Use Of Low-level Laser Therapy Research Articles

EFFECTS OF LOW-LEVEL LASER THERAPY ON LIVER REGENERATION AND THE LASER PARAMETERS EMPLOYED

Low-level laser therapy has various biological effects; one of them is tissue regeneration. Its application in the liver of rats after partial hepatectomy to promote liver regeneration has recently been studied. The aim of this article was to review the recent studies on the effects of low-level laser therapy on rat liver regeneration after partial hepatectomy and the laser parameters used. A review of recent relevant literature was performed in Pubmed, Scielo, Medline and Bireme databases. Articles about the application of low-level laser therapy on hepatic regeneration were included. Articles with hepatic regeneration in the presence of pathologies were not included. Nine studies were found matching the study criteria. In most studies, low-level laser therapy promoted liver regeneration after partial hepatectomy, without further damage to the remaining liver. Not all laser parameters necessary for the reproducibility of the study were described by all authors. The therapeutic use of low-level laser therapy in liver regeneration can be promising, however, as liver is a vital organ and the laser application is intraoperative, future studies are needed. The parameters used must be properly described and standardized to allow the reproducibility of the study, so that a therapeutic window can be defined and its clinical use can be considered. It is also essential to clarify the mechanisms by which the laser promotes liver regeneration, to guarantee its safety and therapeutic efficacy.

Comparison of the incidence of post-operative pain after low-level laser therapy between single- and multi-visit root canal treatments for chronic apical periodontitis: A prospective randomized clinical trial

Aim: The aim of this clinical study was to evaluate the effect of low-level laser therapy, used in conjunction with conventional canal disinfection techniques, on post-operative pain after single- and multi-visit root canal treatments for chronic apical periodontitis.
 Methodology: 100 volunteers were randomly divided into 4 groups. The main inclusion criteria were radiographic evidence of apical periodontitis (minimum size of 2.0 × 2.0 mm) and a diagnosis of pulpal necrosis confirmed by a negative response to vitality tests. All the root canals were prepared using a standard shaping technique and irrigation procedure. In Groups I and III, the root canals were obturated during the first visit following chemo-mechanical preparation. In Groups II and IV, the root canals were medicated with calcium hydroxide and obturated during a second visit, 1 week later. In Groups III and IV, after the chemo-mechanical preparation, the root canals were additionally irradiated by an 810-nm diode laser at 1.5 W output for 20 seconds. A modified visual analogue scale was used to measure pain at 4, 8, 12, 24, and 48 hours and 7 days after the treatment.
 Results: There was no statistically significant difference between the groups in terms of post-operative pain at any time during the observation period (p > .05). Post-operative pain occurred only at 8 and 12 hours and at 1, 2, and 3 days in all groups. There was no correlation between the results regarding age, gender, periapical index scores, or tooth type.
 Conclusion: The use of low-level laser therapy had no significant effect on the incidence of post-operative pain, and single-visit root canal treatment may be a strong alternative to multi-visit treatment.
 How to cite this article: Özkan Özcan H, Haznedaroğlu F, Gökyay S. Comparison of the incidence of post-operative pain after low-level laser therapy between single- and multi-visit root canal treatments for chronic apical periodontitis: A prospective randomized clinical trial. Int Dent Res 2021;11(1):30-7. https://doi.org/10.5577/intdentres.2021.vol11.no1.6
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Low-level laser therapy in cases of dentin hypersensitivity

Dentin hypersensitivity is characterized by short, sharp pain in response to a stimulus – thermal, drying, tactile, osmotic or chemical. These stimuli cause an unpleasant sensation lasting from seconds to minutes after provocation. Many alternative treatment methods have been introduced. One of the options is the use of low-level laser therapy, whose effect is based on the increase of the excitability threshold of the free nerve endings causing an analgesic effect, as well as on the stimulation of pulp mesenchymal cells to differentiate into odontoblasts and produce reparative dentin. To investigate the efficacy of low-level laser therapy in treating dentin hypersensitivity, we selected a group of patients complaining of sensitivity at the cervical area of teeth provoked by stimuli such as air, touch and cold spray. The patients were with good oral hygiene and with intact teeth or small non-carious cervical lesions. They confirmed the absence of serious systematic and psychological diseases; some of them smoked electronic cigarettes, which may aggravate the pain. The patients were submitted to six sessions of treatment of dentin hypersensitivity with intervals from 48 to 72 hours, as indicated by the manufacturer of the low-intensity laser device. The painful sensation was measured before each of the six sessions and immediately after the treatment. The results were evaluated by using a four-point scale. The answers assessment showed good results – there was a decrease of the pain sensation from 3-4 level to 1-2 level. Yet, we have to interpret this carefully, because pain evaluation is subjective and some of the smokers have quit smoking electronic cigarettes during the treatment. As a method of curing dentin hypersensitivity, the low-level laser therapy shows a good treatment efficacy, but needs further continuous follow-up.

Role of Low-Level Laser Therapy as an Adjunct in the Management of Diabetic Ulcer

Diabetes mellitus (DM) is a chronic debilitating condition affecting people worldwide and diabetic foot ulcers are also a common problem. The treatment of diabetic ulcers requires a multimodal approach. Adjuvant low-level laser therapy (LLLT) may be useful in lesions with protracted healing course but the evidence is still limited. In this study, we share our experience regarding the use of low-level laser therapy as an adjuvant treatment modality in a patient with diabetic foot ulcer.

Use of low level laser therapy (LLLT) as an adjunct in treatment with combined therapies in patients with Peripheral Facial Palsy (PFP)

Peripheral Facial Palsy is a neurological disorder that has motor and sensory consequences and affects the facial nerve. It causes alterations in the action of the muscles of the face, in the secretion of saliva, tears, and in the sense of taste. The objective of this publication is to report a case in which a treatment with minimally invasive combined therapies was performed together with the use of low-level laser therapy, in a 52-yearold female patient. With relevant medical history, referred for aesthetic evaluation and with unresolved moderate facial paralysis. She was subjected to laser therapy with wavelength (808 nm) and an energy of 3 Joules per session on the affected side, supplemented with Botulinum Toxin Type A, on the healthy side. The treatment of peripheral facial paralysis with minimally invasive combined therapies has proven to be a useful therapeutic tool for facial sequelae. In turn, low-level laser photobiomodulation therapy is promising as an adjunct in the nerve repair process, which would allow functional recovery of the facial nerve in the medium and long term.

The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis

Surgical removal of third molars carries morbidity and significantly affects patients' quality-of-life. This study aims to investigate whether administration of low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars compared with placebo. A systematic review and meta-analysis involving a comprehensive search strategy implemented across 5 electronic databases. This was supplemented by hand searching and contacting international experts and grey literature. Titles, abstracts, and full articles were scrutinized for studies meeting the inclusion criteria. All randomized controlled trials comparing treatment group of LLLT with a placebo control group were eligible for inclusion. The outcomes variables were postoperative pain, swelling, and trismus. Risk of bias and methodological quality assessment was carried out. We pooled data statistically, and meta-analyses were carried out using a random-effects model. Seventeen randomized controlled trials were included in this systematic review, all of which were considered to have a low risk of bias. Participants, aged 13 to 70 years, and 35% women, totaled 1064. Meta-analyses found significant reductions in standardized mean differences (SMDs) in swelling at day 2 and day 7 postoperatively (SMD, -0.611; 95% confidence interval, -0.968, -0.234 and SMD, -0.532; 95% confidence interval, -0.795, -0.269). There were nonsignificant reductions in SMD in pain and trismus at day 2 and day 7 postoperatively. LLLT significantly reduces swelling after extraction of mandibular third molars compared with placebo. LLLT has not shown to reduce postoperative pain and trismus. LLLT does not cause adverse effects. There is currently insufficient evidence available, to promote the investment in LLLT vs the net clinical benefit. Randomized controlled trials with larger sample size and standardized study design and outcome measures are required, to make definitive recommendations to clinicians on its use on patients.

Review on the Cellular Mechanisms of Low-Level Laser Therapy Use in Oncology.

Photobiomodulation (PBM) using low-level laser therapy (LLLT) is a treatment that is increasingly used in oncology. Studies reported enhancement of wound healing with reduction in pain, tissue swelling and inflammatory conditions such as radiation dermatitis, oral mucositis, and lymphedema. However, factors such as wavelength, energy density and irradiation frequency influence the cellular mechanisms of LLLT. Moreover, the effects of LLLT vary according to cell types. Thus, controversy arose as a result of poor clinical response reported in some studies that may have used inadequately planned treatment protocols. Since LLLT may enhance tumor cell proliferation, these will also need to be considered before clinical use. This review aims to summarize the current knowledge of the cellular mechanisms of LLLT by considering its effects on cell proliferation, metabolism, angiogenesis, apoptosis and inflammation. With a better understanding of the cellular mechanisms, bridging findings from laboratory studies to clinical application can be improved.

Assessment of the Healing of Dental Implant Surgical Site Following Low-Level Laser Therapy Using Bioclinical Parameters: An Exploratory Study

The purpose of this study was to evaluate whether low-level laser therapy improves healing of the implant surgical site with clinical and biochemical parameters. Thirty patients with an edentulous space spanning a single tooth were selected. The patients were randomly allocated to 1 of 2 groups: control group and test group. The test group received laser energy at a power of 2 J/cm2 with a total of 4-6 J energy over each implant. Clinical parameters (implant stability quotient, probing index, modified sulcus bleeding index) and osteoprotegerin were assessed at baseline and follow-up intervals (2 weeks, 6 weeks, and 3 months). The test group showed significantly higher implant stability quotient than the control group at 2 weeks (57.93 ± 3.95 vs 35.67 ± 3.08; P < . 01) and 3 months (58.86 ± 3.75 vs 67.06 ± 3.78; P < . 01). A significant rise in osteoprotegerin levels of the test group (686.30 ± 125.36 pg/mL at baseline and 784.25 ± 108.30 pg/mL at 3 months; P < . 01) was seen contrary to significant decline in the control group (839.50 ± 249.08 pg/mL at baseline vs 415.30 ± 78.39 pg/mL at 3 months; P < . 01). Within the limitations of the study, the findings suggest that the healing of peri-implant hard and soft tissues may be enhanced with the use of low-level laser therapy as an explicit modality during the postoperative period.

Evaluation of Aquaporins 1 and 5 Expression in Rat Parotid Glands After Volumetric Modulated Arc Radiotherapy and Use of Low-Level Laser Therapy at Different Times.

Introduction: This experimental study investigated the mRNA expression of aquaporins (AQPs) 1 and 5 in the parotid glands of rats irradiated with volumetric modulated arc therapy (VMAT) and subjected to low-level laser therapy (LLLT) at different time points. Methods: The sample consisted of 30 Wistar rats (Rattus norvegicus) divided into the following groups: control, LLLT alone (LG), radiotherapy alone (RG), and experimental groups that received LLLT at 24 hours (early experimental group [EEG], n=12) and 120 hours (late experimental group [LEG], n=12) after radiotherapy. VMAT was delivered at a single dose (12 Gy) and LLLT was performed with an aluminium-gallium-arsenide diode laser (660 nm, 100 mW), spot area of 0.0028 cm2, energy of 2 J/cm2 applied to 3 spots in the region corresponding to the right parotid gland, for 10 consecutive days. The right parotid gland was resected and prepared for RNA extraction. The gene expression of AQPs was evaluated by quantitative polymerase chain reaction (qPCR) using specific TaqMan probes, with the HPRT gene as an internal control. Results: The lowest AQP1 gene expression was 0.83 (0.27) with the use of LLLT 24 hours after radiotherapy (EEG), and the highest was 1.56 (0.80) with the use of LLLT alone (LG). Likewise, the lowest AQP5 gene expression was found in the EEG (mean = 0.88; SD = 0.49) and the highest in the LG (mean = 1.29; SD = 0.33). Conclusion: The use of LLLT after radiotherapy may contribute to the maintenance and an increase of these proteins, even when used at a later time point after radiotherapy.

Laserterapia aplicada ao tratamento da mucosite oral em pacientes oncológicos. Uma análise bibliométrica

Objetivo: Este trabalho teve como objetivo analisar a produção científica brasileira sobre o uso da terapia com laser de baixa intensidade (LBI) na prevenção e tratamento da mucosite oral em pacientes submetidos ao tratamento oncológico. Metodologia: Este estudo foi do tipo transversal e observacional, com abordagem quantitativa a partir de dados secundários. Foi realizada uma pesquisa nos anais das reuniões da Sociedade Brasileira de Pesquisa Odontológica (SBPqO), no período compreendido entre 2009 a 2019, localizando as seguintes palavras-chaves: “Laser” e “Mucosite”. Com base nos critérios utilizados, todos os resumos que contivessem os termos foram identificados utilizando a ferramenta de busca do programa. Resultados: Após análise e leitura, obedecendo aos critérios de inclusão e exclusão, foram incluídos 33 resumos. Do total avaliado, 21,2% (n = 7) dos resumos eram de estudos utilizando a laserterapia na mucosite oral foram realizados no ano de 2018. A região Centro-oeste, destacadamente o estado do Goiás e especificamente a UFG, foram a origem do maior número de resumos publicados (33,3%). Um total de 60,4% das pesquisas não teve nenhum tipo de auxílio ou financiamento. Conclusão: Dentre as pesquisas publicadas com base nos resumos das reuniões anuais da SBPqO, pode-se concluir que houve um ligeiro aumento das pesquisas utilizando a terapia a laser/ fotobiomodulação para o tratamento da mucosite oral em pacientes oncológicos, sugerindo que a laserterapia é um recurso terapêutico alternativo auxiliar na redução dos efeitos adversos resultantes do tratamento antineoplásico.

Use of Low-level Laser Therapy in the Treatment of Diabetic Foot Ulcers

Use of Low-level Laser Therapy in the Treatment of Diabetic Foot Ulcers

Photobiomodulation Therapy (PBMT) Applied in Bone Reconstructive Surgery Using Bovine Bone Grafts: A Systematic Review.

The use of low-level laser therapy (LLLT) with biomodulatory effects on biological tissues, currently called photobiomodulation therapy (PBMT), assists in healing and reduces inflammation. The application of biomaterials has emerged in bone reconstructive surgery, especially the use of bovine bone due to its biocompatibility. Due to the many benefits related to the use of PBMT and bovine bones, the aim of this research was to review the literature to verify the relationship between PBMT and the application of bovine bone in bone reconstruction surgeries. We chose the PubMed/MEDLINE, Web of Science, and Scopus databases for the search by matching the keywords: “Bovine bone AND low-level laser therapy”, “Bovine bone AND photobiomodulation therapy”, “Xenograft AND low-level laser therapy”, and “Xenograft AND photobiomodulation therapy”. The initial search of the three databases retrieved 240 articles, 18 of which met all inclusion criteria. In the studies concerning animals (17 in total), there was evidence of PBMT assisting in biomaterial-related conduction, formation of new bone, bone healing, immunomarker expression, increasing collagen fibers, and local inflammation reduction. However, the results disagreed with regard to the resorption of biomaterial particles. The only human study showed that PBMT with bovine bone was effective for periodontal regeneration. It was concluded that PBMT assists the process in bone reconstruction when associated with bovine bone, despite divergences between applied protocols.

Use of low-level laser therapy (LLLT) or photobiomodulation (PBM) for the management of the hand-foot syndrome (HSF) or palmo-plantar erythrodysesthesia (PPED) associated with cancer therapy.

The purpose of this pilot study was to determine whether photobiomodulation (PBM) might be effective for chemotherapy-induced palmo-plantar erythrodyesthesia (PPED), as it is for mucositis or radio dermatitis; no standard therapy exists for PPED. Patients were allocated to PBM or sham irradiation and were blindly assessed after 2 weeks. Pain and satisfaction with treatment were also evaluated. We found a significant benefit from PBM in comparison with sham treatment (p < 0.03) and a decrease of pain in 49% of the patients. No adverse reactions were observed. We concluded that PBM might represent a useful approach for the management of PPED.

Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis.

The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of low-level laser therapy (LLLT) and photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) in treatment of chronic periodontitis. Each quadrant was categorized into control group (SRP alone; two quadrants per patient), test group 1 (SRP + PDT), and test group 2 (SRP + LLLT. The test groups showed significantly higher reductions in Gingival Index, probing depth, and clinical attachment level as well as reductions in Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans counts at 1-, 3-, 6-, and 9-month follow-ups when compared with the control group.

Clinical Outcomes of Low-level Laser Therapy in Management of Advanced Implant Surgery Complications: A Comparative Clinical Study

Nowadays, implant insertion is accompanied by undesired consequences. As surgery techniques become more and more complex, an increase of intra- and post-op complications can be expected. Application of low-level laser (LLL) is one of the conservative approaches to control the complications with any side effects and low treatment costs. The present study aimed to evaluate the effect of 650 nm LLL irradiation on the reduction of complications after advanced implant surgeries. In this triple-blinded clinical trial, 30 patients aged between 25 to 65 years were in need of bone graft or sinus lift procedure for simultaneously implant insertion. In the LLL treatment group, the surgical site of each implant was treated with 650 nm laser. The same method and duration were applied in the placebo group. The pain levels, facial swelling, and wound healing were evaluated. This study indicated that pain levels were reduced in the laser group (p <0.05). Also, facial swelling in the 3rd and 7th day after the surgery relieved more in laser group. Furthermore, investigation of the surgical site showed a higher level of wound healing in the laser group (p <0.05). Regarding the biological effects of advanced implant surgeries and accompanying complications, adjuvant treatment with a laser could significantly improve wound healing and reduce the severity and duration of pain and swelling. This clinical trial demonstrates reductions of the level of pain, facial swelling and improvements of wound healing are followed by the use of low-level laser therapy.

The effect of low-level laser therapy after simple tooth extraction

Aims and Objectives: The purpose of this study is to assess the use of low-level laser therapy (LLLT) on pain, discomfort, bleeding, and clot formation inside the socket after extraction the upper anterior teeth of healthy adult patients. Materials and Methods: Twenty patients, their age 15–60-year-old, were used in this current study. Patients were randomly separated into two groups; each group has 10 patients using the same surgical protocol for both groups. Immediately after the extraction, the laser group received low power laser therapy intraorally using a diode laser 940nm and 0.8 W power output in continuous mode with exposure time ranging 15–60s. All patients were given postoperative recommendation. Variable parameters were evaluated after teeth extraction for 7 days including pain, discomfort, and bleeding. Data analysis was achieved by using the Statistical Package for the Social Sciences statistics Version 21. Results: The pain scores in the laser group revealed significant difference (P = 0.001). There was found a significant difference only in the 5th day (P < 0.05) postoperatively when comparing the pain level between the two groups. The study results also showed a significant decreased level of discomfort in the second group (laser group), while the level of discomfort in the first group (control group) was not significant. On the 1st day up to the 5th, 6th, and 7th day (P < 0.05), postoperatively, there were significant differences when comparing the discomfort level between the two groups. Bleeding score was significant between the two groups (P = 0.001). Conclusion: Using a diode laser 940nm with 0.8 W (output power) in continuous mode, as LLLT has a significant effect in reducing pain, discomfort, and bleeding levels with the formation of a stable blood clot inside the tooth socket.

Acute effects of photobiomodulation therapy (PBMT) combining laser diodes, light-emitting diodes, and magnetic field in exercise capacity assessed by 6MST in patients with COPD: a crossover, randomized, and triple-blinded clinical trial.

Chronic obstructive pulmonary disease (COPD) is characterized by dyspnea, as well as musculoskeletal and systemic manifestations. Photobiomodulation therapy (PBMT) with use of low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) is an electrophysical intervention that has been found to minimize or delay muscle fatigue. The aim of this study was to evaluate the acute effect of PBMT with combined use of lasers diodes, light-emitting diodes (LEDs), magnetic field on muscle performance, exercise tolerance, and metabolic variables during the 6-minute stepper test (6MST) in patients with COPD. Twenty-one patients with COPD (FEV1 46.3% predicted) completed the 6MST protocol over 2weeks, with one session per week. PBMT/magnetic field or placebo (PL) was performed before each 6MST (17 sites on each lower limb, with a dose of 30J per site, using a cluster of 12 diodes 4 × 905nm super-pulsed laser diodes, 4 × 875nm infrared LEDs, and 4 × 640nm red LEDs; Multi Radiance Medical™, Solon, OH, USA). Patients were randomized into two groups before the test according to the treatment they would receive. Assessments were performed before the start of each protocol. The primary outcomes were oxygen uptake and number of steps, and the secondary outcome was perceived exertion (dyspnea and fatigue in the lower limbs). PBMT/magnetic field applied before 6MST significantly increased the number of steps during the cardiopulmonary exercise test when compared to the results with placebo (129.8 ± 10.6 vs 116.1 ± 11.5, p = 0.000). PBMT/magnetic field treatment also led to a lower score for the perception of breathlessness (3.0 [1.0-7.0] vs 4.0 [2.0-8.0], p = 0.000) and lower limb fatigue (2.0 [0.0-5.0] vs 4.0 [0.0-7.0], p = 0.001) compared to that with placebo treatment. This study showed that the combined application of PBMT and magnetic field increased the number of steps during the 6MST and decreased the sensation of dyspnea and lower limb fatigue in patients with COPD.

Use of Low-Level Laser Therapy as a Treatment Proposal for Oral Lichen Planus in Children

Use of Low-Level Laser Therapy as a Treatment Proposal for Oral Lichen Planus in Children

A pilot study of laser energy transmission through bone and gingiva

BackgroundThe use of low-level laser therapy is growing in the field of dentistry especially in orthodontics to speed up tooth movement and in implantology to aid osseointegration. In these dental applications, the laser energy needs to penetrate through the periodontium to the target site to stimulate photobiomodulation. The percentage of energy loss when laser is transmitted through the periodontium has not been previously studied. With the use of an 808-nanometer diode laser, the aim was to investigate the percentage loss of laser energy when transmitted through the periodontium to the extraction socket. MethodsThe percentage energy loss of an 808-nm diode laser through the periodontium was measured in 27 tooth sockets by using a specifically designed photodiode ammeter. ResultsFor each millimeter of increased bone thickness there was 6.81% reduction in laser energy (95% confidence interval, 5.02% to 8.60%). The gingival thickness had no statistically significant effect on energy penetration. ConclusionEnergy penetration depends markedly on bone thickness and is independent of gingival thickness. Practical ImplicationsTo the best of the authors’ knowledge, this study is one of the first to investigate laser penetration through the periodontium. Evidence from this study showed that laser energy penetration through the periodontium is markedly affected by bone thickness but less so by gingival thickness. Clinicians need to be aware of the biological factors that could affect laser energy penetration to the target site and adjust their laser dosages accordingly. These findings may guide dental practitioners in selecting the appropriate laser dosage parameters for low-level laser therapy.

Administration of low-level laser on muscles of mastication following the induction of initial fatigue: protocol for a randomized, controlled, clinical trial.

Background:Orofacial pain encompasses painful conditions, such as temporomandibular disorder (TMD). Multidisciplinary health teams seek to control such musculoskeletal disorders to improve the quality and functional capacity of the muscles of mastication. The aim of the proposed study is to evaluate the effect of low-level laser therapy as a form of treatment for the prevention of initial fatigue of the muscles of mastication (masseter and anterior temporal muscles) as well as the recovery of these muscles after induced exhaustion (caused by isometric contraction) in young adults.Methods:The participants will be 78 healthy male and female volunteers between 18 and 34 years of age. The volunteers will be randomly allocated to a laser group (n = 26), sham group (n = 26), and control group (n = 26). All participants will be submitted to a clinical evaluation to record mandibular movements, bite force, muscle sensitivity to palpation, and initial muscle fatigue. Initial fatigue will be induced by isometric contraction of the jaws. Maximum voluntary contraction will be performed to record the time until initial exhaustion of the masseter muscle (determined by electromyography). The groups will then be submitted to the interventions: active laser therapy (wavelength: 780 nm; fluence: 134 J/cm2; power: 50 mW; irradiance: 1.675 W/cm2; exposure time: 80 seconds per point) on 3 points of the masseter and 1 point on the anterior temporal muscles on each side; sham laser (placebo effect); or no intervention (control). Maximum voluntary contraction will be performed again after the interventions to record the time until initial exhaustion of the masseter muscle (determined by electromyography). Differences in individual time until exhaustion between the pre- and postintervention evaluations will be measured to determine the effect of low-level laser therapy.Discussion:Although studies have been made with the use of low-level laser therapy in TMDs and on the effect of photobiomodulation on fatigue, this the first study to test this therapy in the prevention of fatigue in this region. The clinical relevance lies in the fact that longer dental procedures could take place if the patients are less prone to fatigue.