Comparative Effectiveness of Botulinum Toxin, Low-Level Laser, and Ultrasound for Temporomandibular Disorders.

BACKGROUND

The key manifestations of temporomandibular disorders are clicking, pain, and loss of function. An ideal treatment for managing these symptoms has not yet been defined.

PRIMARY STUDY

OBJECTIVE

This study aimed to determine the most effective treatment for symptomatic management of temporomandibular disorder.

METHODS/

DESIGN

The study was designed as clinical, prospective, randomized, and controlled.

SETTING

The research was conducted at the Faculty of Dentistry, Nigde Omer Halisdemir University.

PARTICIPANTS

Forty-five individuals who sought treatment for symptoms of temporomandibular disorder were chosen, along with fifteen asymptomatic volunteers.

INTERVENTION: Botulinum toxin-A was administered to the first group, whereas the second group underwent low-dose laser therapy, and the third group received ultrasound therapy. The control group did not receive any form of treatment. Each group had 15 participants.

PRIMARY OUTCOME MEASURES: Evaluation of temporomandibular disorder findings was conducted before the procedure, on the 15th day, and at the 3-month follow-up after the procedure. Changes in clicking, pain, and mouth opening were assessed to determine treatment effectiveness.

RESULTS

Administration of botulinum toxin-A alleviated joint sounds and pain significantly, outperforming alternative treatments at the 15-day and three-month marks (P = .011, P = .026, and P < .001, respectively). Low-dose laser and ultrasound therapies increased mouth opening 15 days and three months after the procedure (P < .001).

CONCLUSION

Botulinum toxin-A effectively relieves pain and joint sounds associated with temporomandibular disorder symptoms, both in the short and long term. Although low-dose laser therapy and ultrasound therapy provided a shorter-term improvement in pain, they significantly improved mouth opening. Hence, in the context of treating temporomandibular disorder, the focus should be on prioritizing the utilization of botulinum toxin-A for pain control, alongside giving precedence to low-dose laser therapy and ultrasound therapy to improve mouth opening.