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Comparative study of the physiotherapeutic and drug protocol and low-level laser irradiation in the treatment of pain associated with temporomandibular dysfunction
Cavalcanti MFXB, Silva UH, Leal-Junior ECP, Lopes-Martins RAB, Marcos RL, Pallotta RC, Diomede F, Trubiani O, de Isla N, Frigo L
Photomedicine and Laser Surgery 2016 Dec;34(12):652-656
clinical trial
1/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The temporomandibular joint (TMJ) is a structure of the craniofacial complex affected by neurological diseases. Orthopedic and musculoskeletal changes can also cause temporomandibular disorders (TMD) and pain. Low-level laser (LLL) therapy has been studied in the treatment of temporomandibular jaw (TMJ) dysfunction, and controversial results were obtained. OBJECTIVE: The objective of this work was comparing the physiotherapeutic and drug protocol (PDP) to LLL therapy in the treatment of pain associated with TMD. METHODS: A sample of 60 female patients, 20 to 50 years of age, TMD triggering agents (stress, parafunctional habits) controlled, was randomly divided into three groups, group 1 (G1) -- LLL (780nm laser, dose of 35.0 J/cm2, for 20 sec, thrice a week, for 4 weeks); group 2 (G2) -- PDP (hot packs thrice a day, morning, afternoon, and evening, for 15 min, exercise of opening and closing the mouth, twice a day, myorelaxing and anti-inflammatory drug administration); and group 3 (G3) -- placebo (450 nm halogen lamp, Max LD Gnatus, light curing unit). RESULTS: Patients were evaluated every return appointment for the presence (P) or absence (A) of pain for 4 weeks and results were statistically analyzed. First week: 60% of G1, 100% G2, and 70% of G3-related pain. Second week: 55% of G1, 15% of G2, and 100% of G3-related pain. Third week: 10% of G1, 15% of G2, and 85% of G3-related pain. Last week: 0% of G1, 0% of G2, and 100% of G3-related pain. CONCLUSIONS: Based on obtained data, we concluded that, compared to PDP, LLL treatment is effective to control pain associated with TMD.

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