Botulinum Toxin A and Osteosarcopenia in Experimental Animals: A Scoping Review

Tang, Min; Graham, H. Kerr; Davidson, Kelsey E

doi:10.3390/toxins13030213

Cited by 6 publications

(3 citation statements)

References 49 publications

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“…In preclinical studies, BTX injections in hindlimbs are an established experimental animal model to study disuse-induced bone loss. 14,15 To maintain healthy bones, mechanical loads from muscular contraction and gravitational forces are required. The forces falling on bone are sensed by cells known as osteocytes that signal other bone cells including osteoblasts and osteoclasts to form and resorb bone, respectively, maintaining a steady state of bone remodelling.…”

Section: Introductionmentioning

confidence: 99%

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Adverse effect of botulinum toxin‐A injections on mandibular bone: A systematic review and meta‐analysis

Moussa,

Bachour,

Komarova

2023

J of Oral Rehabilitation

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IntroductionBotulinum toxin‐A (BTX) is a potent neurotoxin that is emerging in the scope of dental practice for its ability to temporarily paralyse musculature and reduce hyperfunction. This may be desirable in diseases/disorders associated with hyperactive muscles such as the muscles of mastication, most implicated in painful temporomandibular disorders (TMDs). The use of BTX extends beyond its indications with off‐label use in TMD's and other conditions, while potential adverse effects remain understudied. BTX is well‐established hindlimb paralysis model in animals leading to significant bone loss with underlying mechanisms remaining unclear. The objective of this study is to systematically review the literature for articles investigating changes in mandibular bone following BTX injections and meta‐analyse available data on reported bone outcomes.MethodsComprehensive search of Medline, Embase and Web of Science retrieved 934 articles. Following the screening process, 36 articles in animals and humans were included for quantitative synthesis. Articles in human individuals (6) and three different animal species (14) presented mandibular bone outcomes that were included in the meta‐analysis.ResultsThe masseter and temporalis muscles were frequently injected across all species. In humans, we observe a decrease of about 6% in cortical thickness of mandibular regions following BTX injection with no evident changes in either volume or density of bone structures. In animals, bone loss in the condylar region is significantly high in both cortical and trabecular compartments.DiscussionOur analysis supports the concept of BTX‐induced bone‐loss model in animal mandibles. Further, bone loss might be confined to the cortical compartments in humans. Most studies did not address the reality of repeated injections and excessive dosing, which occur due to the reversible action of BTX. More rigorous trials are needed to draw a full picture of potential long‐term adverse effects on bone.

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Section: Introductionmentioning

confidence: 99%

“…In preclinical studies, BTX injections in hindlimbs are an established experimental animal model to study disuse‐induced bone loss 14,15 . To maintain healthy bones, mechanical loads from muscular contraction and gravitational forces are required.…”

Section: Introductionmentioning

confidence: 99%

Adverse effect of botulinum toxin‐A injections on mandibular bone: A systematic review and meta‐analysis

Moussa,

Bachour,

Komarova

2023

J of Oral Rehabilitation

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“…21 A scoping review by Tang et al showed all rats and mice injected with an average dose of 20 U/kg presented with significant changes in bony density, architecture and strength. Additionally, Tang et al 22 noted a rapid increase in osteoclasts, downregulation of genes related to bone formation and upregulation of genes related to bone resorption after BoNTA injection.…”

mentioning

confidence: 99%

Impact of botulinum toxin injection into the masticatory muscles on mandibular bone: A systematic review

Gray¹,

Hack

Pérez

et al. 2022

J of Oral Rehabilitation

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Background Botulinum toxin type A (BoNTA) injection into the masticatory muscles has been widely used to treat a number of painful and nonpainful conditions; however, no systematic reviews have been performed on the long‐term effect to the mandibular bone. Objective Our systematic review aimed to evaluate the impact of botulinum toxin injection into the masticatory muscles on mandibular bone based. Methods PubMed, Embase, Ovid, CINAHL and Web of Science were searched for human studies assessing mandibular bone after injection of BoNTA using computed tomography (CT) and cone beam CT (CBCT). Results Seven studies were eligible for review; five reported significant bony changes to one or more areas of the mandible. Most frequently affected were the condylar head, coronoid process and ramus. The most frequent changes were decreased bone volume, cortical thickness and cortical and trabecular density. Conclusions This is the first systematic review to examine an association between BoNTA injection into the masticatory muscles and mandibular bone quality. Data were analysed from a limited number of studies with a small sample size, and the quality of the included studies was very low. While the majority of available evidence suggests BoNTA injection results in bony change, further study is required to confirm a dose‐dependence effect and the impact of gender and age. High‐quality trials should utilise a combination of software analysis and radiologist review, with longer‐term follow‐up to monitor for persistence of bony effect and clinical significance.

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