Analgesia with low level diode laser (LLDL) for temporomandibular disorders (TMD) in children

Pain is the main reason for consultation related TMD. NSAIDs have risks associated with their use and poor adherence to treatment reduces the effectiveness of these drugs. OBJECTIVE: To evaluate pain response using applications of low level laser (LLDL) compared with oral administration of ibuprofen in pediatric patients with TMD DESIGN: Experimental, comparative, longitudinal and unicentric study METHOD: Sample included all the patients who sought treatment for pain related TMD, diagnosed with DC/TMD criteria (Dentists Kappa 0.94) during 2019. Patients were assigned to one of two groups according to the day of the week in what they attended to the Pediatric Department: GI n=11: administration of ibuprofen 10mg/kg 3 times a day during 2 weeks and GL n=8; 5 weekly applications using a Low Level Infrared Laser equipment (Photon Laser III® DMC Brazil with a wavelength of 808 nm, and a continuous output power of 100 mW, dose 2 J/cm2) in 18 points, (9 in TMJ area and 9 in masseter and temporalis muscles). Informed consents and assents were obtained prior to the start of treatments. Pain was measured and recorded baseline and in the following five weeks using a visual analogue scale (VAS). Records were loaded in a data base for statistical analysis,   RESULTS: Mean age was 13.22±2.3 years, 78% female. The data recorded were statistically analyzed using a one-factor repeated measures ANOVA to estimate the size of treatment effects in weeks 1 to 5. Baseline assessment of pain and age were considered covariates. Significant differences were found with both treatments between the start and end of the controls (p=0.0016). Multiple comparisons analysis between treatments for each week showed significant differences in only one (p=0.0434), with pain intensity 2.6 points higher in G2 than in G1 CONCLUSIONS: In this preliminary study both treatments were effective in treating pain. These results suggest that low level laser therapy is a successful, minimally invasive alternative treatment for pain related TMD without serious side effects for TMD in pediatric patients.