Laser treatment for temporomandibular disorder: a randomized controlled clinical trial

Abstract

This study aimed to assess the impact of photobiomodulation therapy (PBMT) using low-level laser therapy, an occlusal splint (OS), and their combined application (OSL) on symptoms of muscular temporomandibular disorder (TMD) through a randomized clinical trial. Participants diagnosed with muscular TMD following the Diagnostic Criteria for TMD guidelines were allocated to three groups: OS, L, and OSL. The OS and OSL groups utilized the device during sleep, while PBMT (3 J/cm² per point) was applied to the L and OSL groups in 5 weekly sessions employing infrared light (808 nm). Pain levels were evaluated using the visual analogue scale (VAS), mandibular mobility was assessed via maximum unassisted mouth opening, and quality of life was measured using the Oral Health Impact Profile (OHIP-14). A total of 99 participants (OS: n = 34, L: n = 32, OSL: n = 33), including 80 women and 19 men with an average age of 31.54 ± 10.39 years, were enrolled. Significant pain reduction occurred in the L and OSL groups (p < 0.05), with the OSL group demonstrating higher effectiveness compared to the OS group within the initial two weeks (p < 0.05). Post-treatment, the L and OSL groups exhibited notable improvements in mandibular mobility, except during the final session (p < 0.05). All groups reported enhanced quality of life, with the L group achieving higher scores than the OS and OSL groups during reassessment (p < 0.05). Laser therapy effectively treated muscular TMD, both as a standalone therapy and in combination with the OS, particularly for immediate pain relief. The combination of therapies was important for maintaining stable symptom control over time.

Keywords: Conservative treatment; Low-level laser therapy; Occlusal splint; Quality of life; Temporomandibular joint disorder.