Efficacy of Low-Level Laser Therapy In Treatment of Temporomandibular Myalgia: A Randomized Controlled trial.
Netshilindi, Neo, E.
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Background: Objective: The objective of the study was to compare pain and functional limitation of temporomandibular myalgia patients, before and after low-level-laser treatment (LLLT). Methods: This was a prospective, randomized, placebo-controlled, triple-blinded clinical study. Patients diagnosed with temporomandibular myalgia according to the DC/TMD protocol were recruited from the TMD clinic of the Mitchell’s Plain Oral Health Centre. Treatment was performed using diode laser (Sirolaser, Dentsply Sirona). The 3 regions of the masseter and temporalis muscles were treated bilaterally with a dose of 8J/cm2 per region. Pain and function were assessed using pain-free opening, numeric rating scales (NRS), Characteristic Pain Intensity Scores (CPIS), Interference Score (IS), and Jaw Functional Limitation Scale (JFLS) at the first and last LLLT and at 4-week recall (intervals 1, 2, 3). Statistical analysis was done by means of explorative categorical principal and multivariate interdependent analysis. Results: Seventeen (15 females) of the 19 patients completed the LLLT (89% retention). Mean pain-free opening increased for both treatment (A) and placebo (B) group (35.0 mm to 41.2mm; 34.8 mm to 37.9 mm respectively). This increase was not statistically significant between groups. All patients from group A reported less (n = 7) or similar pain (n = 2) with opening after treatment. For group B, 4 patients reported improvement, 1 no change and 3 worse pain with opening after treatment. Mean CPIS for groups A and B for the 3 time intervals were 69.63, 47.41, 34.07 and 70.42, 55.71, 52.92 respectively. Mean IS were 53.67, 32.22, 25.56 and 49.88, 40.48, 22.88 respectively. Global scores calculated from the JFLS for groups A and B for the 3 time intervals were 4.368, 3.380, 3.189 and 4.760, 4.396, 5.046 respectively. No effect between groups and no effect of time was statistically significant. Conclusions: Within the limitations of this trial, the laser group reported more improvement in mobility, pain experience and function but these improvements were not statistically significant.