CoDAS
https://www.codas.org.br/article/doi/10.1590/2317-1782/20212021138
CoDAS
Revisão Sistemática

Effects of low-level laser photobiomodulation on the masticatory function and mandibular movements in adults with temporomandibular disorder: a systematic review with meta-analysis

Fotobiomodulação com laser de baixa potência na função mastigatória e nos movimentos mandibulares em adultos com disfunção temporomandibular: revisão sistemática com metanálise

Camila Fonsêca Guedes Pereira Máximo; Julyane Feitoza Coêlho; Silvia Damasceno Benevides; Giorvan Ânderson dos Santos Alves

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Abstract

Purpose

To review the effects of low-level laser photobiomodulation on masticatory function and mandibular movements in adults with temporomandibular disorder.

Research strategies

Search in PubMed, Web of Science, Scopus, EMBASE, Cochrane, LILACS, ScienceDirect, and Google Scholar, using the following descriptors: “temporomandibular joint disorders”, “low-level light therapy”, “low-level laser therapy”, “mastication”, and “mandible”.

Selection criteria

Randomized clinical trials in adults with temporomandibular disorder, using low-level laser and assessing the mastication and mandibular movements.

Data analysis

Firstly, the titles and abstracts of all retrieved studies were read. Then, only the studies selected in the first stage were read in full and assessed regarding eligibility. After the selection, the characteristics, methodological quality, and quality of evidence of the studies included in the review were analyzed. In the meta-analysis, the mean amplitude of mouth opening was considered as a measure of intervention effect.

Results

The 10 articles included in the review had quite different results one from the other, especially regarding the amplitude of mouth opening, while the mastication was assessed in only one of them. Most studies had a high risk of bias, demonstrating a low methodological quality. Significantly higher results for photobiomodulation were identified in the six studies included in the meta-analysis.

Conclusion

Due to the scarcity in the literature, there is not enough evidence of the effects of low-level laser photobiomodulation on mastication. As for the mandibular movements, this intervention presented significant results, particularly in the amplitude of mouth opening.

Keywords

Low-Level Light Therapy,; Temporomandibular Joint Dysfunction Syndrome,; Mastication,; Mandible,; Systematic Review

Resumo

Objetivo

Revisar os efeitos da Fotobiomodulação com Laser de Baixa Potência na função mastigatória e nos movimentos mandibulares, em adultos com Disfunção Temporomandibular.

Estratégia de pesquisa

Busca nas bases de dados PubMed, Web of Science, Scopus, Embase, Cochrane, Lilacs, Science Direct e Google Scholar, utilizando os descritores: “temporomandibular joint disorders”, “low level light therapy”, “low level laser therapy”, “mastication” e “mandible”.

Critérios de seleção

Ensaios clínicos randomizados envolvendo adultos com Disfunção Temporomandibular, que utilizaram laser de baixa potência e avaliaram a mastigação e os movimentos mandibulares.

Análise dos dados

Inicialmente realizou-se a leitura dos títulos e resumos de todos os estudos encontrados. Em seguida, apenas os estudos selecionados na primeira etapa foram lidos na íntegra e avaliados quanto à elegibilidade. Após a seleção, foram analisadas as características dos estudos incluídos, bem como a sua qualidade metodológica e da evidência. Na metanálise, a média da amplitude de abertura de boca foi considerada como medida de efeito da intervenção.

Resultados

Verificou-se que os dez artigos incluídos apresentaram resultados muito distintos entre si, principalmente com relação à amplitude de abertura de boca, sendo a mastigação avaliada em apenas um deles. A maioria dos estudos apresentou alto risco de viés, demonstrando uma baixa qualidade metodológica. Considerando os seis estudos incluídos na metanálise, foram identificados resultados significativamente superiores para a fotobiomodulação.

Conclusão

Devido à escassez na literatura, não há evidências suficientes para os efeitos da fotobiomodulação com laser de baixa potência na mastigação. Já nos movimentos mandibulares, notou-se que essa intervenção apresentou resultados significativos, principalmente para o desfecho de amplitude de abertura de boca.

Palavras-chave

Terapia com Luz de Baixa Intensidade,; Síndrome da Disfunção da Articulação Temporomandibular,; Mastigação,; Mandíbula,; Revisão Sistemática

Referências

  1. Leeuw R. Dor orofacial: guia de avaliação, diagnóstico e tratamento. 4ª ed. São Paulo: Quintessence; 2010.
  2. Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J Pain Res. 2018;11:571-87. http://dx.doi.org/10.2147/JPR.S127950 PMid:29588615.
  3. Melchior MO, Machado BC, Magri LV, Mazzetto MO. Effect of speech-language therapy after low-level laser therapy in patients with TMD: a descriptive study. CoDAS. 2016;28(6):818-22. http://dx.doi.org/10.1590/2317-1782/20162015099 PMid:28001273.
  4. Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015;350(9):h1154. http://dx.doi.org/10.1136/bmj.h1154 PMid:25767130.
  5. Piccin CF, Pozzebon D, Chiodelli L, Boufleus J, Pasinato F, Corrêa EC. Clinical and psychosocial aspects assessed by the research diagnostic criteria for temporomandibular disorder. Rev CEFAC. 2016;18(1):113-9. http://dx.doi.org/10.1590/1982-021620161817215
  6. Sassi FC, Silva AP, Santos RKS, Andrade CRF. Oral motor rehabilitation for temporomandibular joint disorders: a systematic review. Audiol Commun Res. 2018;23:e1871.
  7. Felício CM, Melchior MO, Silva MA. Effects of orofacial myofunctional therapy on temporomandibular disorders. Journal Cranio Pract. 2010;28(4):249-59. http://dx.doi.org/10.1179/crn.2010.033 PMid:21032979.
  8. Catão MH, Oliveira PS, Costa RO, Carneiro VS. Evaluation of the efficacy of low-level laser therapy (lllt) in the treatment of temporomandibular disorders: a randomized clinical trial. Rev CEFAC. 2013;15(6):1601-8.
  9. Frare JC, Nicolau RA. Clinical analysis of the effect of laser photobiomodulation (GaAs – 904 nm) on temporomandibular joint dysfunction. Rev Bras Fisioter. 2008;12(1):37-42. http://dx.doi.org/10.1590/S1413-35552008000100008
  10. Vivan CL. O efeito da terapia com fotobiomodulação na dor, na qualidade de vida e na percepção da limitação funcional de indivíduos com disfunção temporomandibular: resultados preliminares [dissertação]. São Paulo: Faculdade de Odontologia, Universidade de São Paulo; 2019.
  11. Silva MA, Botelho AL, Turim CV, Silva AM. Low level laser therapy as an adjunctive technique in the management of temporomandibular disorders. Cranio. 2012;30(4):264-71. http://dx.doi.org/10.1179/crn.2012.040 PMid:23156967.
  12. De Carli BMG, Magro AKD, Souza-Silva BN, Matos FS, De Carli JP, Paranhos LR, et al. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: a randomized clinical trial. J Photochem Photobiol B. 2016;159:120-3. http://dx.doi.org/10.1016/j.jphotobiol.2016.03.038 PMid:27045280.
  13. Kato MT, Kogawa EM, Santos CN, Conti PC. Tens and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci. 2006;14(2):130-5. http://dx.doi.org/10.1590/S1678-77572006000200012 PMid:19089044.
  14. Kogawa EM, Kato MT, Santos CN, Conti PC. Evaluation of the efficacy of low-level laser therapy (LLLT) and the microelectric neurostimulation (MENS) in the treatment of myogenic temporomandibular disorders: a randomized clinical trial. J Appl Oral Sci. 2005;13(3):280-5. http://dx.doi.org/10.1590/S1678-77572005000300015 PMid:20878031.
  15. Machado BCZ, Mazzetto MO, Da Silva MA, De Felício CM. Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci. 2016;31(5):945-54. http://dx.doi.org/10.1007/s10103-016-1935-6 PMid:27085322.
  16. Öz S, Gökçen-Röhlig B, Saruhanoglu A, Tuncer EB. Management of Myofascial Pain: Low-Level Laser Therapy Versus Occlusal Splints. J Craniofac Surg. 2010;21(6):1722-8. http://dx.doi.org/10.1097/SCS.0b013e3181f3c76c PMid:21119408.
  17. Seifi M, Ebadifar A, Kabiri S, Badiee MR, Abdolazimi Z, Amdjadi P. Comparative effectiveness of Low Level Laser therapy and Transcutaneous Electric Nerve Stimulation on Temporomandibular Joint Disorders. J Lasers Med Sci. 2017;8(Supl. 1):S27-31. http://dx.doi.org/10.15171/jlms.2017.s6 PMid:29071032.
  18. Gökçen-Röhlig B, Kipirdi S, Meriç U, Capan N, Keskin H. Masticatory muscle pain and low-level laser therapy: a double-blind and placebo-controlled study. Turk J Phys Med Rehab. 2011;57:31-7. http://dx.doi.org/10.4274/tftr.57.06.12
  19. Madani A, Ahrari F, Fallahrastegar A, Daghestani N. A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci. 2020;35(1):181-92. http://dx.doi.org/10.1007/s10103-019-02837-x PMid:31396794.
  20. Sancakli E, Gökçen-Röhlıg B, Balık A, Öngül D, Kıpırdı S, Keskın H. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health. 2015;15(1):131. http://dx.doi.org/10.1186/s12903-015-0116-5 PMid:26496720.
  21. Ferreira CLP, Machado BCZ, Borges CGP, Silva MAMR, Sforza C, Felício CM. Impaired orofacial motor functions on chronic temporomandibular disorders. J Electromyogr Kinesiol. 2014;24(4):565-71. http://dx.doi.org/10.1016/j.jelekin.2014.04.005 PMid:24816190.
  22. Gomes FC, Schapochnik A. The therapeutic use of low intensity laser (LLLT) in some diseases and its relation to the performance in speech therapy. Distúrb Comun. 2017;29(3):570-8. http://dx.doi.org/10.23925/2176-2724.2017v29i3p570-578
  23. Xu GZ, Jia J, Jin L, Li JH, Wang ZY, Cao DY. Low-level laser therapy for temporomandibular disorders: a systematic review with meta-analysis. Pain Res Manag. 2018;2018:4230583. http://dx.doi.org/10.1155/2018/4230583 PMid:29861802.
  24. Santos N, Cavalcante J, Silva T, Santos S, Fernandes E, Leitão A, et al. Low-power laser use for tratment of temporomandibular muscle dysfunction: a systematic review. Braz J Health Rev. 2020;3(6):18331-41. http://dx.doi.org/10.34119/bjhrv3n6-231
  25. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):n71. http://dx.doi.org/10.1136/bmj.n71 PMid:33782057.
  26. Higgins JPT, Savovic J, Page MJ, Sterne JAC. Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) Short Version (CRIBSHEET). Cochrane; 2019.
  27. Grade Working Group. The grading of recommendations assessment, development and evaluation [Internet]. 2014 [citado em 2021 Dez 14]. Disponível em: http://www.gradeworkinggroup.org
  28. Brasil. Conselho Federal de Fonoaudiologia. Resolução CFFa nº 541, de 15 de março de 2019. Diário Oficial da União; Brasília; 2019 [citado em 2021 Mar 20]. Disponível em: https://www.fonoaudiologia.org.br/resolucoes/
     
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