Application of Botulinum Toxin in Temporomandibular Disorders: A Systematic Review of Randomized Controlled Trials (RCTs)

Abstract

Temporomandibular disorders (TMDs) are multi-factorial and polysymptomatic pathologies and their management must be customized for every patient. Numerous therapy techniques are available to treat temporomandibular disorders-related muscular discomfort and persistent orofacial pain. Botulinum toxin (BoNT) has emerged as a popular option for patients with myofascial TMD who do not completely recover from their condition after receiving conservative care and medication. A systematic search of the literature, from January 2000 until 1 April 2022, was performed in the MEDLINE (PubMed), Web of Science, and Lilacs databases. The following search terms combination: (temporomandibular disorders) OR (botulinum) OR (toxin) was employed. A total of 357 articles were initially found in the electronic search. After screening, 11 full-text articles satisfied the inclusion criteria. The Cochrane risk of bias tool (RoB 2) tool, which uses seven domains of bias to assess random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment of self-reported outcomes, blinding of outcome assessment of objective measures, incomplete outcome data, selective reporting, and other biases, was employed to analyze randomized controlled trials. The aim of this systematic review of randomized controlled trials is to provide an overview of the use of BoNT for TMDs by comparing the application of BoNT with other therapeutic approaches. BoNT-A could help patients that do not respond to conservative treatments. Low doses are recommended when BoNT-A is considered for persistent orofacial pain related to TMD. Future research should, however, conduct clinical trials with a stricter design. The results of BoNT-A could be confirmed by more randomized controlled trials with larger sample sizes, less bias, and longer follow-up times.

Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis

“…Temporomandibular joint (TMJ), which provides essential biological activities, including chewing and speaking, is one of the most intricate and frequently utilized joints in the human body [ 1 ]. Avascular, non-innervated fibrocartilage with a strong capacity for regeneration covers the articular surfaces.…”

An Investigation of the Fracture Loads Involved in the Framework of Removable Partial Dentures Using Two Types of All-Ceramic Restorations

“…Lastly, the fracture test in this study was applied to the saddle area between the first premolar and second molar, which have been selected due to the maximum forces found in these regions according to the previous study. However, the outcomes might be changed using anterior teeth because of the different masticatory forces [ 44 , 45 , 46 , 47 , 48 ]. This led to the current and continued debate about whether to use all-ceramic restorations in the anterior or posterior teeth.…”

The Association between COVID-19 Related Anxiety, Stress, Depression, Temporomandibular Disorders, and Headaches from Childhood to Adulthood: A Systematic Review

“…Temporomandibular disorders are characterized by jaw joint and jaw muscle soreness, clicks, or creaks when opening or closing the mouth [ 4 , 5 , 28 , 29 , 30 , 31 ]. All these symptoms can be disabling and occur during chewing and when the patient yawns or even speaks [ 32 , 33 , 34 , 35 ]. Temporomandibular disorders are also manifested by pain in the cervical area, frequent headaches, and pain in the dental arches, and are caused and worsened by stress and psychosocial problems [ 36 ].…”