Application of low level laser therapy (Red laser 635 nm) and ultrasound therapy and a combination of (US/Laser 635 nm) therapy in patients with temporomandibular joint disorders (TMDs)

Abstract Purpose This study aimed to compare and find out the best treatment method between Laser (635 ± 10 nm), (US) and a combination of (US/Laser 635 ± 10 nm) in treatment of Temporomandibular disorders (TMDs). Methods This prospective study was done at the Department of Oral and Maxillofacial Surgery, AL Imam Ali Hospital in Al-Sadr City, and the oral medicine clinic at specialized curve center in Baghdad from January to August 2024. The study was carried out on (75) TMD patients, (25) of them were treated with (Laser635 ± 10nm), (25) were treated with (US) and (25) were treated with a combination of (US/Laser 635 ± 10 nm) in four treatment sessions (two sessions every week). The average power in laser treatment was 0.3 Watts, irradiation time: 30 seconds on each tender point. The average power in US treatment was 0.5 Watts, and application time was 3 minutes. Numbers of tender points were measured by palpation, and mouth opening was measured by electronic digital caliper. Pain intensity was recorded on a scale from 1 to 10 using rating visual analog scale (VAS). Results The most common age group was (20–29) years among all age groups and the mean age was (28.7 ± 8.4) years, and female patients were highly dominated (85.3%) over males (14.7%). The (laser 635 ± 10 nm) group showed significantly lower pain intensity, larger mouth opening, when compared with US treated patients in all the 4 treatment sessions. As a comparison between groups at different time periods, before second session, laser (635 ± 10 nm) group had the lowest pain intensity (p = 0.000). Before third session, laser (635 ± 10 nm) group had the lowest pain intensity, followed by (US/laser635 ± 10 nm) group (p = 0.000). Mouth opening was significantly largest (P = 0.010) in laser (635 ± 10 nm) group, followed by (US/laser 635 ± 10 nm) group. Before fourth session, the same significant results regarding pain intensity and mouth opening were obtained (P = 0.000). One month later, the same previous significant results regarding pain intensity and mouth opening (P = 0.000) were achieved. Number of masseter tender points was significantly lower (P = 0.028) in (laser 635 ± 10 nm) group as compared with (US/Laser 635 ± 10 nm) group. Conclusions The treatment of TMD patients with (laser 635 ± 10 nm) was shown to be more effective than treatment with (US) and with a combination of (US/Laser635 ± 10 nm) in reducing pain intensity and mouth opening.