Fotobiomodulação no tratamento de disfunção temporomandibular: ensaio clínico controlado randomizado

Abstract

The present study aimed to evaluate the efficacy of photobiomodulation (PBMT), the occlusal device (OS), and the combination of therapies (OSL) on the symptoms of muscular temporomandibular dysfunction (TMD) through a randomized controlled clinical trial. Based on the DC/TMD, participants were divided into three groups: OS, L and OSL. The OS and OSL groups were instructed to use the device during sleep; in the L and OSL groups, the PBMT protocol (3J/cm² per point) was administered in 5 sessions, once a week. Pain intensity was assessed using the Visual Analog Scale (VAS), mandibular mobility by determining the maximum unassisted mouth opening, and quality of life through the Oral Health Impact Profile (OHIP-14). The sample included 99 participants (OS (n=34), L (n=32), and OSL (n=33)), with 80 women and 19 men, with a mean age of 31.54 ± 10.39 years. The results revealed a notable decrease in pain levels immediately after treatment in all periods analyzed in the L and OSL groups (p<0.05), with greater efficacy of the OSL group over the OS group up to the second week (p<0.05). Additionally, significant improvement in mandibular mobility parameters was observed immediately after treatment in all evaluated periods in the PBM and OSL groups, except in the last session (p<0.05). All therapeutic modalities were effective regarding quality of life, with higher scores in the PBM group compared to both the OS and OSL groups during reevaluation (p<0.05). The OS and PBMT were effective, with the combination of therapies being superior in the short term. At the end of the treatment, the combination of therapies was not superior to the isolated use of either therapy.