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Comparative Effectiveness of Botulinum Toxin, Low-Level Laser, and Ultrasound for Temporomandibular Disorders
Background:
The key manifestations of temporomandibular disorders are clicking, pain, and loss of function. An ideal treatment for managing these symptoms has not yet been defined.
Primary Study Objective:
This study aimed to determine the most effective treatment for symptomatic management of temporomandibular disorder.
Methods/Design:
The study was designed as clinical, prospective, randomized, and controlled.
Setting:
The research was conducted at the Faculty of Dentistry, Nigde Omer Halisdemir University.
Participants:
Forty-five individuals who sought treatment for symptoms of temporomandibular disorder were chosen, along with fifteen asymptomatic volunteers.
Intervention:
Botulinum toxin-A was administered to the first group, whereas the second group underwent low-dose laser therapy, and the third group received ultrasound therapy. The control group did not receive any form of treatment. Each group had 15 participants.
Primary Outcome Measures:
Evaluation of temporomandibular disorder findings was conducted before the procedure, on the 15th day, and at the 3-month follow-up after the procedure. Changes in clicking, pain, and mouth opening were assessed to determine treatment effectiveness.
Results:
Administration of botulinum toxin-A alleviated joint sounds and pain significantly, outperforming alternative treatments at the 15-day and three-month marks (P = .011, P = .026, and P < .001, respectively). Low-dose laser and ultrasound therapies increased mouth opening 15 days and three months after the procedure (P < .001).
Conclusion:
Botulinum toxin-A effectively relieves pain and joint sounds associated with temporomandibular disorder symptoms, both in the short and long term. Although low-dose laser therapy and ultrasound therapy provided a shorter-term improvement in pain, they significantly improved mouth opening. Hence, in the context of treating temporomandibular disorder, the focus should be on prioritizing the utilization of botulinum toxin-A for pain control, alongside giving precedence to low-dose laser therapy and ultrasound therapy to improve mouth opening.
