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Randomized Controlled Trial
. 2025 Feb 6;29(2):118.
doi: 10.1007/s00784-025-06189-5.

Piano level laser therapy versus epidermal growth factor injection for painful myogenic temporomandibular disorder (a randomized clinical trial)

Passant Osama Qataya  1 , Azza Mohamed Zaki  2 , Fatma Amin  2 , Ahmed Swedan  3 , Hagar Elkafrawy  4
Affiliations
Randomized Controlled Trial

Piano level laser therapy versus epidermal growth factor injection for painful myogenic temporomandibular disorder (a randomized clinical trial)

Passant Osama Qataya et al. Clin Oral Investig. .

Abstract

Objective: The aim of this clinical trial was to evaluate the effectiveness of Piano level laser therapy using Nd-YAG laser and intramuscular EGF injection in pain alleviation, function, and quality of life improvement in patients suffering from myogenic TMD.

Materials and methods: A randomized clinical trial was performed on 29 patients suffering from chronic painful myogenic TMD based on diagnostic criteria for temporomandibular disorders. Group I (n = 13patients) was treated using 1064 nm Nd-YAG Laser (4 sessions once/week). Group II (n = 14 patients) was treated by intramuscular injection of EGF. Pain using numerical rating score, pain free opening and unassisted maximum opening were measured at baseline, 7,14,21 days, 1 and 3 months. Quality of life using OHIP-14 was assessed at baseline, 1 and 3 months.

Results: Results showed that there was a significant pain reduction (P < 0.000) and increase in pain free opening (P < 0.0001) in both test groups. However, only group I showed a significant increase in maximum opening (P = 0.007). Quality of life significantly improved in both groups (P = 0.0001). There was no significant difference between the two treatments in pain scores, pain free opening, maximum opening nor quality of life.

Conclusion: Both treatment modalities offered effective and cost-effective non- to minimally invasive treatment options for myogenic TMD with no side effects.

Clinical relevance: Myogenic TMD forms a public health issue and is a common musculoskeletal problem causing pain and disability. The proposal of effective, non-invasive, and affordable treatment options can help solve this issue.

Keywords: HILT; Injection; Non-invasive; Photobiomodulation.

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Conflict of interest statement

Declarations. Ethical approval: This clinical trial received the approval of the ethical committee of Faculty of Dentistry, Alexandria University, Egypt in December 2022. This clinical trial was registered at ClinicalTrials.gov Identifier: NCT06044974. Consent to participate: Participants of this clinical trial were treated according to the principles of the modified Helsinki’s code for human clinical studies [26]. Informed consent: An informed written consent was obtained from each patient before the start of the clinical procedures. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram following consort’s guidelines (2010)
Fig. 2
Fig. 2
Effect of treatment modalities on clinical pain scores using Numerical Rating Scale (NRS). Data are presented as mean (±) SD in response to treatment from baseline to weekly and monthly follow-ups. NRS = Numerical Rating Score. D = Day. EGF = Epidermal Growth Factor
Fig. 3
Fig. 3
Effect of treatment modalities on Pain Free Opening (PFO). Data are presented as mean and (±) SD of PFO in centimeters in response to treatment at baseline and weekly and monthly follow-ups. PFO = Pain Free Opening. EGF = Epidermal Growth Factor. D = Day
Fig. 4
Fig. 4
Effect of treatment modalities on Unassisted Maximum Mouth Opening (MO). Data are presented as mean and (±) SD of MO in centimeters in response to treatment modalities at baseline and during weekly and monthly follow-ups. MO = Maximum Mouth Opening. EGF = Epidermal Growth Factor. D = Day
Fig. 5
Fig. 5
Effect of treatment modalities on quality of life as measured by Oral Health Impact Profile (OHIP-14) questionnaire. Data are presented as mean and (±) SD of OHIP-14 scores in response to treatment modalities at baseline, 1- and 3-month follow-ups. OHIP = Oral Health Impact Profile-14 questionnaire. EGF = Epidermal Growth Factor
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