Low Level Laser Therapy for the Treatment of Temporomandibular Disorders: A Systematic Review of the Literature

Abstract

The authors performed a review of the literature to evaluate the efficacy of low level laser therapy (LLLT) for the treatment of temporomandibular disorders (TMD). Selection criteria included: 1) human subjects, 2) articles written in English, and 3) randomized placebo-controlled trials. Evaluation was performed according to the CONSORT 2010 criteria. A total of 14 articles were included in the review. Studies varied considerably in terms of methodological design, particularly regarding the site of application of the laser beam, the number of applications performed, their duration, the laser beam features (wavelength, frequency, output, dosage), and outcome measures. The outcome of the trials was controversial and not particularly related to any features of the laser beam, to the number of laser applications, and their duration. Based on the results of this review no definitive conclusions can be drawn on the efficacy of LLLT for the treatment of TMD. Many methodological differences among the studies, especially regarding the number and duration of laser applications and characteristics of the laser beam (wavelength, frequency, output), do not allow for standardized guidelines for effective treatment with LLLT. The only indication seems to be that LLLT is probably more effective for the treatment of TMJ disorders, and less effective for the treatment of masticatory muscle disorders.

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Notes on contributors

Marcello Melis

Dr. Marcello Melis received his pharmacy degree from the University of Cagliari (Italy) in 1990 and his D.M.D. degree from the Dental School of the same university in 1998. He was a resident at the Gelb Orofacial Pain Center at Tufts University, Boston from 1998 to 2000 when he completed the Fellowship Certification Program in Temporomandibular Disorders and Orofacial Pain. Currently, Dr. Melis practices in Cagliari in the field of temporomandibular disorders and orofacial pain and is an adjunct clinical instructor in the Craniomandibular Pain Center at Tufts University. He has been involved in several international research activities focusing on temporomandibular disorders and orofacial pain, occlusion, and muscle function.

Massimiliano Di Giosia

Dr. Massimiliano Di Giosia received his D.D.S. degree from the Dental School of the University of Chieti (Italy) in 2001. He completed a threeyear residency in orofacial pain at the University of Kentucky Orafacial Pain Center, directed by Dr. Jeffrey P. Okeson, in 2007. In 2008, Dr. Di Giosia completed a postgraduate course in “Headache and Cranial Neuralgias” at the University of Torino. His is a Diplomate of the American Board of Orofacial Pain. He is currently enrolled in the orthodontic residency program at the University of Cagliari. Dr. Di Giosia limits his clinical practice to the field of orofacial pain and dental sleep medicine.

Khalid H. Zawawi

Dr. Khalid H. Zawawi is an associate professor of orthodontics at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. He received his Certificate in Orthodontics and D.Sc. degree from Boston University and completed the Fellowship Certification Program in TMD and Orofacial Pain at Tufts University School of Dental Medicine. Dr. Zawawi has been on the staff of the Faculty of Dentistry at King Abdulaziz University since 1993. He also served as a research associate at the Craniofacial Pain Center at Tufts University where he published numerous articles on TMD and orofacial pain.