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This study aimed to evaluate the sustainability of the efficacy of using low level laser therapy and CAD/CAM Michigan splint in improving the range of mandibular movements, muscle activity and reducing the pain.
56 female patients were randomly divided into two groups, Group A: Patients received applications of low-level laser therapy using semiconductor InGaAsp diode LASER type 940 nm with continuous mode of operation, with time of application 180 sec per session for 12 sessions. Group B: Patients received hard occlusal splints (Michigan splints) of 2 mm thickness constructed on their upper teeth, the hard occlusal splint was 3D digitally printed. ARCUS digma facebow was used to evaluate the range of mandibular movements affected from TMJ problems. The opening measurements of the patient were taken using a millimeter ruler. Electromyogram (EMG) was used to evaluate muscle activity. Visual analogue scale (VAS) was used to evaluate the pain intensity. All was done before the beginning of the treatment at three and six months follow up period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LASER group | Experimental | Group A: Patients received applications of low-level laser therapy using semiconductor InGaAsp diode LASER type 940 nm with continuous mode of operation, with time of application 180 sec per session for 12 sessions. |
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| Splint group | Active Comparator | Group B: Patients received hard occlusal splints (Michigan splints), used for 3 months during sleeping then the patient stops using it and told to only wear it if discomfort return usually during stressful times. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low Level LASER therapy | Radiation | using semiconductor InGaAsp diode LASER type 940 nm with continuous mode of operation, with time of application 180 sec per session for 12 sessions. |
| Measure | Description | Time Frame |
|---|---|---|
| Electromyographic muscle activity | The change in muscle activity was assessed using EMG in terms of Microvolt | Measured 3 times through 6 months from the beginning of the treatment. (0,3,6 months) |
| Range of mandibular movement | The increase in the range of movement measured using ARCUS digma in terms of angular inclination. | Measured 3 times through 6 months from the beginning of the treatment. (0,3,6 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | The degree of pain is assessed using a 10 cm scale (VAS) | Measured 3 times through 6 months from the beginning of the treatment. (0,3,6 months) |
| Mouth opening | degree of mouth opening in cm using ruler |
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Inclusion Criteria: tenderness in the TMJ or muscles of mastication (e.g., temporalis and masseter) that might get worse in the morning or with eating, headache, periauricular pain, teeth wear that appears in the form of multiple smooth shinny facets, teeth mobility, and malocclusion
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rami M Ghali, professor | oral and maxillofacial prosthodontics department, faculty of dentistry, Ain Shams University | Study Director |
| Amany M Farahat, PhD | Oral and Maxillofacial prosthodontics department, faculty of dentistry, Ain Shams University | Principal Investigator |
| Dina E Bahig, PhD | Oral and Maxillofacial prosthodontics department, faculty of dentistry, Ain Shams University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| faculty of dentistry, Ain Shams University | Cairo | 11766 | Egypt |
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| ID | Term |
|---|---|
| D013706 | Temporomandibular Joint Dysfunction Syndrome |
| ID | Term |
|---|---|
| D013705 | Temporomandibular Joint Disorders |
| D017271 | Craniomandibular Disorders |
| D008336 | Mandibular Diseases |
| D007571 | Jaw Diseases |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D013812 | Therapeutics |
| D010789 | Phototherapy |
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Group A: Patients received applications of low-level laser therapy. Group B: Patients received hard occlusal splints (Michigan splints).
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Blocked randomization technique was used to divide the patients into two equal groups using sealed envelopes, the person who was in charge for randomization was blinded to the group allocation of the patients. The outcome assessor also didn't know the allocated groups, and the patients were instructed not to mention their groups to the assessors.
| Hard occlusal splint | Device | 2 mm thickness occlusal splint constructed over the maxillary arch using CAD/CAM technology. |
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| Measured 3 times through 6 months from the beginning of the treatment. (0,3,6 months) |
| D009140 | Musculoskeletal Diseases |
| D007592 | Joint Diseases |
| D009135 | Muscular Diseases |
| D009209 | Myofascial Pain Syndromes |
| D009057 | Stomatognathic Diseases |