The effectiveness of low level laser therapy and acupuncture as interventions for temporomandibular joint disorders in adults: a systematic review and meta-analysis

Abel Getachew

Abstract


Temporomandibular joint disorders (TMD) encompass a range of disorders of the temporomandibular joint, the masticatory muscles and other associated structures. The main symptom of TMD patients is pain within the orofacial region. The objective of this review is to compare the effectiveness of low level laser therapy (LLLT) and acupuncture as interventions for TMD. Randomized controlled trials comparing LLLT versus PLT and real acupuncture versus placebo acupuncture were included within the review. The primary outcome was subjective pain intensity expressed via a numerical visual analogue scale (VAS) upon palpation of the masseter muscles. Secondary outcomes include pain intensity via VAS upon palpation of other areas of the myofascial region; the lateral pole of the condyle, the pre-auricular region and the external auditive meatus. The author performed the data extraction, analysis and the risk of bias assessment. 10 studies (n=317) were included in assessment of LLLT vs PLT. LLLT was found to be statistically more effective than PLT in reducing subjective pain intensity upon palpation. Six studies (n=165) were included in the assessment of real acupuncture versus placebo acupuncture. Acupuncture was not statistically more effective in reducing subjective pain compared to placebo acupuncture in TMD patients. The I2 statistic described the percentage of variability in the effect estimates from the different subgroups which shows considerable heterogeneity across the subgroups. In comparing both treatments as measures for managing pain intensity in patients with TMD, LLLT significantly reduced subjective pain on palpation of the masseter muscles, lateral pole of the condyle, the pre-auricular region and the external auditive meatus. Acupuncture therapy, on the other hand, did not significantly reduce pain intensity upon palpation of the masseter muscles in patients with temporomandibular disorders. The results suggest that LLLT is a more effective non-invasive intervention for TMD.


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