Pharmacotherapy versus photobiomodulation therapy in patients with temporomandibular disorders: randomized clinical trial.

Purpose: The purpose of this study was to compare the efficacy of photobiomodulation and pharmacotherapy in the relief of signs and symptoms of temporomandibular disorders (TMDs).

Methods: In this single-blind, prospective randomized trial, patients with unilateral TMDs were evaluated. The patients were randomized into two groups: Photobiomodulation therapy and Pharmacotherapy. Patients in the Pharmacotherapy group received a capsule of MEGAFEN (Acetaminophen 325 mg/Caffeine 30 mg/Ibuprofen 200 mg) every 8 h for four weeks. The second group received photobiomodulation therapy in three sessions per week for four consecutive weeks. Patients were evaluated prior to the initiation of therapy and on days 7, 14 and 28 following the start of therapy.

Results: A total of 42 patients diagnosed with TMDs participated in this study. Photobiomodulation therapy group had significantly lower mean pain level and higher mean maximum mouth opening score on day 28 (P = 0.001 and P = 0.024). Photobiomodulation therapy group also exhibited a significantly lower occurrence of joint clicking and tenderness on all follow-up days (joint clicking: P = 0.008; P = 0.004; P = 0.001; tenderness: P = 0.008; P = 0.005; P = 0.001). No significant differences in mean lateral excursion scores were noted between the groups on all follow-up days (P = 0.259; P = 0.172; P = 0.172).

Conclusion: Photobiomodulation therapy was more efficient in the improvement of pain, mouth opening, joint clicking, and tenderness of TMDs compared to the pharmacotherapy with MEGAFEN. Further investigations are required to establish a standard laser protocol for TMDs.