Efficacy of Low-Level Laser, Hard Occlusal Appliance and Conventional Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome; A Preliminary Study

Myofascial pain dysfunction syndrome (MPDS) is a common temporomandibular joint disorder. Due to its multifactorial etiology, treatment usually involves more than one modality to obtain complementary results. The purpose of this study was to compare the combined effect of low level laser, hard occlusal appliance and conventional pharmacotherapy versus pharmacotherapy only in the management of patients with MPDS.

In this randomized clinical trial, 15 MPDS patients were diagnosed and randomly assigned to 3 groups (n=5). Subjects in Group 1 were treated with pharmacotherapy (PT), Group 2 received active laser (940 nm Gallium Arsenide) every other day for a total of 10 sessions, plus pharmacotherapy (PTL) and Group 3 were given hard occlusal splint 12 h/day for 4 weeks plus pharmacotherapy (PTO). The intensity of pain was measured using visual analog scale (VAS) prior to treatment, 2 and 4 weeks after treatment onset and 2 weeks later. Maximum painless mouth opening and pain intensity at muscle palpation was also recorded. Comparisons were made between groups in 4 treatment sessions via repeated measure analysis of variance (ANOVA) (P < 0.05).

Pain relief, in subjective VAS was observed in both laser and appliance groups in the third and fourth examination sessions, though occlusal appliance significantly showed to provide the best results between the three groups (p<0.05). No statistically significant reduction in pain was noted using pharmacotherapy only. Maximum painless mouth opening and muscle tenderness was not significantly different among the three groups (p>0.05).

Both Laser and occlusal appliance combined with pharmacotherapy proved to be effective for pain reduction. The 3 groups however failed to result in significant improvement in maximum mouth opening or tenderness of the muscles of mastication.