Photobiomodulation in Temporomandibular Disorders

Objective: This systematic review aimed to comprehensively review all available documents regarding photobiomodulation therapy (PBMT) application in temporomandibular disorder (TMD) patients and to suggest an evidence-based protocol for therapeutic PBM administration for these patients. Background data: The existence of temporomandibular joint and/or pain and dysfunction in masticatory muscles is characterized in TMDs. PBMT is, due to its impact on biological processes, especially inflammation, considered as an adjuvant treatment modality in TMD cases. Materials and methods: All original articles related to PBMT for TMDs in EMBASE, MEDLINE (NCBI PubMed and PMC), Cochrane library, Scopus, Web of Science, and Google Scholar were reviewed until December 2018. Results: The energy density ranging from 0.75 to 112.5 J/cm² with 0.9-500 mW power was found to be a window protocol for light application. The best results for pain relief and mandibular movement enhancement were reported after application of GaAlAs diode laser, 800-900 nm, 100-500 mW, and <10 J/cm², twice a week for 30 days on trigger points. The session of light applications varied from 1 to 20. Conclusions: Although most articles showed that PBMT is effective in reducing pain and contributed to functional enhancement in TMD patients, the heterogenic parameters that have been reported in various studies made the standardization of PBMT complicated. However, such evidence-based consensus can be beneficial for both future research and for clinical applications.