• Carolina Marciela Herpich, Leal-JuniorErnesto Cesar PintoECPa Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis , University Nove de Julho (UNINOVE) , São Paulo , Brazil., Cid Andre Fidelis de Paula Gomes, Igor Phillip Dos Santos Gloria, Ana Paula Amaral, Maitê de Freitas de Rocha Souza Amaral, Fabiano Politti, and Daniela Aparecida Biasotto-Gonzalez.
• a Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis , University Nove de Julho (UNINOVE) , São Paulo , Brazil.
• Disabil Rehabil. 2018 Sep 1; 40 (19): 2318-2324.

ObjectivesThe aim of the present study was to evaluate the immediate and short-term effects of phototherapy on pain intensity, the pressure pain threshold (PPT), maximum vertical mandibular movement, and the electrical activity of the masseter and temporal muscles in women with temporomandibular disorder (TMD).MethodsSixty women were randomly allocated to four different groups and submitted to phototherapy with a combination of super-pulsed laser (905 nm), red (640 nm), and infrared (875 nm) light emitting diodes in the same equipment on the masseter (three points) and temporal (two points) muscles bilaterally in a single session. The following doses were used in each point of application: Group 1 - 2.62 J; Group 2 - 5.24 J; Group 3 - 7.86 J; placebo group. Pain intensity was determined using the visual analog scale. The PPT was analyzed using a digital algometer. Vertical mandibular movement was measured using digital calipers. Myoelectrical activity of the masseter and temporal muscles was measured using electromyography. Four evaluations were performed: pre-intervention, immediately after, 24 and 48 hours after phototherapy.OutcomesA significant reduction in pain intensity during the post-treatment evaluations in comparison to the pretreatment evaluation was observed in group 1 (Median difference = 2.60 [95% CI = 1.35-3.85]) and group 2 (Median difference = 2.2 [95% CI = 0.98-3.42]) especially after 48 hours and group 3 (Median difference = 2.50 [95% CI: 0.56-4.46]) especially after 24 hours, with a moderate effect size, but no effect was found regarding the other variables.ConclusionsA single session of combined phototherapy was capable of reducing pain intensity in individuals patients with TMD. ClinicalTrials.gov (NCT02018770). Implications for Rehabilitation Phototherapy device combining two light sources (LED and laser), and different densities in the same device is a novelty in the rehabilitation market, and has proved to be a useful intervention for people with temporomandibular disorders. This mode of phototherapy is another option that assists in the rapid intervention in pain symptoms, promoting a considerable degree of comfort to the patient moments after its application.

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