Application of low level laser therapy (laser 980 nm) and ultrasound therapy and a combination of (US/Laser 980 nm) therapy in patients with temporomandibular joint disorders (TMDs)

Abstract

Background: Temporomandibular disorders (TMD) are a group of disorders that damage the temporomandibular joint (TMJ) and the muscles of mastication. They are commonly associated with parafunctional habits and clinical symptoms, such as: headache, clicking, limitation of lateral movement, protrusion and mouth opening, discomfort in the TMJ region and vertigo. Recent studies have shown that Lower level laser therapy (LLLT) is a professional therapeutic alternative for the treatment of TMD. Ultrasound (US) applies mechanical as well as thermal effects by enhancing blood flow and metabolic activity. Combined treatment of TMD with (LLLT) and (US) was shown to relieve TMD symptoms in many studies. Aim: This study aimed to compare between (Laser980 nm), (US) and a combination of (US/Laser 980 nm) in treatment of Temporomandibular disorders (TMD s).Materials and methods: This prospective study was done at the Department of Oral and Maxillofacial Surgery, AL Imam Ali Hospital in Al-Sadr City, and the oral medicine clinic at specialized curve center in Baghdad from January to August 2024. The study was carried out on (75) TMD patients, (25) of them were treated with (Laser980 nm ), (25) were treated with (US) and (25) were treated with a combination of (US/Laser980 nm) in four treatment sessions (two sessions every week). The average power in laser treatment was 0.3 Watts, irradiation time: 30 seconds on each tender point. The average power in US treatment was 0.2 Watts, and application time was 3 minutes. Numbers of tender points were measured by palpation, and mouth opening was measured by electronic digital caliper. Pain intensity was recorded on a scale from 1 to 10 using rating visual analog scale (VAS).Results: The most common age group was (20-29) years among all age groups and the mean age was (27.5±7.7) years, and female patients were highly dominated (80%) over males (20%). Before 1^st session, no significant result (P>0.05) was observed regarding all variables. Before 2^nd session, also no significant result (P>0.05) was observed. Before 3^rd session, a significant difference in pain intensity (P=0.007) was obtained among the groups, in which laser 980 nm group had the lowest pain intensity, followed by (US/laser 980 nm)  group. Before 4^th session, also a significant difference in pain intensity (P=0.001) was obtained among the groups, in which (laser 980) group had the lowest pain intensity, followed by (US/laser 980 nm) group. Mouth opening was significantly largest (P=0.001) in laser 980 group, followed by (US/laser 980 nm)  group. One month later, the same previous significant results regarding pain intensity and mouth opening (P=0.000) was observed. Conclusion: The treatment of TMD patients with (laser 980 nm) was shown to be more effective than treatment with (US) and with a combination of (US/Laser980 nm) in reducing pain intensity and mouth opening.