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Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial.
- Source :
-
Brazilian oral research [Braz Oral Res] 2018 Jul 10; Vol. 32, pp. e50. Date of Electronic Publication: 2018 Jul 10. - Publication Year :
- 2018
-
Abstract
- The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
- Subjects :
- Adult
Aged
Anxiety physiopathology
Anxiety prevention & control
Chronic Pain physiopathology
Chronic Pain psychology
Chronic Pain therapy
Combined Modality Therapy methods
Depression physiopathology
Depression prevention & control
Female
Follow-Up Studies
Humans
Jaw physiopathology
Male
Masticatory Muscles physiopathology
Middle Aged
Pain Management methods
Pain Measurement
Reference Values
Reproducibility of Results
Surveys and Questionnaires
Temporomandibular Joint Disorders physiopathology
Temporomandibular Joint Disorders psychology
Time Factors
Treatment Outcome
Visual Analog Scale
Young Adult
Low-Level Light Therapy methods
Musculoskeletal Manipulations methods
Temporomandibular Joint Disorders therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1807-3107
- Volume :
- 32
- Database :
- MEDLINE
- Journal :
- Brazilian oral research
- Publication Type :
- Academic Journal
- Accession number :
- 29995062
- Full Text :
- https://doi.org/10.1590/1807-3107bor-2018.vol32.0050