The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials

Nima Farshidfar; Golnoush Farzinnia; Nazafarin Samiraninezhad; Sahar Assar; Parsa Firoozi; Fahimeh Rezazadeh; Neda Hakimiha

doi:10.34172/jlms.2023.24

The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials

J Lasers Med Sci. 2023 Aug 5:14:e24. doi: 10.34172/jlms.2023.24. eCollection 2023.

Authors

Nima Farshidfar¹, Golnoush Farzinnia², Nazafarin Samiraninezhad³, Sahar Assar⁴, Parsa Firoozi⁵, Fahimeh Rezazadeh⁶, Neda Hakimiha⁷

Affiliations

¹ Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
² Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
⁵ School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran.
⁶ Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
⁷ Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. Methods: A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. Results: A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. Conclusion: This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm², and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.

Keywords: Low-level light therapy; Temporomandibular joint; Temporomandibular joint disk; Temporomandibular joint disorders.

Publication types

Review