Photodynamic Therapy Outperforms Intra-Articular Injections for TMD Treatment, Study Finds

"PDT led to greater pain reduction, as measured by the Visual Analog Scale (VAS), along with significant improvements in mouth opening and masseter muscle pain threshold. Additionally, PDT was more effective in lowering the Fricton Temporomandibular Joint Index and enhancing oral health and overall quality of life scores," the researchers reported in Therapeutics and Clinical Risk Management.

Temporomandibular joint disorders (TMDs) encompass various conditions affecting the jaw joints and masticatory muscles, impacting around 31% of adults globally. Factors such as malocclusions, trauma, muscle dysfunction, and psychological stress contribute to its development, with the COVID-19 pandemic further increasing cases. Symptoms include jaw pain, restricted mobility, and clicking sounds, affecting daily activities and quality of life. While treatments range from physiotherapy to intra-articular injections, concerns over side effects have led to interest in photodynamic therapy (PDT). By reducing inflammation and improving healing, PDT shows potential as an alternative treatment.

Xiaotong Wei and colleagues from the Department of Oral and Maxillofacial Surgery, Cangzhou Central Hospital, China, conducted a retrospective analysis to compare the efficacy of intra-articular injections and photodynamic therapy in treating TMD. Their study aims to bridge the knowledge gap and provide clearer clinical insights to guide treatment decisions.

A retrospective analysis of 91 TMD patients (August 2022–February 2024) divided them into a control group (n=45, intra-articular injection) and an observation group (n=46, photodynamic therapy). The study compared clinical outcomes, pain levels (VAS), maximum mouth opening, masseter muscle pain threshold, Fricton Temporomandibular Joint Index, oral health (OHIP-14), and quality of life (SF-36) between the groups.

Based on the study, the researchers reported the following findings:

• The total effective rate was higher in the observation group (91.30%) compared to the control group (75.56%).
• VAS scores showed significant differences in group (F=5.487), time (F=8.356), and interaction effects (F=6.931).
• VAS scores decreased significantly at 1 and 4 weeks post-treatment, with the observation group showing lower scores than the control group.
• Maximum mouth opening and masseter muscle pain threshold improved in both groups, with greater improvement in the observation group.
• Fricton Temporomandibular Joint Index scores significantly decreased in both groups, with a more pronounced reduction in the observation group.
• OHIP-14 scores decreased, and SF-36 scores increased in both groups, with greater improvement in the observation group.

The findings showed that photodynamic therapy is a more effective treatment for temporomandibular joint disorder than intra-articular injections. It offers superior pain relief, enhanced joint function, and improved oral health and quality of life. Its photochemical mechanism promotes tissue repair, reduces inflammation, and enhances microcirculation, leading to longer-lasting benefits.

Additionally, PDT's non-invasive nature and the absence of side effects associated with repeated injections make it a promising alternative, particularly for patients with chronic or severe TMD.

Reference:

Wei X, Gao J, Tian Z, Zhao F, Wang H, Yan W. Retrospective Study on the Comparative Efficacy of Intra-Articular Injection and Photodynamic Therapy in the Treatment of TMD. Ther Clin Risk Manag. 2025;21:415-424 https://doi.org/10.2147/TCRM.S512151