Analysis of laser therapy and assessment methods in the rehabilitation of
temporomandibular disorder: a systematic review of the literature

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Abstract

The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: “temporomandibular joint laser therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD.

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Most cited references 32

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Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state.

M Helkimo (1974)

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A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.

Susan Armijo-Olivo, Margaret L McNeely, Timothy Magee (2006)

The purpose of this qualitative systematic review was to assess the evidence concerning the effectiveness of physical therapy interventions in the management of temporomandibular disorders. A literature search of published and unpublished articles resulted in the retrieval of 36 potential articles. Twelve studies met all selection criteria for inclusion in the review: 4 studies addressed the use of therapeutic exercise interventions, 2 studies examined the use of acupuncture, and 6 studies examined electrophysical modalities. Two studies provided evidence in support of postural exercises to reduce pain and to improve function and oral opening. One study provided evidence for the use of manual therapy in combination with active exercises to reduce pain and to improve oral opening. One study provided evidence in support of acupuncture to reduce pain when compared with no treatment; however, in another study no significant differences in pain outcomes were found between acupuncture and sham acupuncture. Significant improvements in oral opening were found with muscular awareness relaxation therapy, biofeedback training, and low-level laser therapy treatment. Most of the studies included in this review were of very poor methodological quality; therefore, the findings should be interpreted with caution.

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Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder.

Stephen Peterson, Luis Buenaver, Jodi Edwards … (2009)

We characterized sleep disorder rates in temporomandibular joint disorder (TMD) and evaluated possible associations between sleep disorders and laboratory measures of pain sensitivity. Research diagnostic examinations were conducted, followed by two consecutive overnight polysomnographic studies with morning and evening assessments of pain threshold. Orofacial pain clinic and inpatient sleep research facility. Fifty-three patients meeting research diagnostic criteria for myofascial TMD. N/A. We determined sleep disorder diagnostic rates and conducted algometric measures of pressure pain threshold on the masseter and forearm. Heat pain threshold was measured on the forearm; 75% met self-report criteria for sleep bruxism, but only 17% met PSG criteria for active sleep bruxism. Two or more sleep disorders were diagnosed in 43% of patients. Insomnia disorder (36%) and sleep apnea (28.4%) demonstrated the highest frequencies. Primary insomnia (PI) (26%) comprised the largest subcategory of insomnia. Even after controlling for multiple potential confounds, PI was associated with reduced mechanical and thermal pain thresholds at all sites (P < 0.05). Conversely, the respiratory disturbance index was associated with increased mechanical pain thresholds on the forearm (P < 0.05). High rates of PI and sleep apnea highlight the need to refer TMD patients complaining of sleep disturbance for polysomnographic evaluation. The association of PI and hyperalgesia at a nonorofacial site suggests that PI may be linked with central sensitivity and could play an etiologic role in idiopathic pain disorders. The association between sleep disordered breathing and hypoalgesia requires further study and may provide novel insight into the complex interactions between sleep and pain-regulatory processes.

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Author and article information

Journal

Journal ID (nlm-ta): J Phys Ther Sci

Journal ID (iso-abbrev): J Phys Ther Sci

Journal ID (publisher-id): JPTS

Title: Journal of Physical Therapy Science

Publisher: The Society of Physical Therapy Science

ISSN (Print): 0915-5287

ISSN (Electronic): 2187-5626

Publication date (Electronic): 09 January 2015

Publication date (Print): January 2015

Volume: 27

Issue: 1

Pages: 295-301

Affiliations

[1) ] Postgraduate Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE): Rua Profa Maria Jose Barone Fernandes, 300, Sao Paulo, SP, 02117-020, Brazil

[2) ] Postgraduate Program in Rehabilitation Sciences, Laboratory of Phototherapy in Sports and Exercise, University Nove de Julho (UNINOVE), Brazil

[3) ] Postgraduate Program in Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Brazil

[4) ] Graduation Phisical Therapy, Universidade Nove de Julho (UNINOVE), Brazil

[5) ] Program in Rehabilitation Sciences, Movement Analysis Research Support Center, University Nove de Julho (UNINOVE), Brazil

[6) ] Department of Physical Therapy Universidade Nove de Julho (UNINOVE), Brazil

Author notes

[* ]Corresponding author. Carolina Marciela Herpich (E-mail: carolinaherpich12@ 123456hotmail.com )

Article

Publisher ID: jpts-2014-313

DOI: 10.1589/jpts.27.295

PMC ID: 4305586

PubMed ID: 25642095

SO-VID: fa84088d-2cd7-4cc4-bb9c-466ab4926aee

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This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature

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Most cited references 32

Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state.

A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.

Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder.

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