Growth effects of botulinum toxin type A injected unilaterally into the masseter muscle of developing rats

Park, Chanyoung; Park, Kitae; Kim, Jiyeon

doi:10.1631/jzus.b1400192

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…As reported by other scholars, subchondral bone, cortical bone, alveolar bone, and even the growth of the mandible were influenced by loading as well [ 25 – 27 ]. However, it is still unclear how much decreased loading could consistently lead to a bone defect.…”

Section: Discussionmentioning

confidence: 78%

Condylar Degradation from Decreased Occlusal Loading following Masticatory Muscle Atrophy

Shi

Zheng

Yang

2018

BioMed Research International

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Objective The masticatory muscles are the most important contributor to bite force, and the temporomandibular joint (TMJ) receives direct occlusal loading. The present study aimed to investigate condylar remodeling after masseter muscle atrophy in rats. Methods Sixty 5-week-old female Sprague-Dawley rats were divided into the following 3 groups: the control group, soft diet (SD) group, and botulinum toxin (BTX) group. The cross-sectional area (CSA) of the masseter muscles was investigated as well as atrogin-1/MuRF-1 expression. Changes in the condylar head were evaluated by H-E, toluidine blue staining, and contour measurements. The biomechanical sensitive factors PTHrP Ihh, Col2a1, and ColX of condylar cartilage were detected by immunohistochemical staining and western blotting. Furthermore, micro-CT and tartrate-resistant acid phosphatase (TRAP) staining were performed to determine the osteopenia in subchondral bone. Results The histological and protein analysis demonstrated muscle hypofunction in the SD and BTX groups. Condylar cartilage contour was diminished due to different treatments; the immunohistochemistry and protein examination showed that the expressions of PTHrP, Ihh, Col2a1, and ColX were suppressed in condylar cartilage. A steady osteoporosis in subchondral bone was found only in the BTX group. Conclusion The current results suggested that a steady relationship between muscular dysfunction and condylar remodeling exists.

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Section: Discussionmentioning

confidence: 78%

Condylar Degradation from Decreased Occlusal Loading following Masticatory Muscle Atrophy

Shi

Zheng

Yang

2018

BioMed Research International

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“…Efficacy and safety of BoNT-A depend on dose and application and should be adjusted based on indication and clinical assessment. In animal studies, described long-term effects on the muscular skeletal system, in the sense of degradation, underline the need for moderate dosages in an elaborated treatment strategy such as the key-muscle concept [ 96 , 97 ]. Dose optimisation and best practice in application are crucial.…”

Section: Optimising Injectionmentioning

confidence: 99%

Best Clinical Practice in Botulinum Toxin Treatment for Children with Cerebral Palsy

Strobl¹,

Theologis

Brunner

et al. 2015

Toxins

122

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Botulinum toxin A (BoNT-A) is considered a safe and effective therapy for children with cerebral palsy (CP), especially in the hands of experienced injectors and for the majority of children. Recently, some risks have been noted for children with Gross Motor Classification Scale (GMFCS) of IV and the risks are substantial for level V. Recommendations for treatment with BoNT-A have been published since 1993, with continuous optimisation and development of new treatment concepts. This leads to modifications in the clinical decision making process, indications, injection techniques, assessments, and evaluations. This article summarises the state of the art of BoNT-A treatment in children with CP, based mainly on the literature and expert opinions by an international paediatric orthopaedic user group. BoNT-A is an important part of multimodal management, to support motor development and improve function when the targeted management of spasticity in specific muscle groups is clinically indicated. Individualised assessment and treatment are essential, and should be part of an integrated approach chosen to support the achievement of motor milestones. To this end, goals should be set for both the long term and for each injection cycle. The correct choice of target muscles is also important; not all spastic muscles need to be injected. A more focused approach needs to be established to improve function and motor development, and to prevent adverse compensations and contractures. Furthermore, the timeline of BoNT-A treatment extends from infancy to adulthood, and treatment should take into account the change in indications with age.

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“…Considering that muscle contraction drives the mechano-transduction and molecular signaling required for bone homeostasis, what happens to mandibular bone when masticatory muscles are paralyzed? Pre-clinical evidence showed that masticatory muscle atrophy induced by BoNT/A impairs craniofacial bone development by reducing the size of particular regions of mandible (such as mandibular condyle) and altering its morphology, when compared with normally developed individuals [ 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. However, the adverse effects of this intervention in adult individuals remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

Balanta‐Melo

Toro‐Ibacache

Kupczik

et al. 2019

Toxins

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The injection of botulinum toxin type A (BoNT/A) in the masticatory muscles, to cause its temporary paralysis, is a widely used intervention for clinical disorders such as oromandibular dystonia, sleep bruxism, and aesthetics (i.e., masseteric hypertrophy). Considering that muscle contraction is required for mechano-transduction to maintain bone homeostasis, it is relevant to address the bone adverse effects associated with muscle condition after this intervention. Our aim is to condense the current and relevant literature about mandibular bone loss in fully mature mammals after BoNT/A intervention in the masticatory muscles. Here, we compile evidence from animal models (mice, rats, and rabbits) to clinical studies, demonstrating that BoNT/A-induced masticatory muscle atrophy promotes mandibular bone loss. Mandibular bone-related adverse effects involve cellular and metabolic changes, microstructure degradation, and morphological alterations. While bone loss has been detected at the mandibular condyle or alveolar bone, cellular and molecular mechanisms involved in this process must still be elucidated. Further basic research could provide evidence for designing strategies to control the undesired effects on bone during the therapeutic use of BoNT/A. However, in the meantime, we consider it essential that patients treated with BoNT/A in the masticatory muscles be warned about a putative collateral mandibular bone damage.

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Growth effects of botulinum toxin type A injected unilaterally into the masseter muscle of developing rats

Cited by 12 publications

References 18 publications

Condylar Degradation from Decreased Occlusal Loading following Masticatory Muscle Atrophy

Condylar Degradation from Decreased Occlusal Loading following Masticatory Muscle Atrophy

Best Clinical Practice in Botulinum Toxin Treatment for Children with Cerebral Palsy

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

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