Efeitos da fototerapia sobre a dor, atividade muscular e mobilidade articular em indivíduos com disfunção temporomandibular: ensaio clínico aleatorizado, placebo-controlado e duplo-cego

Abstract

Introduction: Temporomandibular dysfunction syndrome is characterized as a subgroup of the oral-facial pain, whose signs and symptoms include pain or discomfort in the temporomandibular joints. Resources that emit different light sources ( light emitting diode and low intensity Laser) have been used for the treatment of temporomandibular dysfunction. Objective: To evaluate and compare the effect of phototherapy with the combination of different sources of light on the pain, temporal muscle activity and bilateral masseteres and mandibular movement range in subjects with temporomandibular muscle dysfunction, immediately after the aplication, 24 hours and 48 hours afterward, and identify the dose (0; 2.62; 5.24; 7.86 J/point) which most influence on pain and range of motion and muscle activity of the temporal muscles and bilateral masseteres in subjects with temporomandibular joint dysfunction. Material and methods: Randomized clinical trial, controlled-placebo and double-blind. Participated in this work 60 subjects with Temporomandibular muscle dysfunction diagnosed by the diagnostic criteria in the research for temporomandibular disorders being allocated in 4 groups randomized and stratified by method of sealed envelopes. Interventions: Evaluations were carried out using: Algometry, visual analogue scale, digital caliper and electromyography. The protocol with application of phototherapy was performed in a single session, however the evaluations were carried out in four different moments: before, immediately after, 24 hours and 48 hours after phototherapy. Main result: the primary outcome was the measure of the pain intensity using the visual analogue scale. Results: The result in relation to pain intensity have demonstrated a statistically significant difference (p ≤ 0.05) when compared to the pre-phototherapy, immediate after, 24 hours and 48 hours in all groups. But for the threshold of pain, range of motion and electrical activity of mastigatorios muscles was not verified statistical difference between the groups and moments of evaluation. Conclusion: The combination of superpulsed laser (905 nm), LED with red (640 nm) and infrared (875 nm) was effective to decrease the intensity of the pain for all doses, however there was no difference with the other variables studied.