Non-Pharmacological Therapies for Management of Temporomandibular Myofascial Pain Syndrome: Laser Photobiomodulation or Dry Needling? Meta-Analyses of Human Clinical Trials

This review aims to compare the effect of photobiomodulation therapy (PBMT) using visible and near-infrared diode laser wavelengths to that of the dry needling technique (DNT) on the management of orofacial pain in patients with Temporomandibular Disorder Myofascial Pain Syndrome (TMD/MPS) in term of effectiveness, speed of recovery, and lasting of treatment. A systematic search of multiple electronic databases was carried out to identify the relevant clinical trials published between 1 January 2010 and 1 January 2024. The included studies were limited to human subjects who had orofacial pain associated with Axis 1 of TMD/MPS, involving two genders with age >18 years and were treated either with photobiomodulation using diode laser with wavelengths ranging from 600 up to 1200 nanometer (nm), or with the dry needling (DN) technique (superficial SDN or deep DDN), as a non-pharmacological therapies to decrease the intensity of orofacial pain associated with TMD/MPS. The risk of bias for included studies was assessed using the Cochrane RoB tool (for randomized studies). Three distinct meta-analyses were performed to quantify the pooled effects of PBM and DN in the management of TMD/MPS myofascial pain and deactivation of myofascial trigger points (MTPs). The meta-analyses were performed using Review Manager (RevMan) 5.3 from Cochrane. The confidence interval (CI) was established at 95% and p-values of less than 0.05 (p < 0.05) were considered statistically significant. Statistical heterogeneity was assessed using I2. Qualitative data were extracted and summarized in tables for each group study, while quantitative data were reported as Mean and Standard Deviation (SD) values for assessment variables in each sub-group study. The results among groups were systematically evaluated to draw the final conclusion. A rigorous electronic and manual search revealed 4150 possible articles. Following the application of the inclusion and exclusion criteria, twelve eligible studies were included in the analysis. Both PBMT and DNT were found to be effective in controlling the myalgia pain and primary symptoms associated with TMD/MPS, as well as deactivating the MTPs. DNT was statistically superior in terms of recovery time while PBMT was the more effective long-term therapy.