Title	Low Level Laser Therapy (LLLT) Is Not An Effective Treatment For Temporomandibular Disorder Pain
Clinical Question	For a patient with temporomandibular disorder, will the application of low level laser therapy be beneficial in reducing TMD pain compared to not receiving laser therapy?
Clinical Bottom Line	There is not sufficient evidence to support the effectiveness of low level laser therapy in reducing temporomandibular disorder pain.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 22247925 Petrucci/2011 Patients with TMD Systematic Review with Meta-analysis Key results Six randomized controlled studies were selected for this analysis. All six trials provided data on pain intensity using the VAS scale. Of the six trials, two trials reported non-significant difference between pre-treatment and post-treatment pain. The four remaining trials revealed no significant differences between the LLLT treatment groups and the placebo groups. The pooled effect of LLLT on pain was 7.77 mm (95% CI: -2.49 to 18.02).
Evidence Search	("temporomandibular joint disorders"[MeSH Terms] OR ("temporomandibular"[All Fields] AND "joint"[All Fields] AND "disorders"[All Fields]) OR "temporomandibular joint disorders"[All Fields] OR ("temporomandibular"[All Fields] AND "disorders"[All Fields]) OR "temporomandibular disorders"[All Fields]) AND ("laser therapy, low-level"[MeSH Terms] OR ("laser"[All Fields] AND "therapy"[All Fields] AND "low-level"[All Fields]) OR "low-level laser therapy"[All Fields] OR ("low"[All Fields] AND "level"[All Fields] AND "laser"[All Fields] AND "therapy"[All Fields]) OR "low level laser therapy"[All Fields])
Comments on The Evidence	The authors performed a comprehensive, detailed search for relevant trials and data. Individual studies were assessed for validity using clear criteria. The authors reviewed 323 articles, 6 were selected with a total of 191 subjects. A meta-analysis was done.
Applicability	The use of Low Level Laser Therapy (LLLT) does not significantly reduce pain for patients with TMD. The use of LLLT is not worth the additional cost to patients.
Specialty	(General Dentistry)
Keywords	TMD, TMD therapy, Low Level Laser Therapy, LLLT
ID#	2219
Date of submission	04/09/2012
E-mail	dos@livemail.uthscsa.edu
Author	Sang Do
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Edward F. Wright, DDS, MS
Faculty mentor e-mail	WrightE2@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Aaron Fritsch (San Antonio) on 11/30/2017 A PubMed search was conducted in November 2017 for more recent evidence on the effectiveness of LLLT for TMD pain. The author of this CAT had come to the conclusion that LLLT is not an effective therapy for TMD pain. A more recent meta-analysis (PMID: 25491183) also came to the same conclusion, with a p-value of .0009 and a 95% confidence interval of -40.80 to 2.03 to show that there was no significant pain reduction between the two groups.