Beyond Pain Relief: Six-month Stability of ILTT Combined with Occlusal Splint in Temporomandibular Disorders: A Randomized Controlled Trial

Alessandro Marchesi*, Andrea Sardella, Paolo Aschedamini, Sumire Battelani, Chiara Beretta and Giulia Nocco

Introduction: Low Level Laser Therapy (LLLT), or photobiomodulation, is a non-invasive technique employed for its anti-inflammatory, analgesic, and tissue healing-stimulating effects. This study evaluates the efficacy of LLLT, alone and in combination with a Michigan occlusal splint, in patients with temporomandibular disorders (TMD) of an arthritic or osteoarthritic nature, investigating whether their combination provides more stable long-term results through occluso-photobiomodulation synergy.

Methods: Forty patients were randomized into three groups: LLLT alone (n=13), LLLT + splint (n=14), and placebo + splint (n=13). Laser therapy (810 nm, 500 mW, 10 minutes per session) was administered in seven weekly sessions. Pain symptoms (NRS, GCPS 2.0) and mandibular kinematics (maximum opening, laterality, protrusion) were assessed before treatment (T0), after treatment (T1), and at six-month follow-up (T2). Repeated measures ANOVA was used for statistical analysis.

Results: All groups showed significant improvement in pain and mandibular function over time (p<0.05). Mean NRS scores decreased from 6.2 to 2.1 in group A, from 6.4 to 1.9 in group B, and from 6.1 to 2.4 in group C. Maximum mouth opening increased by approximately 5-7 mm in all groups. No statistically significant differences were found between groups at T1. At T2, however, group B (LLLT + splint) showed continued pain improvement (NRS 1.5), while group A (LLLT alone) exhibited partial recurrence (NRS 3.4). Group C showed stable results (NRS 2.6). CPI, Interference Score, and disability points improved in all groups without significant intergroup differences. However, the between-group differences at T2 did not reach statistical significance, and these findings should therefore be considered preliminary and hypothesis-generating.

Discussion: LLLT confirms its efficacy in reducing pain and improving function in arthritic/osteoarthritic TMD. The combination of LLLT with a Michigan occlusal splint, while not superior in the short term, showed a numerically more favorable pain trajectory at six months, suggesting a synergistic effect between photobiomodulation and occlusal stabilization. Given that between-group differences did not reach statistical significance, this potential synergy should be regarded as a hypothesis-generating observation rather than a confirmed effect. LLLT represents a safe, non-invasive therapeutic option. Larger samples and longer follow-ups are needed to establish standardized protocols.

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Published on: Sep 18, 2026 Pages: 16-22

Full Text PDF Full Text HTML DOI: 10.17352/ijocs.000068
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