Temporomandibular disorders (TMD) are common and it is estimated that up to 30% of adults will experience symptom of TMD at some point. TMD can affect the muscles of mastication or temporomandibular joint (TMJ) and associated structures.

Facial and jaw pain are common symptoms that can be aggravated by jaw movements. low-level laser therapy (LLLT) is a popular treatment for musculo-skeletal problems and has been used for TMD. The aim of this review was to investigate the analgesic effect of applying LLLT for TMJ pain.

Methods

Searches were conducted in Medline/PubMed and CINHAL databases for randomised controlled trials (RCTs) . Trials where diagnosis had been by physical examination and the control group had been treated without laser therapy or with a placebo were included. All articles are assessed using the Physiotherapy Evidence Database (PEDro) scale.

Results

• 7 RCTs were included with 6 studies involving 223 patients contributing to a meta-analysis.
• 4 studies found a positive effect on pain relief for LLLT.
• The meta-analysis found a statistically significant reduction in pain with a pooled effect size of -0.6 ( 95%CI, -0.73 to -0.47 p < 0.05)

Conclusions

The authors concluded

Use of LLLT on the masticatory muscle or joint capsule for TMJ pain had a moderate analgesic effect. The optimal parameters for LLLT to treat TMJ pain have not been confirmed.

Commentary

An earlier review of this topic was published by Petrucci et al in 2012 (Dental Elf 8^th Feb 2012) . That review searched a wider range of databases and included 6 studies. All six studies included in this reviews meta-analysis were published prior to 2012. In contrast to this reviews authors Petrucci  concluded that there was no evidence to support the effectiveness of LLLT for TMDs. While this review does suggest a small reduction in pain with the use of LLLT there is the question as to whether this clinically significant. Also the available studies are small so larger high quality RCTs are needed to answer this question.

Links

Chang WD, Lee CL, Lin HY, Hsu YC, Wang CJ, Lai PT. A Meta-analysis of Clinical Effects of Low-level Laser Therapy on Temporomandibular Joint Pain. J Phys Ther Sci. 2014 Aug;26(8):1297-300. doi: 10.1589/jpts.26.1297. Epub 2014 Aug 30. Review. PubMed PMID: 25202201; PubMed Central PMCID: PMC4155240.

Dental Elf – 8^th Feb 2012 – No evidence to support the effectiveness of low-level laser therapy for treatment of temporomandibular disorders

PEDro Scale