Laser phototherapy as primary treatment in acute trismus.

Emilia Rasca; Aude Fauchon�Giumelli; Samir Nammour

Volume : VI, Issue : X, October - 2016

Laser phototherapy as primary treatment in acute trismus.

Emilia Rasca, Aude Fauchon Giumelli, Samir Nammour

Abstract :

Background and Objective: This study aimed to assess the effectiveness of laser phototherapy (LPT), administered within 48 hours after an acute mandibular trauma, on restricted mouth opening and accompanying pain. Study Design/Materials and Methods: From 86 patients, 43 females and 43 males, which sustained a jaw trauma within the preceding 240 hours, 54 were treated exclusively by LPT at ≤ 48 hours after injury, and 32, seen 49 to 240 hours after the injury, continued with the pharmacotherapy already set (control group). Myalgia and arthralgia diagnoses were established accordingly to the diagnostic criteria of temporomandibular joint disorders (DC/TMD). The unassisted mouth opening (MUO) and the self–reported pain assessed on a visual analogic scale (VAS) were recorded at baseline and at 15 minutes after LPT or after 15 days of pharmacotherapy. The pain was additionally assessed at day 7 and 15 for the LPT group. A 25 cm²–area, covering the masticatory muscles, the temporomandibular joint and their innervation was scanned by a laser beam during 60 seconds (10 mm/s speed). An optic fie of 600 µm delivered, at 5 Hz, a double wavelength: 635 nm (125 mW, 29.6 W/cm², 5 J) and 810 nm (1.3 W, 52 W/cm², 52 J). Results: Regardless of gender or age, the posttreatment MUO was increased by 39 % (18.24 ± 4.63 mm) in the LPT group and by 29 % (10.22 ± 4.25 mm) in the control group (p < 0.0001). The VAS score diminished from 8.06 ± 1.25 to 2.37 ± 1.25 at 15 minutes after LPT and from 7.78 ± 1.45 to 5.66 ± 1.47 after 15 days of pharmacotherapy (p < 0.0001). At day 7 after LPT, the VAS score showed another significant reduction but remained unchanged at day 15. Conclusion: when applied within the 48 hours after a facial trauma, LPT alone can resolve, in 15 minutes, both restricted mouth opening and pain in acute posttraumatic painful trismus, for 15 days.