***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A double-blind clinical trial was conducted on 30 female Temporom and ibular Disorders ( TMD ) patients who had pain as a chief complaint . The patients were r and omly allocated into three groups based on Low Intensity Laser ( LILT ) regimes namely 820 nm Gallium Aluminium Arsenide ( GaAlAs ) laser at energy densities of 21.4J/cm(2 ) , 107 J/cm(2 ) and placebo laser . Each patient had three LILT treatments in a week . The pressure pain threshold ( PPT ) of trigger points in masticatory muscles , unassisted maximum mouth opening without pain ( MOSP ) and symptom severity index ( SSI ) were recorded as baseline data and monitored after every treatment . Jaw kinesiology , electromyography ( EMG ) and pain rating index from McGill pain question naire were also recorded as baseline and final results . The analysis of covariance and further analysis showed that the higher energy density laser group had significant increases in PPT and EMG amplitude recorded from voluntary clenching ( cEMG ) compared with the placebo group at P values 0.0001 and 0.022 respectively . A significantly greater number of patients recovered from myofascial pain and TMJ arthralgia as assessed clinical ly in the higher energy group compared with the placebo ( P value = 0.02 and 0.006 respectively ) . There was no statistically significant difference in the other parameters of assessment among the groups at a P value 0.05 . At a period of 2 to 4 weeks review after LILT , there was an average 52 % reduction of pain as assessed by SSI Abstract Aims : This study investigated the efficacy of low-level laser therapy ( LLLT ) for the management of temporom and ibular joint ( TMJ ) osteoarthritis . Methodology : In a double-blind clinical trial , 20 patients with TMJ osteoarthritis were r and omly divided into laser and placebo groups . The patients in the laser group received irradiation from an 810 nm low-level laser ( Peak power 80 W , average power 50 mW , 1500 Hz , 1 μs pulse width , 120 seconds , 6 J , 3·4 J/cm2 per point ) , which was applied on four points around the TMJs and on painful muscles three times a week for 4 weeks . In the placebo group , the treatment was the same as that in the laser group , but with laser simulation . The patients were evaluated before laser therapy ( T1 ) , after 6 ( T2 ) and 12 ( T3 ) laser applications and 1 month after the last application ( T4 ) , and the amount of mouth opening and the pain intensity were recorded . Results : No significant differences were found in mouth opening either between the study groups or between the different evaluation times in each group ( P>0·05 ) . There was no significant difference in pain symptoms of the masticatory muscles and TMJ between the laser and the placebo groups ( P>0·05 ) , but some significant within-group improvements were present for Visual Analogue Scale ( VAS ) scores of the body of the masseter and TMJ in both groups . Conclusions : LLLT using the present laser parameters was no more effective than the placebo treatment for reducing pain and improving mouth opening in patients with TMJ osteoarthritis Background To evaluate the effect of Low Level Laser ( LLL ) application at the points of greatest pain in patients with chronic masticatory muscle pain . Methods A total number of 30 ( 21 women , 9 men , with a mean age of 39.2 ) were selected after the diagnosis of MPDS according to the Research Diagnostic Criteria for Temporom and ibular Disorder ( RDC/TMD ) . The patients were r and omly divided into three groups ; laser group I ( n = 10 ) ; patients received the LLL at the point of greatest pain , laser group II ( n = 10 ) ; patients received LLL at pre-established points in the effected muscles and placebo group ( n = 10 ) . LLL and placebo were applied three times per week , for a total of 12 sessions . M and ibular mobility was examined , masticator muscles tenderness were assessed and PPT values were obtained . Subjective pain levels were evaluated using VAS . The measurements performed before the treatment and after the completion of the therapy . Descriptive statistics ( mean , st and ard deviation , and frequency ) Student ’s t-test , Mann – Whitney U-test and paired- sample t-tests were used for analysis . Results In both laser groups , there was a statically significant reduction in PPT values of the muscles , number of muscles without any pain on palpation increased significantly , m and ibular movements ’ ranges were improved . Laser group I demonstrated statistically better results than the Laser group II in all of the measured values . Plasebo group did not show any statistically difference in any of the measured values . Conclusions LLLT can be accepted as an alternative treatment modality in the management of masticatory muscle pain and direct irradiation seems to effect better . Trial registration Current Controlled Trials IS RCT N31085 , Date of registration 28/08/20145 The purpose of this study was to assess the effect of low level laser therapy on subjects with intra-articular temporom and ibular disorders ( IA-TMD ) , and to quantify and compare severity of signs and symptoms before , during , and after the laser applications . The sample consisted of 45 subjects r and omly divided into three groups ( G ) of 15 subjects each : G-I :  15 individuals with IA-TMD su bmi tted to an energy dose of 52.5 J/cm2 ; G-II : dose of 105.0 J/cm2 ; and G-III : placebo group ( 0 J/cm2 ) . In all groups , the applications were performed on condylar points on the masseter and anterior temporalis muscles . Two weekly sessions were held for five weeks , totaling 10 applications . The assessed variables were : m and ibular movements and painful symptoms evoked by muscle palpation . These variables were measured before starting the study , then immediately after the first , fifth , and tenth laser application , and finally , 32 days after completing the applications . The results showed that there were statistically significant differences for G-I and G-II at the level of 1 % between the doses , as well as between assessment s. Therefore , it was concluded that the use of low level laser increased the mean m and ibular range of motion and reduced painful symptoms in the groups that received effective treatment , which did not occur in the placebo group The aim of this study was to evaluate different approaches to deactivating myofascial trigger points ( MTPs ) . Twenty-one women with bilateral MTPs in the masseter muscle were r and omly divided into three groups : laser therapy , needle treatment and control . Treatment effectiveness was evaluated after four sessions with intervals ranging between 48 and 72 h. Quantitative and qualitative methods were used to measure pain perception/sensation . The Wilcoxon test based on results expressed on a visual analog scale ( VAS ) demonstrated a significant ( P < 0.05 ) decrease in pain only in the laser and needle treatments groups , although a significant increase in the pressure pain threshold was evident only for needling with anesthetic injection ( P = 0.0469 ) , and laser therapy at a dose of 4 J/cm² ( P = 0.0156 ) . Based on these results , it was concluded that four sessions of needling with 2 % lidocaine injection with intervals between 48 and 72 h without a vasoconstrictor , or laser therapy at a dose of 4 J/cm² , are effective for deactivation of MTPs Objective : To investigate the effectiveness of low‐level laser therapy in the treatment of temporom and ibular disorder and to compare treatment effects in myogenic and arthrogenic cases . Methods : Thirty‐five patients were evaluated by magnetic resonance imaging and r and omly allocated to active treatment ( n=20 ) and placebo treatment ( n=15 ) groups . In addition to a daily exercise program , all patients were treated with fifteen sessions of low‐level laser therapy .  Pain , joint motion , number of joint sounds and tender points were assessed . Results : Significant reduction in pain was observed in both active and placebo treatment groups . Active and passive maximum mouth opening , lateral motion , number of tender points were significantly improved only in the active treatment group . Treatment effects in myogenic and arthrogenic cases were similar . Conclusion : Low‐level laser therapy can be considered as an alternative physical modality in the management of temporom and ibular disorder Purpose : The aim of this systematic review was to assess the efficacy of low-level laser therapy ( LLLT ) in patients with temporom and ibular disorders ( TMDs ) . Methods : Medline search was done from 1997 to 2011 using search terms appropriate to establishing a relation between LLLT and TMD . Only r and omized controlled trials were included in this study . Outcome variables related to pain , muscle tenderness , m and ibular movements , and Electromyographic ( EMG ) activity were considered . Of the 242 articles examined , 13 were finally included in the critical analysis conducted as a part of the present systematic review . Results : Of the 242 titles review ed , only 13 articles were considered eligible . 7 articles showed significant improvement in the study group , whereas 5 showed no significant improvement between the study and control groups . The primary outcome of most of the studies was pain . Other variables considered were muscle tenderness , m and ibular movements ; EMG activity was considered . Conclusion : Our results have shown that LLLT seems to be effective in reducing pain in TMD 's . It may be a treatment option for patients with an interest in a noninvasive , complementary therapy This study aim ed to evaluate the effectiveness of low intensity laser therapy ( LILT ) in 30 patients presenting temporom and ibular joint ( TMJ ) pain and m and ibular dysfunction in a r and om and double-blind research design . The sample , divided into experimental group ( 1 ) and placebo group ( 2 ) , was su bmi tted to the treatment with infrared laser ( 780 nm , 30 mW , 10 s , 6.3 J/cm(2 ) ) at three TMJ points . The treatment was evaluated throughout six sessions and 15 , 30 and 60 days after the end of the therapy , through visual analogue scale ( VAS ) , range of m and ibular movements and TMJ pressure pain threshold . The results showed a reduction in VAS ( p < 0.001 ) and through the ANOVA with repeated measures it was observed that the groups did not present statistically significant differences ( P = 0.2060 ) , as the averages of the evaluation times ( P = 0.3955 ) and the interaction groups evaluation times ( P = 0.3024 ) , considering the MVO . The same occurred for RLE ( P = 0.2988 , P = 0.1762 and P = 0.7970 ) , LLE ( P = 0.3265 , P = 0.4143 and P = 0.0696 ) , PPTD ( P = 0.1558 , P = 0.4695 and P = 0.0737 ) and PPTE ( P = 0.2376 , P = 0.3203 and P = 0.0624 ) . For PE , there were not statistically significant differences for groups ( P = 0.7017 ) and the interaction groups evaluation times ( P = 0.6678 ) , even so in both groups the PE varied with time ( P = 0.0069 ) The present study was design ed to evaluate the effects of low-level laser ( Nd : YAG ) therapy and occlusal splints in patients with signs and symptoms of temporom and ibular disorders ( TMD ) characterized with myofascial pain ( MP ) . A total of 30 patients were selected after being diagnosed with MP according to the Research Diagnostic Criteria for Temporom and ibular Disorders ( RDC/TDM ) . The patients were divided into three groups . The first group was occlusal splint ( OS ) group A ( n = 10 ) , the second was low-level laser therapy ( LLLT ) group B ( n = 10 ) , and the last group C was placebo ( n = 10 ) . LLLT ( 1,064 nm , 8 j/cm2 , 250 mW , Fotona ) was applied to the patients in the study group once a day for 10 days , for a total of ten sessions . The same parameters and application times were used for placebo group , but the patients were not irradiated . The application was on the trigger points . The patients in the OS group were instructed to wear occlusal splints 12 h/day for 3 weeks . Functional examination was based on RDC/TDM , and pressure pain values were obtained with the Visual Analog Scale . Comparisons were made between the groups before and after the treatment according to Wilcoxon , Mann – Whitney U , and Kruskal – Wallis tests . The pain score values decreased significantly after both LLLT ( p < 0.05 ) and occlusal splint therapy ( p < 0.05 ) compared to placebo group ( p < 0.05 ) . There was no significant difference between LLLT and OS groups after treatment ( p > 0.05 ) . OS and LLLT are effective for decreasing MP . In addition , this particular type of LLLT is as effective as occlusal splint for pain relief AIMS To evaluate the effectiveness of low-level laser therapy ( LLLT ) in patients presenting with temporom and ibular disorder ( TMD ) in a r and om and placebo-controlled research design . METHODS The sample consisted of 40 patients , divided into an experimental group ( G1 ) and a placebo group ( G2 ) . The treatment was done with an infrared laser ( 830 nm , 500mW , 20s , 4J/point ) at the painful points , once a 
    Output:
    
Combining data from all clinical ly heterogeneous studies revealed positive effects of LLLT on pain relief , regardless of the visual analogue scale ( VAS ) score or the change of VAS score between the baseline and the final follow-up time point , while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD .
Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up .
Temporom and ibular joint function outcomes indicated that the overall effect favored LLLT over placebo .
Conclusion This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD