Effectiveness of Photobiomodulation and Manual Therapy Alone or Combined in TMD Patients (TMDPBMT)

Federal University of Rio Grande do Sul

Status and phase: Completed; Phase 2

Conditions: Temporomandibular Disorder

Treatments: Procedure: Manual Therapy (MT); Procedure: Photobiomodulation

Study type: Interventional

Funder types: Other

Identifiers

NCT03454581

PBM and MT TMD

Details and patient eligibility

About

The aim of the present study was to investigate the effect of photobiomodulation (PBM) and manual therapy (MT) isolated or combined in the reduce of pain, the improve of mandibular movements, the psychosocial aspects and the anxiety symptoms of patients with TMD.

Full description

Temporomandibular disorders (TMD) is a complex and multifactorial disease. Therapeutic modalities, as PBM and MT, expected to relief of symptoms, improve of function and reduce the impact of the disease in patient's life. Fifty-one TMD patients were randomly allocated to three groups: PBM group (n=18) using 808 nm, 100 milliwatt (mW), 13.3 J ∕cm2, 4 J per point), MT group (n=16) with 21 minutes sessions of MT of the masticatory muscles and TMJ and Combined Therapy group (CT) (n=17) applying the 2 protocol described above. All treatments were done three times a week for four consecutive weeks. Evaluations were performed at baseline, during the treatment (days 7, 14, 21, and 28) and follow up (day 60 and day 90). Visual analogue scale (VAS), Research Diagnostic Criteria (RDC/TMD) Axis I and II, Beck anxiety inventory (BAI) were used in different moments of evaluation time.

Enrollment: 51 patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• TMD myogenic and arthrogenic diagnosis based in RDC/TMD Axis I analysis
• Pain in temporomandibular joint (TMJ)
• Limitation in mouth opening.

Exclusion criteria

• Current dental or physical treatment
• Polyarthritis and other rheumatic diseases
• Use of anti-inflammatory and muscle relaxant

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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51 participants in 3 patient groups

Photobiomodulation group (PBM)

Experimental group

Description:

Gallium-aluminium-arsenide (GaAlAs) diode laser (MM Optics Recover, São Carlos, São Paulo, Brazil) with a wavelength of 808 nm, punctual contact mode,spot size of 0.03 cm2, power output of 100 mW, output density of 333 mW∕cm2, energy density of 13.3 J ∕cm2, 40 s exposure time per point, and 4 Joules (J) of total energy per point. 18 individuals

Treatment:

Procedure: Photobiomodulation

Manual Therapy group (MT)

Experimental group

Description:

At masticatory muscles were performed circular movements, slip and compression with fingers movements. At the temporomandibular joint (TMJ) was performed a caudal distraction with anterior projection, placing the thumb on the second or third molar. 16 individuals.

Treatment:

Procedure: Manual Therapy (MT)

Combined therapy group (CT)

Experimental group

Description:

Applied the protocols of PBM group and immediately after, to MT group. 17 individuals.

Treatment:

Procedure: Photobiomodulation

Procedure: Manual Therapy (MT)