Aim of the study was to compare the efficacy of internal versus external photobiomodulation (PBM) in the management of patients with TMJ internal derangements (TMJ-ID).
Painful click at temporomandibular joint (TMJ) area.
Pain at the lateral pterygoid muscle.
Presence of full or nearly full complement of natural teeth with acceptable occlusion
Patients who have radiographic evidence of degenerative conditions of TMJ.
Patients under current dental or physical therapy that could affect TMD.
History of recent trauma.
The presence of systemic diseases (i.e. rheumatoid arthritis, osteoarthritis).
Parallel
External low level laser therapy
DevicePatients received 8 sessions of external diode laser (635 nm).
Internal low level laser therapy
DevicePatients received 8 diode laser (635 nm) sessions applied internally
Pain level assessment using Visual Analogue Scale
All patients will be evaluated subjectively through Visual Analogue Scale (VAS) to clinically assess the pain intensity with ratings between 0 for pain-free and 10 for maximum pain
Oral health-related quality of life using OHIP-TMD
Oral health-related quality of life will be assessed using OHIP-TMD, a 22-item temporomandibular disorder-specific version of the Oral Health Impact Profile (OHIP). Each item in the OHIP-TMDs is scored on a Likert scale, often ranging from: 0 (Never) to 4 (Very often). For each respondent, the scores for all 22 items are summed to create a total score. The total score ranges from 0 to 88, where higher scores indicate a greater negative impact on oral health-related quality of life.
Maximum mouth opening evaluation using the Miller index
The Miller Index is calculated as a ratio of the observed maximum interincisal distance (distance between the edges of the upper and lower incisors when the mouth is fully open) to the patient's height. This provides a normalized measure of mouth opening relative to body stature. Miller Index= Maximum Interincisal Distance (mm)/Height (cm) Normal Range: A typical Miller Index is around 1.6 to 1.7 mm/cm in healthy individuals. This means that for every centimeter of height, the expected mouth opening is about 1.6 to 1.7 mm. Deviations: * Lower than Normal: May indicate restricted mouth opening (e.g., trismus, TMDs, fibrosis, ankylosis). * Higher than Normal: May occur in conditions involving hypermobility.
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Nourhan M.Aly
Lead sponsor
University of Alexandria
Sponsor institution
