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Published in: Lasers in Medical Science 3/2022

01-04-2022 | Laser | Original Article

Effect of oral exercises and photobiomodulation therapy in the rehabilitation of patients with mandible fractures: randomized double-blind clinical trial

Authors: Karoline Weber dos Santos, Fernando Neves Hugo, Esther da Cunha Rodrigues, Airton Tetelbom Stein, Juliana Balbinot Hilgert

Published in: Lasers in Medical Science | Issue 3/2022

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Abstract

Mandible fractures compromise stomatognathic functions, requiring rehabilitation. Evaluate the effectiveness of photobiomodulation (PBM) associated with oral exercises for rehabilitation of patients with mandible fractures. In this randomized clinical trial, we compared PBM with PBM sham in 14 adults with mandibular fractures who underwent surgical intervention. The sessions were performed 24 h and 48 h after surgical procedure, and weekly for 4 weeks after hospital discharge. Both groups performed oral exercises after each PBM session. Restriction of food consistencies, mandibular mobility, pain, and facial sensitivity measured before and after the surgical procedure were the outcomes evaluated, one and 3 months after surgery. Maximum interincisal distances (MID), exercise pain, and restriction of food consistencies were also evaluated during each week of intervention. Both groups showed normal MID (> 35 mm) and food consistencies consumed 1 month after the surgical procedure, with no significant differences between them. Individuals in the PBM group had less pain response to exercise during all the weeks of intervention than the sham group (p < 0.05). The patients presented a reduction in the painful response in MID and mandibular laterality movements 1 month after surgery compared to the preoperative period. In contrast, there was an improvement in laterality in the sham group only 3 months postoperatively and persistent pain in MID. There was no significant difference in facial sensitivity within and between groups during follow-up. The performance of oral exercises associated with PBM effectively facilitated the early rehabilitation of oral functions, with significant gains in pain management.
Literature
1.
go back to reference da Silva AP, Sassi FC, Bastos E, Alonso N, de Andrade CRF (2017) Oral motor and electromyographic characterization of adults with facial fractures: a comparison between different fracture severities. Clinics 72(5):276–283CrossRef da Silva AP, Sassi FC, Bastos E, Alonso N, de Andrade CRF (2017) Oral motor and electromyographic characterization of adults with facial fractures: a comparison between different fracture severities. Clinics 72(5):276–283CrossRef
2.
go back to reference Pepato AO, Palinkas M, Regalo SC, de Medeiros EH, de Vasconcelos PB, Sverzut CE, Siéssere S, Trivellato AE (2014) Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility. J Craniofac Surg 25(5):1714–20CrossRef Pepato AO, Palinkas M, Regalo SC, de Medeiros EH, de Vasconcelos PB, Sverzut CE, Siéssere S, Trivellato AE (2014) Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility. J Craniofac Surg 25(5):1714–20CrossRef
3.
go back to reference Lauriti L, de Cerqueira Luz JG, AgnelliMesquita-Ferrari R, Fernandes KPS, Deana AM, TempestiniHorliana ACR, Bussadori SK (2018) Evaluation of the effect of phototherapy in patients with mandibular fracture on mandibular dynamics, pain, edema, and bite force: a pilot study. Photomed Laser Surg 36(1):24–30CrossRef Lauriti L, de Cerqueira Luz JG, AgnelliMesquita-Ferrari R, Fernandes KPS, Deana AM, TempestiniHorliana ACR, Bussadori SK (2018) Evaluation of the effect of phototherapy in patients with mandibular fracture on mandibular dynamics, pain, edema, and bite force: a pilot study. Photomed Laser Surg 36(1):24–30CrossRef
4.
go back to reference Bohluli B, Mohammadi E, Oskui IZ, Moharamnejad N (2019) Treatment of mandibular angle fracture: revision of the basic principles. Chin J Traumatol 22(2):117–119CrossRef Bohluli B, Mohammadi E, Oskui IZ, Moharamnejad N (2019) Treatment of mandibular angle fracture: revision of the basic principles. Chin J Traumatol 22(2):117–119CrossRef
5.
go back to reference Cornelius CP, Audigé L, Kunz C, Rudderman R, Buitrago-Téllez CH, Frodel J, Prein J (2014) The comprehensive AOCMF classification system: mandible fractures-level 3 tutorial. Craniomaxillofac Trauma Reconstr 7(Suppl 1):S031-43PubMedPubMedCentral Cornelius CP, Audigé L, Kunz C, Rudderman R, Buitrago-Téllez CH, Frodel J, Prein J (2014) The comprehensive AOCMF classification system: mandible fractures-level 3 tutorial. Craniomaxillofac Trauma Reconstr 7(Suppl 1):S031-43PubMedPubMedCentral
6.
go back to reference Dos Santos KW, Rech RS, Wendland EMDR, Hilgert JB (2020) Rehabilitation strategies in maxillofacial trauma: systematic review and meta-analysis. Oral Maxillofac Surg 24(1):1–10CrossRef Dos Santos KW, Rech RS, Wendland EMDR, Hilgert JB (2020) Rehabilitation strategies in maxillofacial trauma: systematic review and meta-analysis. Oral Maxillofac Surg 24(1):1–10CrossRef
7.
go back to reference Vincent AG, Ducic Y, Kellman R (2019) Fractures of the mandibular condyle. Facial Plast Surg 35(6):623–626CrossRef Vincent AG, Ducic Y, Kellman R (2019) Fractures of the mandibular condyle. Facial Plast Surg 35(6):623–626CrossRef
8.
go back to reference Santos MT, Diniz MB, Gouw-Soares SC, Lopes-Martins RA, Frigo L, Baeder FM (2016) Evaluation of low-level laser therapy in the treatment of masticatory muscles spasticity in children with cerebral palsy. J Biomed Opt 21(2):28001CrossRef Santos MT, Diniz MB, Gouw-Soares SC, Lopes-Martins RA, Frigo L, Baeder FM (2016) Evaluation of low-level laser therapy in the treatment of masticatory muscles spasticity in children with cerebral palsy. J Biomed Opt 21(2):28001CrossRef
9.
go back to reference de Godoy CHL, Motta LJ, Steagall Júnior W, Gonçalves MLL, Teixeira da Silva DF, Mesquita-Ferrari RA, BrugneraJúnior A, Bussadori SK (2018) Effect of phototherapy on masseter and anterior temporal muscles before induction of fatigue: a randomized, sham-controlled, blind clinical trial. Photomed Laser Surg 36(7):370–376CrossRef de Godoy CHL, Motta LJ, Steagall Júnior W, Gonçalves MLL, Teixeira da Silva DF, Mesquita-Ferrari RA, BrugneraJúnior A, Bussadori SK (2018) Effect of phototherapy on masseter and anterior temporal muscles before induction of fatigue: a randomized, sham-controlled, blind clinical trial. Photomed Laser Surg 36(7):370–376CrossRef
10.
go back to reference Neto FCJ, Martimbianco ALC, de Andrade RP, Bussadori SK, Mesquita-Ferrari RA, Fernandes KPS (2020) Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials. Lasers Med Sci 35(3):513–522CrossRef Neto FCJ, Martimbianco ALC, de Andrade RP, Bussadori SK, Mesquita-Ferrari RA, Fernandes KPS (2020) Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials. Lasers Med Sci 35(3):513–522CrossRef
11.
go back to reference Santinoni CD, Oliveira HF, Batista VE, Lemos CA, Verri FR (2017) Influence of low-level laser therapy on the healing of human bone maxillofacial defects: a systematic review. J Photochem Photobiol B 169:83–89CrossRef Santinoni CD, Oliveira HF, Batista VE, Lemos CA, Verri FR (2017) Influence of low-level laser therapy on the healing of human bone maxillofacial defects: a systematic review. J Photochem Photobiol B 169:83–89CrossRef
12.
go back to reference Pol R, Gallesio G, Riso M, Ruggiero T, Scarano A, Mortellaro C, Mozzati M (2016) Effects of superpulsed, low-level laser therapy on neurosensory recovery of the inferior alveolar nerve. J Craniofac Surg 27(5):1215–1219CrossRef Pol R, Gallesio G, Riso M, Ruggiero T, Scarano A, Mortellaro C, Mozzati M (2016) Effects of superpulsed, low-level laser therapy on neurosensory recovery of the inferior alveolar nerve. J Craniofac Surg 27(5):1215–1219CrossRef
13.
go back to reference Carvalho FR, Barros RQ, Gonçalves AS, Freitas PM (2019) Photobiomodulation therapy on the palliative care of temporomandibular disorder and orofacial/cervical skull pain: study protocol for a randomized controlled clinical trial. Trials 6 20(1):200CrossRef Carvalho FR, Barros RQ, Gonçalves AS, Freitas PM (2019) Photobiomodulation therapy on the palliative care of temporomandibular disorder and orofacial/cervical skull pain: study protocol for a randomized controlled clinical trial. Trials 6 20(1):200CrossRef
14.
go back to reference Schulz KF, Altman DG, Moher D; CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 23(340):c332 Schulz KF, Altman DG, Moher D; CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 23(340):c332
15.
go back to reference Shetty V, Atchison K, Leathers R, Black E, Zigler C, Belin TR (2008) Do the benefits of rigid internal fixation of mandible fractures justify the added costs? Results from a randomized controlled trial. J Oral Maxillofac Surg 66(11):2203–2212CrossRef Shetty V, Atchison K, Leathers R, Black E, Zigler C, Belin TR (2008) Do the benefits of rigid internal fixation of mandible fractures justify the added costs? Results from a randomized controlled trial. J Oral Maxillofac Surg 66(11):2203–2212CrossRef
16.
go back to reference de Felício CM, Medeiros AP, de Oliveira MM (2012) Validity of the ‘protocol of oro-facial myofunctional evaluation with scores’ for young and adult subjects. J Oral Rehabil 39(10):744–753CrossRef de Felício CM, Medeiros AP, de Oliveira MM (2012) Validity of the ‘protocol of oro-facial myofunctional evaluation with scores’ for young and adult subjects. J Oral Rehabil 39(10):744–753CrossRef
17.
go back to reference Cichero JA, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, Duivestein J, Kayashita J, Lecko C, Murray J, Pillay M, Riquelme L, Stanschus S (2017) Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework. Dysphagia 32(2):293–314CrossRef Cichero JA, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, Duivestein J, Kayashita J, Lecko C, Murray J, Pillay M, Riquelme L, Stanschus S (2017) Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework. Dysphagia 32(2):293–314CrossRef
18.
go back to reference Bell-Krotoski J, Weinstein S, Weinstein C (1993) Testing sensitivity, including touch-pressure, two-point discrimination, point localization, and vibration. J Hand Ther 6(2):114–123CrossRef Bell-Krotoski J, Weinstein S, Weinstein C (1993) Testing sensitivity, including touch-pressure, two-point discrimination, point localization, and vibration. J Hand Ther 6(2):114–123CrossRef
19.
go back to reference Angeletti P, Pereira MD, Gomes HC, Hino CT, Ferreira LM (2010) Effect of low-level laser therapy (GaAlAs) on bone regeneration in midpalatal anterior suture after surgically assisted rapid maxillary expansion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(3):e38-46CrossRef Angeletti P, Pereira MD, Gomes HC, Hino CT, Ferreira LM (2010) Effect of low-level laser therapy (GaAlAs) on bone regeneration in midpalatal anterior suture after surgically assisted rapid maxillary expansion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(3):e38-46CrossRef
21.
go back to reference Aras MH, Güngörmüş M (2010) Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)–intraoral and extraoral–on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci 25(5):641–645CrossRef Aras MH, Güngörmüş M (2010) Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)–intraoral and extraoral–on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci 25(5):641–645CrossRef
22.
go back to reference Ylinen J, Kautiainen H, Wirén K, Häkkinen A (2007) Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med 39(2):126–132CrossRef Ylinen J, Kautiainen H, Wirén K, Häkkinen A (2007) Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med 39(2):126–132CrossRef
23.
go back to reference Miernik M, Wieckiewicz M, Paradowska A, Wieckiewicz W (2012) Massage therapy in myofascial TMD pain management. Adv Clin Exp Med 21(5):681–685PubMed Miernik M, Wieckiewicz M, Paradowska A, Wieckiewicz W (2012) Massage therapy in myofascial TMD pain management. Adv Clin Exp Med 21(5):681–685PubMed
24.
go back to reference Bianchini EMG, Mangilli LD, Marzotto SR, Nazário D (2004) Patients with facial trauma: characterization, applicability and results of an specific speech treatment. Rev CEFAC 6(4):388–395 Bianchini EMG, Mangilli LD, Marzotto SR, Nazário D (2004) Patients with facial trauma: characterization, applicability and results of an specific speech treatment. Rev CEFAC 6(4):388–395
25.
go back to reference Machado BC, Mazzetto MO, Da Silva MA, de Felício CM (2016) Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 31(5):945–954CrossRef Machado BC, Mazzetto MO, Da Silva MA, de Felício CM (2016) Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 31(5):945–954CrossRef
26.
go back to reference Anders JJ, Lanzafame RJ, Arany PR (2015) Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg 33(4):183–184CrossRef Anders JJ, Lanzafame RJ, Arany PR (2015) Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg 33(4):183–184CrossRef
27.
go back to reference Peplow PV, Chung TY, Baxter GD (2012) Photodynamic modulation of wound healing: a review of human and animal studies. Photomed Laser Surg 30(3):118–48CrossRef Peplow PV, Chung TY, Baxter GD (2012) Photodynamic modulation of wound healing: a review of human and animal studies. Photomed Laser Surg 30(3):118–48CrossRef
28.
go back to reference Ankri R, Lubart R, Taitelbaum H (2010) Estimation of the optimal wavelengths for laser-induced wound healing. Lasers Surg Med. 42(8):760–4CrossRef Ankri R, Lubart R, Taitelbaum H (2010) Estimation of the optimal wavelengths for laser-induced wound healing. Lasers Surg Med. 42(8):760–4CrossRef
29.
go back to reference Ferraresi C, Hamblin MR, Parizotto NA (2012) Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light. Photonics Lasers Med 1 1(4):267–286 Ferraresi C, Hamblin MR, Parizotto NA (2012) Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light. Photonics Lasers Med 1 1(4):267–286
Metadata
Title
Effect of oral exercises and photobiomodulation therapy in the rehabilitation of patients with mandible fractures: randomized double-blind clinical trial
Authors
Karoline Weber dos Santos
Fernando Neves Hugo
Esther da Cunha Rodrigues
Airton Tetelbom Stein
Juliana Balbinot Hilgert
Publication date
01-04-2022
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 3/2022
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-021-03423-w

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