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Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

Photobiomodulation versus light-emitting diode (LED) therapy in the treatment of temporomandibular disorder: study protocol for a randomized, controlled clinical trial

Authors: Luciana G. Langella, Paula F. C. Silva, Larissa Costa-Santos, Marcela L. L. Gonçalves, Lara J. Motta, Alessandro M. Deana, Kristianne P. S. Fernandes, Raquel A. Mesquita-Ferrari, Sandra Kalil Bussadori

Published in: Trials | Issue 1/2018

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Abstract

Background

Temporomandibular disorder (TMD) is described as a subgroup of orofacial pain with a set of signs and symptoms that involve the temporomandibular joint, masticatory muscles, ears, and neck. TMD can occur unilaterally or bilaterally and approximately 70% of the population is affected with at least one sign. The disorder progresses with orofacial pain, muscle pain involving the masticatory and cervical muscles, joint noises (clicks and pops), joint block, mandibular dysfunction, and headache. The etiology can be abnormal occlusion and/or posture, trauma involving local tissues, repetitive microtrauma, parafunctional habits, and an increase in emotional stress. Studies have demonstrated that phototherapy is an efficient option for the treatment of TMD, leading to improvements in pain and orofacial function.

Methods

The aim of the proposed study is to compare the effects of two sources of photobiomodulation in individuals with TMD. A randomized, controlled, double-blind, clinical trial is proposed, which will involve 80 individuals aged 18–65 years allocated to either a laser group or light-emitting diode (LED) group submitted to 12 sessions of phototherapy. The Research Diagnostic Criteria for TMDs will be used to evaluate all participants. Pain will be measured using the visual analog scale and maximum vertical mandibular movement will be determined with the aid of digital calipers.

Discussion

This study compares the effects of two modalities of laser therapy on the pain and orofacial function of patients with TMD dysfunction. Photobiomodulation and LED therapy are treatment options for reducing the inflammatory process and pain as well as inducing the regeneration of the target tissue.

Trial registration

ClinicalTrials.gov, NCT03257748. Registered on 8 August 2017.
Appendix
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Literature
1.
go back to reference Dostolová T, Hlinakova P, Kasparova M, Rehacek A, Vavrichova L, Navratil L. Effectiveness of physiotherapy disorders and GaAIAs laser in the management of temporomandibular joint. Photomed Laser Surg. 2012;30(5):275–80.CrossRef Dostolová T, Hlinakova P, Kasparova M, Rehacek A, Vavrichova L, Navratil L. Effectiveness of physiotherapy disorders and GaAIAs laser in the management of temporomandibular joint. Photomed Laser Surg. 2012;30(5):275–80.CrossRef
2.
go back to reference Biasotto-Gonzalez DA. Abordageminterdisciplinar das disfunçõestemporomandibulares. Barueri: Manole; 2005. Biasotto-Gonzalez DA. Abordageminterdisciplinar das disfunçõestemporomandibulares. Barueri: Manole; 2005.
3.
go back to reference de Godoy CHL, Silva PFC, Araujo DS, Motta LJ, Biasotto-Gonzalez DA, Politti F, et al. Evaluation of effect of low-level laser therapy on adolescents with temporomandibular disorder: study protocol for a randomized controlled trial. Trials. 2013;14:229–34.CrossRef de Godoy CHL, Silva PFC, Araujo DS, Motta LJ, Biasotto-Gonzalez DA, Politti F, et al. Evaluation of effect of low-level laser therapy on adolescents with temporomandibular disorder: study protocol for a randomized controlled trial. Trials. 2013;14:229–34.CrossRef
4.
go back to reference Pereira TS, Flecha OD, Guimarães RC, de Oliveira D, Botelho AM, Glória JCR, et al. Efficacy of red and infrared lasers in treatment of temporomandibular disorders- a double-blind, randomized, parallel clinical trial. Cranio. 2014;32(1):51–6.CrossRef Pereira TS, Flecha OD, Guimarães RC, de Oliveira D, Botelho AM, Glória JCR, et al. Efficacy of red and infrared lasers in treatment of temporomandibular disorders- a double-blind, randomized, parallel clinical trial. Cranio. 2014;32(1):51–6.CrossRef
5.
go back to reference Salmos-Brito JAL, Menezes RF, Teixeira CEC, Gonzaga RKM, Rodrigues BHM, Braz R, et al. Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders. Lasers Med Sci. 2013;28:57–64.CrossRef Salmos-Brito JAL, Menezes RF, Teixeira CEC, Gonzaga RKM, Rodrigues BHM, Braz R, et al. Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders. Lasers Med Sci. 2013;28:57–64.CrossRef
6.
go back to reference IASP. Classification of chronic pain: descriptors of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP; 1994. IASP. Classification of chronic pain: descriptors of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP; 1994.
7.
go back to reference Mazzetto MO, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, Mazzetto RG. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio. 2007;25:186–92.CrossRef Mazzetto MO, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, Mazzetto RG. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio. 2007;25:186–92.CrossRef
8.
go back to reference Andrade TNC, Frare JC. Estudocomparativo entre osefeitos de técnicas de terapia manual isoladas e associadas à laserterapia de baixapotênciasobre a dorempacientes com disfunção temporomandibular. Rev Bras Fisioter. 2008;56(3):287–95. Andrade TNC, Frare JC. Estudocomparativo entre osefeitos de técnicas de terapia manual isoladas e associadas à laserterapia de baixapotênciasobre a dorempacientes com disfunção temporomandibular. Rev Bras Fisioter. 2008;56(3):287–95.
9.
go back to reference Carrasco TG, Mazzeto MO, Mazatto RG, Mestriner Jr W. Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio. 2008;26(4):274–81.CrossRef Carrasco TG, Mazzeto MO, Mazatto RG, Mestriner Jr W. Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio. 2008;26(4):274–81.CrossRef
10.
go back to reference Gonçalves DA, Dal Fabbro AL, Campos JA, Bigal ME, Speciali JG. Symptoms of temporomandibular disorders in the population: an epidemiological study. J Orofac Pain. 2010;24:270–78.PubMed Gonçalves DA, Dal Fabbro AL, Campos JA, Bigal ME, Speciali JG. Symptoms of temporomandibular disorders in the population: an epidemiological study. J Orofac Pain. 2010;24:270–78.PubMed
11.
go back to reference Mazzetto MO, Hotta TH, de Andrade Pizzo RC. Measurements of jaw movements and TMJ pain intensity in patients treated with GaA1As laser. Braz Dent J. 2010;21(4):356–60.CrossRef Mazzetto MO, Hotta TH, de Andrade Pizzo RC. Measurements of jaw movements and TMJ pain intensity in patients treated with GaA1As laser. Braz Dent J. 2010;21(4):356–60.CrossRef
12.
go back to reference Sarlani E. Diagnosis and treatment of orofacial pain. Braz J Oral Sci. 2003;2:283–90. Sarlani E. Diagnosis and treatment of orofacial pain. Braz J Oral Sci. 2003;2:283–90.
13.
go back to reference Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol. 2003;32:114–18.CrossRef Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol. 2003;32:114–18.CrossRef
14.
go back to reference Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc. 1990;120(3):273–81.CrossRef Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc. 1990;120(3):273–81.CrossRef
15.
go back to reference Nassif NJ, Al-Salleeh F, Al-Admawi M. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among Young adult males. J Oral Rehabil. 2003;30:944–50.CrossRef Nassif NJ, Al-Salleeh F, Al-Admawi M. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among Young adult males. J Oral Rehabil. 2003;30:944–50.CrossRef
16.
go back to reference Frare JC, Nicolau RA. Análiseclínica do efeito da fotobiomodulação laser (GaAs-904 nm) sobre a disfunção temporomandibular. Rev Bras Fisioter. 2008;12(1):37–42.CrossRef Frare JC, Nicolau RA. Análiseclínica do efeito da fotobiomodulação laser (GaAs-904 nm) sobre a disfunção temporomandibular. Rev Bras Fisioter. 2008;12(1):37–42.CrossRef
17.
go back to reference Petrucci A, Sgolastra F, Gatto R, Mattei A, Monaco A. Effectiveness of low level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain. 2011;25(4):298–307.PubMed Petrucci A, Sgolastra F, Gatto R, Mattei A, Monaco A. Effectiveness of low level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain. 2011;25(4):298–307.PubMed
18.
go back to reference Gynther GW, Dijkgraaf LC, Reinholt FP, Holmlund AB, Liem RS, de Bont LG. Synovial inflammation in arthroscopically obtained biopsy specimens from the temporomandibular joint: A review of the literature and a proposed histologic grading system. J Oral Maxillofac Surg. 1998;56:1281–6.CrossRef Gynther GW, Dijkgraaf LC, Reinholt FP, Holmlund AB, Liem RS, de Bont LG. Synovial inflammation in arthroscopically obtained biopsy specimens from the temporomandibular joint: A review of the literature and a proposed histologic grading system. J Oral Maxillofac Surg. 1998;56:1281–6.CrossRef
19.
go back to reference Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, et al. Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci. 2011;27:71–8.CrossRef Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, et al. Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci. 2011;27:71–8.CrossRef
20.
go back to reference Panhoca VH, Lizarelli Rde F, Nunez SC, Pizzo RC, Grecco C, Paolillo FR, et al. Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy. Lasers Med Sci. 2015;30(2):815–22.CrossRef Panhoca VH, Lizarelli Rde F, Nunez SC, Pizzo RC, Grecco C, Paolillo FR, et al. Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy. Lasers Med Sci. 2015;30(2):815–22.CrossRef
21.
go back to reference Peter-Szabo M, Kekesi G, Nagy E, Sziver E, Benedek G, Horvath G. Quantitative characterization of a repeated acute joint inflammation model in rats. Clin Exp Pharmacol Physiol. 2007;34:520–26.CrossRef Peter-Szabo M, Kekesi G, Nagy E, Sziver E, Benedek G, Horvath G. Quantitative characterization of a repeated acute joint inflammation model in rats. Clin Exp Pharmacol Physiol. 2007;34:520–26.CrossRef
22.
go back to reference Yamazaki Y, Ren K, Shimada M, Iwata K. Modulation of paratrigeminal nociceptive neurons following temporomandibular joint inflammation in rats. Exp Neurol. 2008;214:209–18.CrossRef Yamazaki Y, Ren K, Shimada M, Iwata K. Modulation of paratrigeminal nociceptive neurons following temporomandibular joint inflammation in rats. Exp Neurol. 2008;214:209–18.CrossRef
23.
go back to reference Laakso E, Cramond T, Richardson C, Galligan J. Plasma ACTH and beta-endorphin levels in response to low-level laser therapy (LLLT) for myofascial trigger points. Laser Ther. 1994;6:133–42.CrossRef Laakso E, Cramond T, Richardson C, Galligan J. Plasma ACTH and beta-endorphin levels in response to low-level laser therapy (LLLT) for myofascial trigger points. Laser Ther. 1994;6:133–42.CrossRef
24.
go back to reference Vinck EM, Cagnie BJ, Cornelissen MJ, Declerq HA, Cambier DC. Increased fibroblast proliferation induced by light emitting diode and low power laser irradiation. Lasers Med Sci. 2003;18:89–94.CrossRef Vinck EM, Cagnie BJ, Cornelissen MJ, Declerq HA, Cambier DC. Increased fibroblast proliferation induced by light emitting diode and low power laser irradiation. Lasers Med Sci. 2003;18:89–94.CrossRef
25.
go back to reference Laakso E, Cabot PJ. Nociceptive scores and endorphin-containing cells reduced by low-level laser therapy (LLLT) in inflamed paws of Wistar rat. Photomed Laser Surg. 2005;23:32–5.CrossRef Laakso E, Cabot PJ. Nociceptive scores and endorphin-containing cells reduced by low-level laser therapy (LLLT) in inflamed paws of Wistar rat. Photomed Laser Surg. 2005;23:32–5.CrossRef
26.
go back to reference Brugnera JRA. Biomodulatory effect of laser therapy-clinical indications. Dentistry Braz Dent J. 2005;15(Suppl):60. Brugnera JRA. Biomodulatory effect of laser therapy-clinical indications. Dentistry Braz Dent J. 2005;15(Suppl):60.
27.
go back to reference Bjordal JM, Ljunggren AE, Klovning A, Slordal L. Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo-controlled trials. BMJ. 2004;329:1317.CrossRef Bjordal JM, Ljunggren AE, Klovning A, Slordal L. Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo-controlled trials. BMJ. 2004;329:1317.CrossRef
28.
go back to reference Bjordal J, Johnson MI, Lopes-Martins RA, Bogen B, Chow R, Ljunggren AE. Short-term efficacy of physical interventions in osteoarthritic knee pain: A systematic review and meta-analysis of randomised placebo controlled trials. BMC MusculoskeletDisord. 2007;8:51.CrossRef Bjordal J, Johnson MI, Lopes-Martins RA, Bogen B, Chow R, Ljunggren AE. Short-term efficacy of physical interventions in osteoarthritic knee pain: A systematic review and meta-analysis of randomised placebo controlled trials. BMC MusculoskeletDisord. 2007;8:51.CrossRef
Metadata
Title
Photobiomodulation versus light-emitting diode (LED) therapy in the treatment of temporomandibular disorder: study protocol for a randomized, controlled clinical trial
Authors
Luciana G. Langella
Paula F. C. Silva
Larissa Costa-Santos
Marcela L. L. Gonçalves
Lara J. Motta
Alessandro M. Deana
Kristianne P. S. Fernandes
Raquel A. Mesquita-Ferrari
Sandra Kalil Bussadori
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2444-7

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