Low Level Laser Therapy in the Treatment of Temporomandibular Joint Arthritis: Questions and Answers

Osteoarthritis (OA) affects a large proportion of the population. Low Level Laser Therapy (LLLT) is a light source that generates extremely pure light, of a single wavelength. The effect is not thermal, but rather related to photochemical reactions in the cells. LLLT was introduced as an alternative non-invasive treatment for OA about 10 years ago, but its effectiveness is still controversial. For the treatment of OA, the results are conflicting in different studies and may depend on the method of application of the LLLT . Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques used; consequently new trials on LLLT should make use of standardized, validated outcomes Low-level energy diode laser therapy has been used in a variety of chronic and acute pain conditions, including neck, back and myofascial pain, degenerative osteoarthritis, and tennis elbow and also may be an effective treatment for burning mouth syndrome. LLLT reduces also pain in knee osteoarthritis and improves microcirculation as well as stimulated collagen production and fibroblast activity in the irradiated area. .Mandibular function may be improved in LLLT patients proving the effectiveness in the treatment of pain, as demonstrated by a significant improvement in clinical signs and symptoms of temporomandibular joint disc displacement without reduction and osteoarthritis at the end of treatment and stability over a period of 1 month. Other results suggest that LLLT (application of 10 J/cm(2) and 15 J/cm(2)) can be considered as a useful method for the treatment of temporomandibular disorders (TMD)-related pain, especially long lasting pain.. LLLT is demonstrated also to be an appropriate treatment for TMD and should be considered as an alternative to other methods Finally low level laser therapy with the suggested dose range significantly reduces pain and improves health status in chronic joint disorders, but the heterogeneity in patient samples, treatment procedures and trial design calls for cautious interpretation of the results] The aim of our contribute is to assess the effectiveness of LLLT in the treatment of temporomandibolar joint osteoarthritis by trying to reply to the controversial questions about this topic. The research method will consist in examining the existing literature not in the light of a systematic review but in the tentative to offer a practical solutions to the problems arising from the application of the LLT. The key results we attend will be on treatment of osteoarthritis patients with high levels of pain-related fear in order to optimize daily functioning. It opens up opportunities for tailoring treatment.