Abstract
Objective: To compare the efficacy of photobiomodulation and occlusal splint in patients with TMD-associated myofascial pain. Material and methods: 23 patients were randomized into 2 groups: laser group (LG) (n = 12) and occlusal splint group (OSG) (n=11). For the LG, laser was applied to 3 points on each side of the face. Twelve applications were made, 2 sessions per week. In the OSG, patients were instructed to use the device during sleep, 8 hours per night, for a period of 6 weeks, and 12 adjustment and follow-up sessions were performed. Patients in both groups were reevaluated 30 days after the end of the treatments. Results: There was a decrease in pain intensity, according to a visual analogue scale, in both groups before and after 1 month (LG, p = 0.008 and OSG p = 0.002), but with no difference between groups. For the quality of life, both treatments had a positive impact, with this impact being higher in the LG compared to the OSG (p <0.05). Regarding the cost-effectiveness analysis, laser was more cost-effective than the occlusal splint in the clinical trial. The incremental cost of the laser was $3,483.45 compared to the splint, but it had a cost ratio of $4,569.02 for controlled pain intensity while the splint showed $6,691.91 ratio for controlled pain intensity. Conclusion: The photobiomodulation was more cost-effective in controlling painful symptoms in patients with TMD and myofascial pain.
Highlights
According to the American Academy of Orofacial Pain, temporomandibular disorder (TMD) is defined as a set of disorders involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures
Thirty patients were included in the study, of which 7 patients withdrew from treatment and 23 patients completed the study (LG = 12 and occlusal splint group (OSG) = 11)
The occlusal splint group showed superior results compared to the laser group for the following parameters: muscle pain (0.909* / p=0.047) and visual analogue scale (VAS) right temporal muscle (0.364 * / p=0.048)
Summary
According to the American Academy of Orofacial Pain, temporomandibular disorder (TMD) is defined as a set of disorders involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures. As for the signs, they include muscle and TMJ tenderness to palpation, limited and/or impaired mandibular movements and joint noise (Okeson, 2013; Leeuw, 2010). Orofacial pain is any pain associated with soft and mineralized tissues (skin, blood vessels, bones, teeth, glands or muscles) of the oral cavity and face. This pain can be referred to the head and/or neck region or even be associated with cervical pain, primary headache and rheumatic diseases such as fibromyalgia and rheumatoid arthritis (Leeuw, 2010). Pain impairs physical and mental function and results in costly treatments and reductions of productivity and quality of life (Basto et al, 2017)
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