Photobiomodulation therapy (PTB) is a therapeutic possibility for temporomandibular disorders (TMD), but its effectiveness and protocols for use remain controversial. This study is a RCT that compared the effectiveness of PTB on pain points of the masticatory muscles and TMJs, located through palpation versus application of pre-established points in women with painful TMD, diagnosis by DC/TMD (Diagnostic Criteria for Temporomandibular Disorders – Brazilian Portuguese version). Therefore, a total sample of 54 women, aged between 18 and 60聽years, was investigated. Volunteers were randomly randomized and PTB was applied in four different groups with a dose of 4聽J and 6聽J divided into pre-established application points (PE – G1) and pain points (PD – G2) – Groups 4PE, 4PD, 6PE and 6PD. Four laser applications were performed with a wavelength of 780聽nm, one session per week, totaling one month of therapy. The following assessments were performed: DC/TMD, Brief Pain Inventory (BPI), McGill Questionnaire – Short Version (SF-MPQ) and Pain Intensity, Visual Analogue Scale (VAS). Friedman's test was used for within-group comparisons, while the Mann-Whitney test was used for between-group comparisons (p聽<聽0.05). According to the results, laser application on pain points (G2) was more effective. McGill's results showed that regardless of dose, the pain point application group had better outcomes (p聽=聽0.004). Pain intensity evaluation (last days) also showed that application at the pain points was more effective regardless of dose (p聽=聽0.0002). Medians and interquartile deviations showed overall that PTB was more effective at pain points, with a trend towards better outcomes at the 6聽J dose. Therefore, it can be concluded that in women with chronic painful TMD, the application of PTB at pain points is more effective than the application at pre-established points. Therefore, individualized PTB protocols are proposed, based on examination palpation of the masticatory structures.
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