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Temporomandibular disorders (TMDs) are among the most common musculoskeletal conditions associated with chronic orofacial pain and functional disability. Chronic Myogenic TMD (MTMD) is the most prevalent subtype and is characterized by persistent masticatory muscle pain driven by peripheral and central sensitization mechanisms. Photobiomodulation (PBM) represents a conservative, non-invasive therapeutic modality within the medical management of TMD; however, the wavelength-dependent clinical and muscular effects remain inadequately defined. Aim: To compare the efficacy of three PBM wavelengths (635, 940, 1,064 nm) on pain intensity, mandibular function, surface electromyographic activity (sEMG), and pressure pain threshold (PPT) in patients with chronic myogenic TMD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PBM therapy I | Experimental |
| |
| PBM therapy II | Experimental |
| |
| PBM therapy III | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 635 nm red diode laser | Other | Participants will receive PBM therapy using a 635 nm red diode laser (Lasotronix), standardized at a fluence of 8 J/cm² for energy density and Irradiance of 0.50 W/cm² power density in continuous wave using PBM applicator (8mm tip) for 16 seconds, near-contact working distance. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in subjective Pain Intensity | It will be assessed using both visual analog scale (VAS) at baseline, 7,14,21 days, and 4, 12 weeks | up to 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in maximum mouth opening | Functional maximum mouth opening (MMO) unassisted and in the pain-free opening range (PFO) by digital caliper at baseline, 7,14,21 days, and 4, 12 weeks. | up to 12 weeks |
| Change in muscles activity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ahmed Shafik, BDS | Contact | 01275607044 | 002 | safwat4dental@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Outpatient Clinic of Oral medicine Department, Faculty of Dentistry, Alexandria University, Egypt | Alexandria | Egypt |
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|
| 940 nm NIR diode laser (Biolase) | Other | Participants will receive PBM therapy using a 940 nm NIR diode laser (Biolase), standardized at a fluence of 8 J/cm² and Irradiance of 0.63 W/cm² power density in continuous wave using deep tissue handpiece (10mm tip) for 12.8 seconds. |
|
| 1064 nm Nd:YAG laser (Fotona) | Other | Participants will receive PBM therapy using a 1064 nm Nd:YAG laser (Fotona), standardized at a fluence of 8 J/cm² energy density and Irradiance 0.53 W/cm² power density, using a genova handpiece (11mm tip) stamping technique for 15.2 sec. |
|
Surface electromyography (sEMG) activity during rest and maximum voluntary clenching (MVC) activity using surface electrodes
| up to 12 weeks |
| Change in Number of tender points | by palpation pressure of muscles | up to 12 weeks |
| Change in pressure pain threshold | Pressure pain threshold (PPT) over the most tender point of the masseter and temporalis muscles by a pressure algometer (PA) to measure the degree of tenderness over the most tender points at the muscles | up to 12 weeks |
| ID | Term |
|---|---|
| D013705 | Temporomandibular Joint Disorders |
| ID | Term |
|---|---|
| D017271 | Craniomandibular Disorders |
| D008336 | Mandibular Diseases |
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
| D007592 | Joint Diseases |
| D009135 | Muscular Diseases |
| D009057 | Stomatognathic Diseases |
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