Botulinum Toxin Therapy for Managing Sleep Bruxism: A Randomized and Placebo—Controlled Trial

Abstract

The purpose of this study is to evaluate the effects of botulinum toxin type A (BoNT-A) for managing sleep bruxism (SB) in a randomized, placebo-controlled trial. Thirty SB subjects were randomly assigned into two groups evenly. The placebo group received saline injections into each masseter muscle, and the treatment group received BoNT-A injections into each masseter muscle. Audio–video–polysomnographic recordings in the sleep laboratory were made before, at four weeks after, and at 12 weeks after injection. Sleep and SB parameters were scored according to the diagnostic and coding manual of American Academy of Sleep Medicine. The change of sleep and SB parameters were investigated using repeated measures analysis of variance (RM-ANOVA). Twenty-three subjects completed the study (placebo group 10, treatment group 13). None of the SB episode variables showed a significant time and group interaction (p > 0.05) except for electromyography (EMG) variables. The peak amplitude of EMG bursts during SB showed a significant time and group interaction (p = 0.001). The injection decreased the peak amplitude of EMG bursts during SB only in the treatment group for 12 weeks (p < 0.0001). A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.

Managements of sleep bruxism in adult: A systematic review

“…Four RCT were reviewed regarding BTX-A injections into bilateral masseter or temporalis (50–100 units overall). They showed the efficacy of BTX-A in reducing the number of SB events [71] , peak amplitude of EMG burst [72] , [73] , number/duration of SB episodes [74] ; however, other SB-related parameters did not indicate a clear reduction.…”

Toxina botulínica vs otros métodos alternativos como opción para el tratamiento de pacientes con bruxismo: Revisión sistemática

“…A propósito de la dosis y lugar de punción del botox, no se ha evidenciado hasta la fecha una norma de la cantidad máxima para el tratamiento del bruxismo, debido a que la literatura reporta que el producto es comercializado en distintas disoluciones (Weill Medical College of Cornell University, 2021). Tampoco se ha establecido el número de punciones ni el mejor sitio en el que se obtengan mejores resultados; esto se puede corroborar en nuestra revisión, puesto que en ciertos artículos el sitio de las punciones van en un rango de 2 a 7 (Ondo et al, 2018) (Ali et al, 2021) (Yurttutan et al, 2019) pero en otras investigaciones no se detalla la cantidad exacta de punciones realizadas (Cahlin et al, 2019) (Shim et al, 2020). De la misma manera, no se ha establecido si existe mayor efectividad al colocar en el músculo masetero o temporal; en base a esto, 4 de los 6 artículos incluidos en la revisión aplicaron 100U de BTX en total; en otras palabras, en el músculo masetero y temporal de manera bilateral.…”

Recovery from Acute Malocclusion in Temporomandibular Disorders with Stabilization Splint: Case Report

“…In her case, the stabilization splint was not enough to reduce muscle tension. Botox injections reduce the frequency of bruxism events, decrease bruxism-related disorders [16].…”