Efficacy of botulinum toxin type A in the management of masticatory myofascial pain

de-la-Hoz, José Luis; Pedro, Miguel de; Martín-Fontelles, Isabel; Mesa-Jiménez, Juan A.; Chivato, Tomás; Bagüés, Ana

doi:10.1016/j.adaj.2021.07.020

Cited by 7 publications

(9 citation statements)

References 33 publications

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“…Considering the results of our study regarding pain sensibility on palpation in masseter and temporalis muscles, BoNT-A groups showed significantly reduced pain sensitivity to palpation 28 days after treatment and this improvement remained for 180 days after treatment. The improvement in this pain parameter is in accordance with other studies where patients with persistent MFP treated with BoNT-A, presented a significant reduction in different pain measurements including the pain pressure threshold of the masticatory muscles [20][21][22][23]. Moreover, the fact that in our study, the positive effects of a single injection of BoNT-A in the assessed variables lasted for 6 months, can clinically explain that the antinociceptive effect of BoNT-A is independent of muscle paralysis which last for 3 to 4 months [24].…”

Section: Discussionsupporting

confidence: 91%

“…BoNT-A (100 U; Botox ® , Allergan, Irvine, CA, USA) was reconstituted using non-preserved sterile saline solution 0.9%. Doses of BoNT-A were based on a previous report [ 20 , 29 ]. Bilateral intramuscular injections were performed in the masseter and anterior temporalis muscles using a 1-mL syringe with a 30-gauge needle by an investigator who was not involved in the dilution process.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial

Canales

Poluha

Pinzón

et al. 2022

Toxins

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This study assessed the effects of botulinum toxin type A (BoNT-A) in mandibular range of motion and muscle tenderness to palpation in persistent myofascial pain (MFP) patients (ReBEC RBR-2d4vvv). Eighty consecutive female subjects with persistent MFP, were randomly divided into four groups (n = 20): three BoNT-A groups with different doses and a saline solution group (placebo control group). Treatments were injected bilaterally in the masseter and anterior temporalis muscle in a single session. Clinical measurements of mandibular movements included: pain-free opening, maximum unassisted and assisted opening, and right and left lateral excursions. Palpation tests were performed bilaterally in the masseter and temporalis muscle. Follow-up occurred 28 and 180 days after treatment. For the statistical analysis the Mann–Whitney U-test with Bonferroni correction was used for groups comparisons. Regardless of dose, all parameters of mandibular range of motion significantly improved after 180 days in all BoNT-A groups, compared with the control group. Palpation pain over the masseter and temporalis muscles were significantly reduced in all BoNT-A groups regardless of dose, compared with the control group, after 28 and 180 days of treatment. Independent of doses, BoNT-A improved mandibular range of motion and muscle tenderness to palpation in persistent MFP patients.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial

Canales

Poluha

Pinzón

et al. 2022

Toxins

View full text Add to dashboard Cite

show abstract

“…Considering the results of our study regarding pain sensibility on palpation in masseter and temporalis muscles, BoNT-A groups showed significantly reduced pain sensitivity to palpation already 28 days after treatment and this improvement remained for 180 days after treatment. The improvement in this pain parameter is in accordance with other studies where patients with persistent MFP treated with BoNT-A, presented a significant reduction in different pain measurements including pain pressure threshold of the masticatory muscles [17][18][19][20] . Also, the fact that in our study, the positive effects of a single injection of BoNT-A in the assessed variables lasted for 6 months, could clinically explain that the antinociceptive effect of BoNT-A is independent of muscle paralysis which last for 3 to 4 months 21 .…”

Section: Discussionsupporting

confidence: 91%

“…In addition, no adverse effects in muscle and bone tissue with low doses of BoNT-A were found in that study. Therefore, it could be proposed that regardless of doses, BoNT-A also diminish pain and improve mandibular movements 17 with low risks of developing serious adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Does Botulinum Toxin Type–a Improve Mandibular Motion and Muscle Sensibility in Myofascial Pain Tmd Subjects? A Randomized, Controlled Clinical Trial

Poluha¹,

Rizzatti-Barbosa²,

Pinzón³

et al. 2022

Preprint

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To demonstrate if botulinum toxin type A (BoNT-A) improves mandibular range of motion and muscle sensibility to palpation in refractory myofascial pain (MFP) patients. METHODS: Eighty consecutive female subjects with refractory MFP, were randomly divided into four equal groups (n=20): BoNT-A low (BoNTA-L/10 U in each temporalis and 30 U in each masseter), BoNT-A medium (BoNTA-M/20 U in each temporalis and 50 U in each masseter), BoNT-A high (BoNTA-H/25 U in each temporalis and 75 U in each masseter) and saline solution 0.9% (SS, placebo control group/0.4 mL in each temporalis and 0.6 mL in each masseter). Clinical measurements of the mandibular movements included: pain-free opening, maximum unassisted and assisted opening, and right and left lateral movements. Palpation tests were performed bilaterally in masseter and temporalis muscle. Results were expressed as median, minimum, maximum, and means ± standard deviation (SD). Chi-Square Test was used to compare differences among groups. A 5% probability level was considered significant in all tests RESULTS: Regardless of dose, all parameters of mandibular range of motion significantly improve after 180 days in BoNT- A groups, when compared to the control group. Pain to palpation on muscles, significantly reduced in all BoNT- A groups regardless of dose, when compared to the control group, after 28 and 180 days of treatment. CONCLUSIONS: Independent of doses, BoNT-A improved mandibular range of motion and muscle sensibility to palpation in refractory MFP patients when compared to SS injections.

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“…It has been used to relieve inappropriate or excessive tension in the skeletal muscles. It has been reported the efficacy of BTx-A in the treatment of spastic smooth muscles of the gastrointestinal disorders [3]. In the last years, the range of application of botulinum toxin was expanded in the treatment of variety of medical disorders including pain syndromes, bruxism, facial asymmetry, hyperhidrosis, osmidrosis, muscle spasm, as well as the cosmetic reduction of masticatory and other muscles.…”

Section: Introductionmentioning

confidence: 99%

The therapeutic use of botulinum toxin in different oral and maxillofacial conditions

Tomeva¹,

Deliverska²,

Ignatov³

2022

MedInform

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Botulinum toxin A (BTx-A), a neurotoxin isolated from Clostridium botulinum, has been used for the treatment of a wide spectrum of conditions involving muscular spasm and hyperactivity, bruxism, in the management of temporomandibular joint disorders (TMD) related to muscle tension, fatigue, in cases of blepharospasm, strabismus, cervical dystonia, as a migraine preventive treatment etc. The established mechanism of the action of BTA is the inhibition of acetylcholine release from the motor nerve endings resulting in a locally decreased muscle contraction. Although the pathophysiology of myofascial pain remains uncertain, multiple neurologic, myogenous, and psychological theories have been accepted. Further evidence has suggested that the analgesic effects of Botox are mediated through the inhibition of the release of substance P and glutamate, which occurs at a lower concentration than the dose, necessary to produce muscle weakness. It could be used as a therapeutic option in functional recovery from dental, oral and maxillofacial surgery.Myofascial pain disorders, in most cases, are due to muscle hyperactivity and could include malocclusion, TMJ internal derangement, cervical pain, psychological stressors and parafunctional habits. Patients non-responsive to conservative treatment modalities, even if etiological factors are eliminated, could be a therapeutic challenge to the clinician. The efficacy of trigger point intramuscular botulinum toxin injections in the management of myofascial pain is still controversial. A lot of clinical trials supported the efficacy of BTx-A in reducing the occlusal force and myofascial pain symptoms.

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Efficacy of botulinum toxin type A in the management of masticatory myofascial pain

Cited by 7 publications

References 33 publications

Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial

Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial

Does Botulinum Toxin Type–a Improve Mandibular Motion and Muscle Sensibility in Myofascial Pain Tmd Subjects? A Randomized, Controlled Clinical Trial

The therapeutic use of botulinum toxin in different oral and maxillofacial conditions

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