于长期维持稳定的症状控制很重要。
