Direct infiltration of botulinum toxin into the pterygoid lateral muscle for repositioning of the disc during arthroscopy of the temporomandibular joint

Martı́n-Granizo, R.; Maniegas, L.; Colorado, L.; Millón-Cruz, Alejandrina; Pedro, Manuel

doi:10.1016/j.bjoms.2018.07.014

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…In the literature, there are many additional tools recommended for increasing the accuracy of the intramuscular injections, including ultrasonography, electromyography, computer-aided design/computeraided manufacturing-derived customized guides, and arthroscopy. [23][24][25][26][27] Electromyography is commonly used to confirm the correct needle tip placement by having the patient move the mandible. 26 Ultrasonography can locate the lateral pterygoid muscle through the gap between the coronoid process and the zygomatic arch as a triangular muscle when the patient is asked to open the mandible.…”

Section: Discussionmentioning

confidence: 99%

“…23 Injection under direct vision during arthroscopy is an invasive alternative for lateral pterygoid muscle injections. 25 Although the guidance of these instruments makes intramuscular injections more precise, they are not handy for physicians who are unfamiliar with them and they may have a steep learning curve. Furthermore, the use of extra instruments increases treatment costs, and it may be time-consuming as well as invasive (e.g., arthroscopy).…”

Section: Discussionmentioning

confidence: 99%

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A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study

Demiryürek

Kucukguven

Vargel

2021

Plastic &Amp; Reconstructive Surgery

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Background: Lateral pterygoid muscle activity is associated with the pathological mechanisms of some temporomandibular disorders. The authors aimed to define and demonstrate a novel, practical, and safe technique for botulinum toxin type A injection to the lateral pterygoid muscle based on their findings. Their secondary aims were to standardize the injection pattern according to the variations of the lateral pterygoid muscle and its surrounding anatomical structures, and to establish its advantages over intraoral injection. Methods: Twenty cadaver heads were dissected. The lateral pterygoid muscle and its surrounding structures were investigated for anatomical variations. Based on these findings, a standardized extraoral injection protocol was defined and compared with the intraoral technique for accuracy and safety. Results: The average depth of the lateral pterygoid plate from the skin surface was 49.9 ± 2.2 mm, and the mean width of the lateral pterygoid plate was 10.5 ± 3.9 mm. The extraoral injection approach based on the location of the maxillary tuberosity, tragus, and lateral pterygoid plate was consistent in all dissections for the accuracy of the intramuscular injection. In the intraoral approach, standardization of the entry point of the needle through the oral mucosa is difficult, which makes adjustment of the depth of the injection challenging while increasing the risk of neurovascular injury. Conclusions:The clinical significance of the lateral pterygoid muscle makes it worthwhile to implement minimally invasive treatments before considering more invasive options. The authors define a safe, accurate, and reliable approach with ease of administration in patients with temporomandibular disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study

Demiryürek

Kucukguven

Vargel

2021

Plastic &Amp; Reconstructive Surgery

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“…On the other hand, BTX injection in the lateral pterygoid was reported to improve pain and TMJ disc position in cases of DDWR 16,21,27,28 . This was attributed to the transient chemodenervation and reduced function of the lateral pterygoid.…”

Section: Discussionmentioning

confidence: 99%

Dextrose prolotherapy versus BOTOX injection for the management of TMJ disc displacement with reduction

Emara

ElAdl

2021

Egyptian Dental Journal

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Background: Temporomandibular disc displacement is a widely faced clinical condition and the management options are vast with varying difficulty and success rates. This study aims to evaluate the use of Botulinum Toxin injection and dextrose prolotherapy for such cases.Methods: 20 joints were included in this study divided into 2 groups; Group 1 receiving 25% 3mL Dextrose injection (with local anesthetic and saline solution) into the retrodiscal region while group 2 received 35 U Botulinum Toxin -Type A injection in the lateral pterygoid muscle. Pain (according to the visual analogue scale), clicking and maximal interincisal opening were assessed preoperatively and at 4 months followup. Results:The results showed no statistically significant differences between the 2 groups. The click disappeared in 7/10 joints in group 1 and 9/10 in group 2. The maximal interincisal opening was regained and slightly increased in all participants of the study. All patients reported better pain scores at the end of the followup period. Conclusions:Within the limitations of this study, we conclude that both treatment options tested are considered acceptable in the management of TMJ anterior disc displacement with reduction. Moreover, the results do not allow recommending one over the other as no statistically significant differences were found.

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“…This could be explained by the repetition of the infiltrative procedures over time [30][31][32][33][34][35][36]. The recommended procedures comprise synovectomy via coblation or laser, the subsynovial infiltration of PRP or CS, biopsies, and the resection of adhesions and pseudowalls [5,[37][38][39][40][41][42][43][44][45][46]. Although there are not enough quality studies, the current evidence recommends conservative management as first line treatment in the late stages (stages IV and V of the Wilkes classification) of TMJID.…”

Section: Are There Differences Between Infiltrations Of the Tmj With ...mentioning

confidence: 99%

Consensus Report and Recommendations on the Management of Late-stage Internal Derangement of the Temporomandibular Joint

Monje Gil,

Martínez Artal,

Cuevas Queipo de Llano

et al. 2024

JCM

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Introduction: This report investigates late-stage internal derangement (ID) of the temporomandibular joint (TMJ) with the aim of establishing a more effective and personalized treatment protocol to improve patients’ quality of life (QoL). Material and methods: A consensus was reached among maxillofacial surgeons specializing in LSID, based on a literature research and collective expert experience following the Delphi method. Consensus was considered to be achieved when a response received at least 80% of votes. Results: Four expert groups were established, respectively, focusing on diagnosis, minimally invasive surgery (MIS), open surgery and joint replacement. A comprehensive approach to late-stage ID of the TMJ requires a consensus report. This underscores the need for a personalized treatment plan, considering the variability in clinical presentations and progression of this pathology. Our recommendations aim to optimize clinical outcomes and enhance patient QoL.

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Direct infiltration of botulinum toxin into the pterygoid lateral muscle for repositioning of the disc during arthroscopy of the temporomandibular joint

Cited by 10 publications

References 5 publications

A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study

A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study

Dextrose prolotherapy versus BOTOX injection for the management of TMJ disc displacement with reduction

Consensus Report and Recommendations on the Management of Late-stage Internal Derangement of the Temporomandibular Joint

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