Limited Additional Benefit of laser therapy in TMJ Arthrocentesis with hyaluronic acid: Study

A new study published in the journal of Oral and Maxillofacial Surgery showed that both temporomandibular joint (TMJ) arthrocentesis alone and arthrocentesis combined with low-level laser therapy (LLLT) significantly improved mouth opening and reduced pain. However, adding LLLT to arthrocentesis with hyaluronic acid did not provide significant additional short-term benefit, suggesting that most clinical improvement is driven by the primary intervention and may reach a therapeutic ceiling effect.

Anterior disc displacement without reduction (ADDwoR) is a common form of temporomandibular disorder in which the cartilage disc inside the jaw joint becomes displaced and fails to return to its normal position during movement. These patients often experience jaw pain, restricted mouth opening, joint stiffness, and difficulty chewing or speaking.

TMJ arthrocentesis is a minimally invasive procedure that flushes the joint space and reduces inflammation and is widely used to relieve symptoms. Hyaluronic acid injections are often added to improve joint lubrication and mobility. Studies have increasingly explored whether adjunctive therapies like LLLT could further enhance recovery and pain control.

The study from The British University in Egypt between December 2022 and December 2023, enrolled 40 female patients diagnosed with ADDwoR. These  participants underwent TMJ arthrocentesis followed by hyaluronic acid treatment and were randomly assigned to one of two groups. One group received ten sessions of adjunctive low-level laser therapy after the procedure, while the control group received arthrocentesis and hyaluronic acid alone.

This study evaluated treatment outcomes over a 12-week period using two primary measures, being pain intensity, assessed with a Visual Analogue Scale (VAS), and maximum mouth opening (MMO). The patients experienced marked reductions in pain and significant increases in mouth opening throughout the follow-up period.

Despite these clinical improvements, no statistically significant differences between the laser therapy group and the control group were observed at any time point during the study. Both groups demonstrated strong functional recovery, with postoperative mouth opening measurements significantly higher than preoperative values. Pain scores also fell dramatically after treatment in both cohorts. 

The primary benefits appeared to result from arthrocentesis combined with hyaluronic acid rather than from the addition of laser therapy. Overall, this study reinforces the effectiveness of arthrocentesis with hyaluronic acid as a minimally invasive option for improving jaw function and reducing pain in patients with TMJ disc displacement disorders.

Reference:

Bahaa, M., Azab, A. M. F. A., 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, 30(1). https://doi.org/10.1007/s10006-026-01573-1