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Immediate and short-term effects of phototherapy on pain, muscle activity, and joint mobility in women with temporomandibular disorder: a randomized, double-blind, placebo-controlled, clinical trial [with consumer summary]
Herpich CM, Leal-Junior ECP, Gomes CAFP, Gloria IPS, Amaral AP, Amaral MFRS, Politti F, Biasotto-Gonzalez DA
Disability and Rehabilitation 2018;40(19):2318-2324
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The aim of the present study was to evaluate the immediate and short-term effects of phototherapy on pain intensity, the pressure pain threshold (PPT), maximum vertical mandibular movement, and the electrical activity of the masseter and temporal muscles in women with temporomandibular disorder (TMD). METHODS: Sixty women were randomly allocated to four different groups and submitted to phototherapy with a combination of super-pulsed laser (905 nm), red (640 nm), and infrared (875 nm) light emitting diodes in the same equipment on the masseter (three points) and temporal (two points) muscles bilaterally in a single session. The following doses were used in each point of application: group 1 -- 2.62 J; group 2 -- 5.24 J; group 3 -- 7.86 J; placebo group. Pain intensity was determined using the visual analog scale. The PPT was analyzed using a digital algometer. Vertical mandibular movement was measured using digital calipers. Myoelectrical activity of the masseter and temporal muscles was measured using electromyography. Four evaluations were performed: pre-intervention, immediately after, 24 and 48 hours after phototherapy. OUTCOMES: A significant reduction in pain intensity during the post-treatment evaluations in comparison to the pretreatment evaluation was observed in group 1 (median difference 2.60 (95% CI 1.35 to 3.85)) and group 2 (median difference 2.2 (95% CI 0.98 to 3.42)) especially after 48 hours and group 3 (median difference 2.50 (95% CI 0.56 to 4.46)) especially after 24 hours, with a moderate effect size, but no effect was found regarding the other variables. CONCLUSIONS: A single session of combined phototherapy was capable of reducing pain intensity in individuals patients with TMD. ClinicalTrials.gov (NCT02018770).

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