Does adjunctive low-level laser therapy provide additional benefit following temporomandibular joint arthrocentesis with hyaluronic acid? A randomized clinical trial.

Clinical Snapshot

Key Findings

• P Value: p > 0.05 for all between-group comparisons

• Effect Size: Not reported

• Primary Outcome: No significant differences between groups in pain (VAS) or maximum mouth opening at any time point

• Nnt Or Sensitivity: Not applicable - no significant benefit demonstrated

• Confidence Interval: Not reported

Clinical Application

LLLT equipment available in many Australian oral surgery practices, but additional sessions increase treatment burden TMJ arthrocentesis covered under Medicare for eligible patients; LLLT typically private fee-for-service, making cost-effectiveness important consideration Female patients with anterior disc displacement without reduction requiring TMJ arthrocentesis

Abstract

PURPOSE: This study aimed to evaluate whether adjunctive low-level laser therapy (LLLT) provides additional clinical benefit over an optimized arthrocentesis protocol with hyaluronic acid in patients with ADDwoR. MATERIALS AND METHODS: From December 2022 to December 2023, a single-blinded prospective randomized clinical trial was conducted at The British University in Egypt's Department of Oral and Maxillofacial Surgery. The study involved 40 female participants diagnosed with Anterior Disc Displacement without Reduction (ADDwoR). Following TMJ arthrocentesis, subjects were assigned to one of two parallel cohorts: Group A received ten subsequent sessions of low-level laser therapy (LLLT), while Group B served as the control, receiving arthrocentesis alone. Treatment efficacy was evaluated based on pain intensity measured via a Visual Analogue Scale (VAS) and maximum mouth opening (MMO). Clinical assessments were performed at 2-week intervals over a 12-week follow-up period. RESULTS: No significant age-related differences were detected when comparing the intervention group to the control group (p = 0.087). No significant intergroup differences were observed in maximum mouth opening (MMO) or pain scores (VAS) at any follow-up time point (p > 0.05). Over the 12-week period, both study arms demonstrated significant clinical enhancement in terms of MMO and pain intensity (p < 0.001). Improvements in MMO were large in both groups, with postoperative values significantly higher than preoperative measurements. Pain scores decreased markedly following treatment, with preoperative scores significantly higher than all postoperative values. Overall, both interventions resulted in significant functional improvement and pain reduction, with no added benefit of the intervention over the control. CONCLUSION: While both TMJ arthrocentesis alone and arthrocentesis supplemented with LLLT significantly improved maximum mouth opening and reduced pain, LLLT did not provide a significant incremental benefit over arthrocentesis with hyaluronic acid. These findings suggest that clinical improvements are primarily driven by the main intervention and may reflect a possible therapeutic ceiling effect, beyond which adjunctive LLLT does not confer measurable short-term benefit. CLINICAL TRIAL NUMBER: Not applicable.

References

1. 1.Bahaa, M., Azab, A. M., Elfarmawy, M. A., & Morsi, H. O. (2026). Does adjunctive low-level laser therapy provide additional benefit following temporomandibular joint arthrocentesis with hyaluronic acid? A randomized clinical trial. Oral and Maxillofacial Surgery. https://doi.org/10.4103/jispcd.jispcd_151_23