Abstract
Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles. Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs. Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations. Key words:Low level laser therapy; phototherapy; temporomandibular joint disorders.
Highlights
The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region
TMD etiology is currently known to be multifactorial, including the presence of parafunctional habits, trauma stress, as well as emotional, systemic, hereditary, and occlusal factors (2).The etiology is related to an association of predisposing factors that increase the risk of TMD, initiating factors that cause the onset of TMD, and perpetuating factors that interference with healing or enhance TMD progression (3)
The aim of our study is to make a review of the literature published on the use of level laser therapy (LLLT) for the treatment of TMDs, considering the level of scientific evidence according to the principals of evidence-based dentistry
Summary
The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. Physical therapy is used in the treatment of TMD because of its analgesic, myorelaxing, anti-inflammatory and stimulations effects. Low level laser therapy (LLLT) is an option for the treatment of musculoskeletal disorders, it is easy application, limited treatment time and minimum contraindications, due to its analgesic, anti-inflammatory and regenerative effects (3,4,8)
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