Synergistic effect of low-level laser and vacuum therapy on the temporomandibular disorder: two cases report

Abstract

Temporomandibular dysfunction (TMD) can be described as a set of clinical conditions that includes disorders of the temporomandibular joint (TMJ) and/or the masticatory muscles that has a multifactorial origin, like bruxism, sleep alteration, trauma, among others. There are several ways to treat TMD, such as: occlusal splints, physiotherapy, viscosupplementation, among others. The aim of this case report was to show the new possibility in the treatment of TMD by means of a combined therapy using low-level laser (LLL) and vacuum therapies in the recovery process of two patients with TMD. A simultaneous LLL under 660 and 808 nm, 600 mW of power divided into six lasers outputs around the tip was used synergistically with a vacuum device under negative pressure between 100 and 150 mbar. This case report included 2 patients and both of them were diagnosed with TMD according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Patients were treated for LLLT and vacuum therapy at the same time. The treatment was applied to the left and right sides of the face on the masseter muscles, temporal muscles on the previous fibers and TMJs. Two sessions per week were performed totaling eight sessions. Oral opening, visual analogue scale (VAS) and OHRQoL (oral health-related quality of life) measurements were evaluated by the Oral Health Impact Profile (OHIP-14) at three moments: pre-treatment (T0), after the eight treatment sessions (T1) and 30 d after the end of treatment (T2). The obtained results showed the improvement of muscle pain and oral opening accompanied by improved quality of life of the volunteers treated with a percentage of 84% in patient 1 and 100% in patient 2. Combined therapies (LLL and vacuum therapies) may be a complementary or alternative treatment to control pain and decrease the recovery time of normality masticatory muscles.