Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double-blind randomised controlled trial M. L. DE CARLI*, M. B. GUERRA*, T. B. NUNES*, R. C. DI MATTEO*, C. E. P.DE LUCA*, A. C. C. ARANHA † , M. C. BOLZAN ‡ & A. L. WITZEL § *Department of Stomatology, School of Dentistry, University of S~ ao Paulo, S~ ao Paulo, † Department of Restorative Dentistry/Special Laboratory of Lasers in Dentistry, School of Dentistry, University of S~ ao Paulo, S~ ao Paulo, ‡ Foundation for Scientific and Technological Development of Dentistry, School of Dentistry, University of S~ ao Paulo, S~ ao Paulo and § Department of Stomatology Oral Medicine, School of Dentistry, University of S~ ao Paulo, S~ ao Paulo, Brazil SUMMARY This study aimed to evaluate the efficacy of piroxicam associated with low-level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double-blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm À2 ) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow-up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0Á05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0Á05) and showed the lowest temporal pain (P = 0Á02) at the 30-day follow-up. The combination of low-level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days. KEYWORDS: arthralgia, laser therapy, piroxicam, temporomandibular joint, temporomandibular joint disorders Accepted for publication 19 November 2012 Introduction Temporomandibular disorder (TMD) is a collective term, characterised by symptoms involving muscles of mastication, temporomandibular joint (TMJ) and oro- facial structures resulting from a dysfunction of the sto- matognatic system. The most common symptoms are jaw and facial pain, but earache and headache may be present. Furthermore, TMD is identified as the main cause of non-dental pain in the oro-facial region and is classified as a subclass of musculoskeletal disorders (1). Patients with arthralgia present considerably impaired oral health-related quality of life (OHRQoL) in compar- ison with the general population (2). Over the past 30 years, several authors have sought to determine the aetiology, pathophysiology and, consequently, therapy and management of patients with TMD. However, many aspects are still unclear (3). In most cases, the aim of the manage- ment should not be normalising the morphology, but to decrease pain and improve function. Therefore, primary treatments should be conservative and reversible and that should be focused on the control and reduction of symptoms (4). © 2012 Blackwell Publishing Ltd doi: 10.1111/joor.12022 Journal of Oral Rehabilitation 2012 Journal of Oral Rehabilitation