COMPARATIVE EVALUATION OF LOW-LEVEL LASER THERAPY (LLLT) VERSUS SODIUM HYALURONATE WITH ARTHROCENTESIS IN MANAGEMENT TEMPOROMANDIBULAR JOINT DISORDERS (TMD): A CLINICAL RANDOMIZED CONTROLLED STUDY

Abstract

Purpose: Temporomandibular joint disorders are one of the most common cause of pain of non-dental origin in the orofacial region and is characterized by pain, joint sounds, and restricted mandibular movements. This disorder is known to be multifactorial. There are wide varieties of treatment for the TMD, including non-surgical and surgical treatments. Recently, the low-level laser therapy (LLLT) has been used as a treatment modality to the TMDs. Aim: The aim of this study was to compare and evaluate the effect of low-level laser therapy (LLLT) versus sodium hyaluronate with arthrocentesis in management symptoms of temporomandibular joint disorders (TMD). Patients and Methods: This was a clinical randomized controlled study conducted on 40 patients with a total of 40 joints (3 males and 37 females) diagnosed with TMDs. The patients were randomly divided into 2 groups. Group A (Laser group) received active application of the low-level laser therapy (LLLT). Group B (Arthrocentesis group) received combined arthrocentesis and low molecular weight sodium hyaluronate intracapsular injection. Results: When comparing the two groups, there were no statistically significant differences; between group A and group B regards changes in measuring pain on visual analogue scale (VAS) and maximum painless opening from pre-operative till post-operative at one month. While, there were statistically significant differences; between the two from pre-operative till post-operative at three months follow up periods. Conclusion: We can conclude from this study that the use of laser is successful when it is applied in a proper way, although the exact mechanism is not yet well understood. Establishment of a specific protocol is still lacking in the literature, also the studies comparing between the two treatment modalities presented in the following research. So, we recommend performing studies with large number of patients and longer time of follow up.