Articles

Treatment of Temporomandibular Joint Pain with Diode Laser Therapy

Kubota, J., Calderhead, R.G.
Joint International Laser Conference
Edinburgh Scotland
2003:O210

Disorders of or trauma to the temporomandibular joint (TMJ) can cause the affected person a great deal of pain as well as negatively influencing the patient’s quality of life (QOL) by interfering with, for example, mastication. In contact sports and those involving a ball traveling at speed, TMJ injuries are now fairly commonly seen by the sports practitioner. If such injuries are left untreated or not treated properly, the injury can progress to a chronic temporomandibular disorder (TMD). Laser therapy has been proved effective in a variety of pain etiologies, and low incident levels of diode laser irradiation are very effective in relieving TMJ joint pain associated with TMD, as the first stage in a two-staged strategy in the successful treatment for TMD, in addition to treating the acute phase of a TMJ injury very effectively and swiftly. The present study reports on representative cases of TMJ pain treated with a GaAlAs diode laser, 830 nm continuous wave, 1000 mW for 10 to 15 sec/point in the defocused non-contact mode, once per week. The incident power density, despite the high output power, was 669 mW/cm². Incident energy densities were thus from approximately 6.7 J/cm² to 10 J/cm². In the case of unilateral involvement, treatment was applied both to the affected side and to the contralateral TMJ area to deal with any compensatory-related pain or functional conditions. One of the possible pain relief mechanisms involves the LLLT-mediated improved microcirculation in the temporal and masseter muscles, thereby relaxing and softening affected muscles and relieving the pain. This also helps with cases of trismus. Laser therapy can also help normalize hyperactive motoneurons which are associated with habitual chronic pain, and has also been shown with MRI to have a good effect on TMJ effusion. LLLT is side-effect free, is easy to apply both pitch-side and in the treatment room environment, and is well-tolerated by all ages and conditions of sportsmen and women. If a TMJ injury has progressed to a TMD, when used in combination with conventional orthodontic maneuvers to remedy the functional defects behind the TMD, laser therapy offers the practitioner a safe and effective method for pain relief in troublesome TMJ pain patients.