Influence of Phototherapy on Thermographic Images and Pain in Individuals with Temporomandibular Disorder: Protocol for a Randomized, Placebo-Controlled, Double-Blind Clinical Trial

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Authors

  • Juliana de Paiva Tosato Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Estrada de Santa Isabel, 1647 - Sala 27, Caputera, Arujá, SP, Brazil
  • Carolina Marciela Herpich Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Estrada de Santa Isabel, 1647 - Sala 27, Caputera, Arujá, SP, Brazil
  • Ernesto Cesar Pinto Leal Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Estrada de Santa Isabel, 1647 - Sala 27, Caputera, Arujá, SP, Brazil
  • Fabiano Politti Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Estrada de Santa Isabel, 1647 - Sala 27, Caputera, Arujá, SP, Brazil
  • Daniela Aparecida Biasotto-Gonzalez Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Estrada de Santa Isabel, 1647 - Sala 27, Caputera, Arujá, SP, Brazil

DOI:

https://doi.org/10.17140/DOJ-2-113

Keywords:

Temporomandibular joint disorder; Pain, Laser; Skin Temperature Thermography.

Abstract

Considering the multifactor aspect of TMD, studies are needed to establish effective forms of
treatment. Thus, the following is the research question of the proposed study: Is phototherapy
capable of reducing pain and influencing skin surface temperature over the masseter and temporal
muscles in patients with TMD?
Study Design: A randomized, placebo-controlled, double-blind study is proposed.
Sample: Thirty-six women will participate in the study and will be allocated to two groups (18
per group) through a randomization process involving the use of opaque envelopes containing
cards stipulating to which group each participant will belong: Group A (39.27 Joules) and
Group B (0 Joules).
Evaluation Procedures: Diagnosis of TMD (RDC/TMD), Classification of TMD (FONSECA
INDEX), Pain intensity (VISUAL ANALOG SCALE), Pain pressure threshold (ALGOMETRY)
and Skin surface temperature (INFRARED THERMOGRAPHY).
Intervention Procedures: A portable, nine-diode cluster phototherapy device (PainAway®, MultiRadiance
Medical®, Solon, OH, USA) will be used for the administration of phototherapy.
Phases of Study: Initial evaluation, Treatment, Immediate evaluation, 10-minute evaluation,
20-minute evaluation and 30-minute evaluation.
Data Analysis: Pain, based on the VAS and algometric scores, will be the primary outcome and
skin surface temperature will be the secondary outcome.
KEYWORDS:;

References

Gonçalves DA, DalFabbro AL, Campos JA, et al. Symptoms of temporomandibular disorders in the population: an epidemio-logical study. Journal of Orofacial Pain. 2010; 24(3): 270-278.

Karacayli U, Mumcu G, Cimilli H, et al. The effects of chron-ic pain on oral health related quality of life in patients with ante-rior disc displacement with reduction. Community Dent Health. 2011; 28(3): 211-215.

Smith MT, Wickwire EM, Grace EG, et al. Sleep disorders and their association with laboratory pain sensitivity in temporo-mandibular joint disorder. Sleep. 2009; 32(6): 779-790.

Rodrigues-Bigaton D, Almeida AFN, Berni KCS, et al. Use of different electrical stimulations for treating pain in women with temporomandibular disorders. J Physiother. 2008; 12(6): 476-481.

Gomes NCMC, Berni-Schwarzenbeck KCS, Packer AC, et al. Effect of cathodal high-voltage electrical stimulation on pain in women with TMD. Brazilian Journal of Physical Therapy. 2012; 16(1): 10-15.

Fikácková H, Dostálova T, Navratil L, et al. Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomedicine and Laser Surgery. 2007; 25(4): 297-303. doi: 10.1089/pho.2007.2053

Rodrigues JH, Biasotto-Gonzalez DA, Bussadori SK, et al. Signs and symptoms of temporomandibular disorders and their impact on psychosocial status in non-patient university student’s population. Physiotherapy Research International. 2010; 17: 21-28. doi: 10.1002/pri.508

Arruda EEC, Amaral AP, Politti F, et al. Immediate effects of mandibular mobilization on static balance in individuals with temporomandibular disorder pilot study. Clinical and Experi-mental Medical Letters. 2012; 53: 165-169.

Amaral AP, Politti F, Hage YE, Arruda EEC, Amorin CF, Bia-sotto-Gonzalez DA. Immediate effect of nonspecific mandibular mobilization on postural control in subjects with temporoman-dibular disorder: a single-blind, randomized, controlled clini-cal trial. Braz J PhysTher. 2013; 17(2): 121-127. doi: 10.1590/ S1413-35552012005000075

Da Cunha LA, Firoozmand LM, Da Silva AP, Camargo SE, Oliveira W. Efficacy of low-level laser therapy in the treatment of temporomandibular disorder. Int Dent J. 2008; 58: 213-217.

Emshoff R, Bosch R, Pumpel E, Schoning H., Strobl H. Low-level laser therapy for treatment of temporomandibular joint pain: a double-blind and placebo-controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 452-456. doi: 10.1016/j.tripleo.2007.09.012

Marini I, Gatto, MR, Bonetti GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain. 2010; 26(7): 611-616. doi: 10.1097/AJP.0b013e3181e0190d

Hotta PT, Hotta TH, Bataglion C, et al. Emg analysis after laser acupuncture in patients with temporomandibular dysfunc-tion (TMD). Implications for practice. Ther Clin Pract. 2010; 16: 158-160. doi: 10.1016/j.ctcp.2010.01.002

Bastos JLN. Comparative Study of Laser and LED Systems of Low Intensity Applied to Tendon Healing. Laser Physics. 2009; 19(9): 1925-1931. doi: 10.1134/S1054660X09170022

Brioschi ML, Macedo JF, Macedo RAC. Skin thermometry: new concepts. J Vasc Br. 2003; 2(2): 151-160.

Johansson A, Kopp S, Haraldson T. Reproducibility and vari-ation of skin surface temperature over the temporomandibular joint and masseter muscle in normal individuals. Acta Odontol Scand. 1985; 43: 309-313.

DibaiFilho AV, Packer AC, Costa ACS, Rodrigues-Bigaton D. Accuracy of infrared thermography of the masticatory mus-cles for the diagnosis of myogenous temporomandibular disor-der. Journal of Manipulative and Physiological Therapeutics. 2013; 36: 245-252. doi: 10.1016/j.jmpt.2013.04.007

Costa ACS, Dibai-Filho AV, Packer AC, Rodrigues-Bigaton D. Intra and inter-rater reliability of infrared image analysis of masticatory and upper trapezius muscles in women with and without temporomandibular disorder. Journal of Physiotherapy. 2013; 17: 24-27. doi: 10.1590/S1413-35552012005000058

Biasotto-Gonzalez DA. Evaluation and physical therapy. In: Biasotto-Gonzalez ed. the Approach intedisciplinar of temporo-mandibular disorders. São Paulo: Manole, 2005; 131-207.

Pereira TS, Flecha OD, Guimarães RC, et al. Efficacy of red and infrared lasers in treatmentof temporomandibular dis-orders. A doubleblind, randomized, parallel clinical trial. doi: 10.1179/0886963413Z.0000000005

Faul F, Erdfelder E, Lang A, Buchner AG. Power 3: A flex-ible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007, 39 (2): 175-191.

Gumesson C, Isacsson SO, Isacsson AH, et al. The transition of reported pain in different body regions: A one-year follow-up study. BMC Musculoskeletal Disorders. 2006; 7: 1-7. doi: 10.1186/1471-2474-7-17

LaTouche R, Fernández-De-Lal-Peñas C, Fernández-Carnei-ro J. The effects of manual therapy and exercises directed at the cervical spine on pain sensitivity in patients with myofascial-temporomandibular disorders. Journal of Oral Rehabilitation. 36 : 644-52, 2009. doi: 10.1111/j.1365-2842.2009.01980.x

Dworkin SF, Leresche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. Journal of Craniomandibular Dis-orders. 1992; 6(4): 301-355.

Fonseca DM. Temporomandibular disorders (TMD): prepa-ration of an anamnesis index. Thesis (MS). Bauru: University of Sao Paulo. 1992.

Pedroni CR, Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in univer-sity students. Journal of Oral Rehabilitation. 2003; 30: 283-289. doi: 10.1046/j.1365-2842.2003.01010.x

Chaves TC, Oliveira AS, Grossi DB. Main tools for assess-ing temporomandibular disorders, Part I: Indices and question-naires; a contribution to clinical practice and research. Physio-therapy and Research. 2008; 15(1): 92-100.

Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011; 152(10): 2399- 2404. doi: 10.1016/j.pain.2011.07.005

Ylinen J, Nykanen M, Kautiainen H, et al. Evaluation of re-peatability of pressure algometry on the neck muscles for clini-cal use. Manual Therapy. 2007; 12: 192-197. doi: 10.1016/j. math.2006.06.010

Biasotto-Gonzalez DA, Berzin F, da Costa JM, de Gonzalez TO. Electromyographic study of stomatognathic system muscles during chewing of different materials. Electromyogr Clin Neuro-physiol. 2010; 50(2): 121-127.

Hakguder A, Birtane M, Gurcan S, Kokino S, Turan FN. Ef-ficacy of low level laser therapy in myofascial pain syndrome: An algometric and thermographic evaluation. Lasers Surg Med. 2003; 33(5): 339-343. doi: 10.1002/lsm.10241

Vargas JVC. Normalized methodology for medical infrared imaging. Infrared Physics & Technology. 2009; 52: 42-47. doi: 10.1016/j.infrared.2008.11.003

Manfredini D, Guarda-Nardini L, Winocur E. Research diag-nostic criteria for temporomandibular disorders: a systematic re-view of axis I epidemiologic findings. Oral Surgery, Oral Medi-cine, Oral Pathology, Oral Radiology & Endodontics. 2011; 112(4): 453-462. doi: 10.1016/j.tripleo.2011.04.021

Karu T, Pyatibrat L, Kalendo G. Irradiation with He-Ne laser increases ATP level in cells cultivated in vitro. J Photochem Pho-tobiolo. 1995; 27: 219-223. doi: 10.1016/1011-1344(94)07078-3

Garcia AR, Lacerda JRN, Pereira SLS. TMJ dysfunction de-gree and jaw movements in young adults. Rev Assoc Paul Cir Dent. 1997; 51: 46-51.

Hakgu A, Birtane M, Gurcan S, Kokino S, Turan FN. Effi-cacy of Low Level Laser Therapy in Myofascial Pain Syndrome: An Algometric and Thermographic Evaluation. Lasers in Sur-gery and Medicine. 2003; 33: 339-343. doi: 10.1002/lsm.10241

Baba K, Tsukiyama Y, Yamazaki M. A review of temporo-mandibular disorder diagnostic techniques. Journal of Prosthetic Dentistry. 2001; 86(2): 184-194. doi: 10.1067/mpr.2001.116231

Hugger A, Hugger S, Schindler HJ. Surface electromyogra-phy of the masticatory muscles for application in dental practice. Current evidence and future developments. International Jour-nal of Computerized Dentistry. 2008; 11(2): 81-106.

Look JO, Schiffman EL, Truelove EL. Reliability and valid-ity of Axis I of the Research Diagnostic Criteria for Temporo-mandibular Disorders (RDC/TMD) with proposed revisions. Journal of Oral Rehabilitation. 2010; 37(10): 744-759. doi: 10.1111/j.1365-2842.2010.02121.x

Casey KL. Problems in the differential diagnosis of chronic pain. Anesth Prog. 1990; 37(2-3): 60-65.

Shah JP, Danoff JV, Desai MJ, et al. Biochemical associated with pain and inflammation are elevated in sites near to and re-mote from active myofascial trigger points. Arch Phys Med Re-habil. 2008; 89: 16-23. doi: 10.1016/j.apmr.2007.10.018

Visscher CM, Lobbezoo F, Naeije M. Comparison of algom-etry and palpation in the recognition of temporomandibular dis-order pain complaints. J Orofac Pain. 2004; 18(3): 214-219.

Schaefer G, Zavisek M, Nakashima T. Thermography based breast cancer analysis using statistical features and fuzzy clas-sification. Pattern Recognition. 2009; 47: 1133-1137.

Ming Z, Siivola J, Pietikainen S, Narhi M, Hanninen O. Post-operative relieve of abnormal vasoregulation in carpal tunnel syndrome. Clin Neurol Neurosurg. 2007; 109(5): 413-417. doi: 10.1016/j.clineuro.2007.02.014

Wishart GC, Campisi M, Boswell M, Chapman D, Shackleton V, Iddles S. The accuracy of digital infrared imaging for breast cancer detection in women undergoing breast biopsy. Eur J Surg Oncol. 2010; 36(6): 535-540. doi: 10.1016/j.ejso.2010.04.003

Marcinkowska-Gapinska A, Koowla P. Blood fluidity and thermography in patients with diabetes mellitus and coronary ar-tery disease in comparison to healthy subjects. Clin Hemorheol Microcirc. 2006; 35(4): 473-479.

Stary O. The pathogenesis of discogenic disease. Rev. Czech. Med Prahe. 1956; 2: 1-16.

Dibenedetto M, Yoshida M, Sharp M, Jones B. Foot evalua-tion by infrared maging. Mil Med. 2002; 167(5): 384-392.

Briosh ML, Teixeira MJ, Silva FM, Colman D. Principles and directions of medical thermography. Sao Paulo Andreoli. 2010; 280.

Haddad DS, Saito AE. Thermographic and clinical correla-tion of myofascial trigger points in muscles of mastication. Mes-trado. Faculty of Dentistry, USP. 2011.

Gerwin RD, Dommerholt J, Shah JP. An expansion of Si-mon’s integrated hypothesis of trigger point formation. Curr Pain Headache Rep. 2004; 8(6): 468-475. doi: 10.1007/s11916- 004-0069-x

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Published

2015-08-19

How to Cite

Juliana de Paiva Tosato, Carolina Marciela Herpich, Ernesto Cesar Pinto Leal, Fabiano Politti, & Daniela Aparecida Biasotto-Gonzalez. (2015). Influence of Phototherapy on Thermographic Images and Pain in Individuals with Temporomandibular Disorder: Protocol for a Randomized, Placebo-Controlled, Double-Blind Clinical Trial. Dentistry, 2(2), 66–73. https://doi.org/10.17140/DOJ-2-113