Effect of Photobiomodulation Applied to Masticatory Muscle Tender Points Combined With the Rocabado Approach in Patients With Myogenic Temporomandibular Disorders: A Double‐Blind, Randomized Controlled Trial

ABSTRACT Background Temporomandibular Joint Disorder (TMD) is a complex condition of multifactorial aetiology. Consequently, numerous studies have investigated optimal treatment strategies, with several reporting that multimodal approaches can effectively enhance pain relief and mandibular mobility. Objectives To investigate the effect of adding Photobiomodulation (PBM) to the Rocabado approach on pain intensity, pain threshold, mouth opening, and TMJ function in patients with myogenic TMDs. Methods Fifty‐two patients of both genders, from 18 to 40 years old, with myogenic TMDs were randomly assigned either to the PBM group or the placebo group. The PBM group ( n = 26) received active PBM in addition to the Rocabado approach, while the control group ( n = 26) received placebo PBM in addition to the Rocabado approach. All patients received 3 sessions a week for 6 weeks. Clinical assessment, including pain pressure threshold, pain intensity, maximum mouth opening, and TMJ function were assessed for all participants before and after the treatment program. Results Fifty‐two participants completed the study. Both groups showed significant within‐group improvements across all outcomes ( p < 0.05). Post‐treatment, the Photobiomodulation group showed significantly greater improvements than the placebo group in pressure pain thresholds across all tested masticatory muscle sites ( p < 0.05). Furthermore, the Photobiomodulation group achieved superior outcomes in mouth opening ROM (MD = 5.84 mm, 95% CI: 3.06 to 8.63, p = 0.001), pain intensity reduction (MD = −1.81, 95% CI: −2.46 to −1.02, p = 0.013), and TMJ functional scores: TMDDI (MD = −24.97, 95% CI: −32.72 to −18.39, p = 0.001), TMDSIS (MD = −16.83, 95% CI: −22.64 to −11.17, p = 0.001), and TMDSFS (MD = −14.98, 95% CI: −21.67 to −11.82, p = 0.001). Conclusion Photobiomodulation combined with the Rocabado approach is more effective than the Rocabado approach alone in improving pain intensity, pain threshold, maximum mouth opening, and TMJ function in patients with myogenic TMDs. All procedures were performed in accordance with the 1964 Declaration of Helsinki and its later amendments. This study was registered in the ClinicalTrials.gov registry, registration number: NCT07026617.