Comparative evaluation of arthrocentesis with or without low level laser therapy for the management of temporomandibular joint osteoarthritis: A clinical comparative study.

INTRODUCTION: Temporomandibular joint osteoarthritis (TMJOA) presents challenges in management, often requiring multimodal approaches. Arthrocentesis, a nonsurgical intervention, offers symptomatic relief but lacks long-term benefits. Low-level laser therapy (LLLT) emerges as a promising adjunctive treatment, leveraging its analgesic and anti-inflammatory properties. Studies indicate that combining LLLT with arthrocentesis enhances outcomes, improving daily activities, reducing pain, and enhancing mandibular mobility. By promoting joint cartilage regeneration and alleviating myofascial pain, LLLT complements the rapid pain reduction and mobility gains facilitated by arthrocentesis. This combined approach offers a minimally invasive alternative, potentially reducing the need for open joint surgery and improving therapeutic outcomes for TMJOA patients. However, in previous studies, the laser was applied at muscle, while in the current study, the laser was applied at TMJ.

OBJECTIVES: To evaluate and compare the effect of arthrocentesis alone versus arthrocentesis combined with low-level laser therapy (LLLT) in patients with temporomandibular joint osteoarthritis (TMJOA).

MATERIALS AND METHODS: Patients undergoing arthrocentesis for temporomandibular joint osteoarthritis (TMJOA) were randomly assigned to two groups. Group one received arthrocentesis along with low-level laser therapy (LLLT), while group two received arthrocentesis alone. Preoperative pain measurements and maximum interincisal opening were recorded. Arthrocentesis involved needle insertion into specific points marked on the skin, followed by injection of Ringer's lactate solution. Group one received LLLT sessions postarthrocentesis. Treatment points were marked, and LLLT was applied with an 810-nm wavelength laser. Short-term follow-up of 1 month and long-term follow-up of 6 month were conducted, and the parameters evaluated at follow up were PAIN (VAS scale) on rest, PAIN (VAS scale) on lateral movements, and maximal interincisal mouth opening. Correlation between the groups was assessed. Postoperative measurements were taken by different operators to minimize bias. No postoperative analgesics or antibiotics were administered.

RESULTS: Both groups showed significant pain reduction (P < 0.001) and increased mouth opening (P < 0.001) postprocedure. However, the study group with LLLT exhibited significantly lower pain levels and greater mouth opening compared to the control group at 1- and 6-months postprocedure. LLLT as an adjunct to arthrocentesis may offer enhanced pain relief and functional improvement in TMJ osteoarthritis management.

CONCLUSION: Arthrocentesis, often effective in TMJ treatment, combines with low-level laser therapy (LLLT) to enhance pain relief and mouth opening in TMJ osteoarthritis patients. This randomized trial compared arthrocentesis alone to arthrocentesis with LLLT. Significant improvements were noted in pain and mouth opening in the LLLT group at the 6th-month follow-up.