Effectiveness of low-level laser therapy on temporomandibular disorders. A systematic review of randomized clinical trials

IF 2.6 3区医学 Q2 ONCOLOGY Photodiagnosis and Photodynamic Therapy Pub Date : 2025-06-01 Epub Date: 2025-03-15 DOI:10.1016/j.pdpdt.2025.104558

Leonardo Díaz , Lukas Restelli , Emilia Valencia , Damla Ilhan Atalay , José Manuel Abarca , Alain Chalple Gil , Eduardo Fernández

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Abstract

Objective

This study aimed to systematically evaluate the efficacy of LLLT in the management of TMD, focusing on its impact on pain reduction and functional improvement. Additionally, this review sought to identify the most effective laser parameters (wavelength, energy density, and duration of therapy) and compare LLLT outcomes with conventional treatment modalities.

Methods

A comprehensive search was conducted across PubMed, Scopus, Web of Science, and EBSCO databases until December 2024. Randomized controlled trials (RCTs) that evaluated LLLT's effects on pain (via Visual Analog Scale) and vertical aperture (VA) were included. The risk of bias was assessed using Cochrane's RoB 2 tool.

Results

This systematic review analyzed 44 randomized clinical trials (RCTs) with 1,816 participants, confirming that low-level laser therapy (LLLT) significantly reduces pain intensity (60–70 % decrease on the Visual Analog Scale) and improves mandibular function (10–20 % increase in maximum mouth opening). The most effective laser wavelengths ranged from 810 to 940 nm, with energy densities of 3–12 J/cm². Longer treatment durations (>4 weeks) provided more sustained benefits. Compared to occlusal splints, NSAIDs, and TENS, LLLT showed superior or comparable pain relief with fewer side effects. However, variability in laser parameters and protocols remains a limitation.

Conclusion

LLLT is a safe and effective non-invasive treatment for TMD, offering substantial benefits in pain management and functional recovery. Standardized protocols based on optimized dosimetry are needed to enhance clinical outcomes further.

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低水平激光治疗颞下颌疾患的疗效观察。随机临床试验的系统综述。

研究目的本研究旨在系统评估 LLLT 治疗 TMD 的疗效，重点关注其对减轻疼痛和改善功能的影响。此外，本综述还试图确定最有效的激光参数（波长、能量密度和治疗持续时间），并将 LLLT 的疗效与传统治疗方法进行比较：方法：我们对 PubMed、Scopus、Web of Science 和 EBSCO 数据库进行了全面检索，直至 2024 年 12 月。纳入的随机对照试验（RCT）评估了 LLLT 对疼痛（通过视觉模拟量表）和垂直孔径（VA）的影响。使用 Cochrane's RoB 2 工具评估了偏倚风险：该系统性综述分析了 44 项随机临床试验 (RCT)，共有 1,816 人参与，结果证实低强度激光疗法 (LLLT) 能显著降低疼痛强度（视觉模拟量表降低 60%-70% ）并改善下颌功能（最大张口度增加 10-20%）。最有效的激光波长为 810 至 940 nm，能量密度为 3-12 J/cm²。较长的治疗时间（大于 4 周）能带来更持久的疗效。与咬合夹板、非甾体抗炎药和 TENS 相比，LLLT 的疼痛缓解效果更佳或相当，且副作用更少。然而，激光参数和方案的可变性仍然是一个限制因素：结论：LLLT 是一种安全有效的 TMD 非侵入性治疗方法，在疼痛控制和功能恢复方面具有显著优势。要进一步提高临床疗效，还需要基于优化剂量测定的标准化方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.