Evaluation of patient-related outcomes following treatment of temporomandibular disorders with a 940-nm diode laser: a retrospective clinical pilot study

The present study was designed to evaluate short-term and long-term effectiveness of photo-bio-modulation (PBM), also known as low-level laser therapy (LLLT), using a 940-nm InGaAs diode laser as a treatment modality for temporomandibular joint disorders (TMD) from the point of view of patient-related outcomes (PRO’s).

A total of 16 patients, who presented to the clinic complaining of TMD symptoms, opted to participate in the study, to try PBM to alleviate their discomfort. Patients were asked to answer a set of 7 questions relating to their symptoms and rate their initial pain level using the Wong–Baker Faces Pain Scale (WBS) from 0 to 5. The same questionnaire was given immediately following 6 sessions of PBM and at least 3 months after the completion of treatment. All patients were offered a night-time stabilization occlusal splint to support the TMJs following PBM therapy. The scores from each of the three questionnaires were then compared using one-way analysis of variance (ANOVA) and Tukey’s pairwise comparisons with a 95% confidence interval. The total score for all 7 questions combined was analyzed as well as scores for each question separately. Pre-treatment scores were compared to immediate post-treatment scores and long-term follow-up scores.

Each 4 cm diameter circular surface area of the face was treated at 3 W, actual output power CW, for 37.5 s to deliver 112.5 J total energy, 9 J/cm² fluence. Seven such circular areas were treated per side in the masseter, temporalis, auricular, and sterno-cleido-mastoid area. Both sides were treated regardless of which side experienced more symptoms.

Six sessions of PBM delivered twice a week over 3 weeks resulted in significant improvement in PROs immediately following treatment, and the results were stable long-term for patients who opted to wear a night-time occlusal splint. For patients who chose to forego the stabilization appliance, their symptoms returned but not to the pre-treatment levels of pain described.

This study shows that PBM is an effective non-pharmaceutical treatment modality to help control acute symptoms of TMD according to patient-related outcomes. The results can be maintained long-term with the help of night-time occlusal splint therapy.