Muscle Weakness After Repeated Injection of Botulinum Toxin Type A Evaluated According to Bite Force Measurement of Human Masseter Muscle

Kim, Ki Seo; Byun, Young Sub; Kim, Yong Jeong; Kim, Seong Taek

doi:10.1111/j.1524-4725.2009.01319.x

Cited by 52 publications

(45 citation statements)

References 24 publications

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“…31 Therefore, only 25 U of BoNT-A was chosen for the present study. In addition, the reducing effect on the masticatory force was maximal at 4 weeks after BoNT-A injection, [31][32][33] and the maximum bite force gradually recovered within 12 weeks. So, we evaluated the effect of BoNT-A on RMMA episodes during sleep at the point when the maximum effect was exerted.…”

Section: Bont-a Injectionmentioning

confidence: 87%

“…Masticatory muscle weakness can recover gradually from 4 to 12 weeks after BoNT injection in association with the changes of masticatory force. 32,33 In association with a decrease in the peak amplitude of EMG burst of RMMA episodes, the BoNT-A injection improved the subjective symptoms for morning jaw stiffness and tooth grinding during sleep. Morning jaw stiffness is commonly reported by the subjects with frequent RMMA episodes.…”

Section: Subjective Symptomsmentioning

confidence: 99%

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Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation

Shim

Lee

Kato

et al. 2014

Journal of Clinical Sleep Medicine

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BRIEF SUMMARYCurrent Knowledge/Study Rationale: Botulinum toxin type A (BoNT-A) has been used for managing involuntary orofacial movements and secondary bruxism in patients with movement disorders, but its usefulness and objective effects on sleep bruxism (SB) have not been evaluated using objective measures. The aim of this study was to investigate the effects of intramuscular BoNT-A injection on orofacial motor events during sleep in patients with clinical diagnosis of SB. Study Impact: A single injection of BoNT-A into jaw-closing muscles is an effective strategy for controlling SB for at least a month. It reduces the intensity rather than the generation of the contraction in the jaw-closing muscles. Establishing management of SB with BoNT-A awaits further studies on larger samples over a longer follow-up period. Medicine, Vol. 10, No. 3, 2014 YJ Shim, MK Lee, T Kato et al equally effective in pain reduction when compared with oral splint. 17,18 The result of these studies and case reports were based on the subjective evaluation of SB, not on the objective assessment using electromyography (EMG) or polysomnography (PSG). A study using portable electromyographic (EMG) device showed that the counts of sleep related masticatory EMG bursts, detected by the pre-defined threshold, were significantly reduced after a single injection of BoNT-A in the masseter muscle. 19 However, it remains unclear how BoNT-A injection works specifically for sleep-related masticatory EMG activity, as a variety of jaw motor activities occur in association with transient arousal changes during sleep. 20 Video-polysomnography (vPSG) can be a useful tool allowing discrimination of the types of sleep-related masticatory EMG events. 2 In previous case reports and studies, some cases injected BoNT-A into the masseter muscle only, [13][14][15]17,18 and others into both the masseter and temporalis muscles. 10,11,15 The masseter and temporalis muscles are synergetic muscles and activated during teeth grinding and clenching; however, there have been no studies assessing the difference between the choices or the combination of the injected muscles for motor activity control of the jaw during sleep. 292 Journal of Clinical SleepTherefore, the aims of this study were to investigate the effects of intramuscular BoNT-A injection on jaw motor episodes using vPSG. In addition to the use of vPSG, we compared the effects of BoNT-A on jaw motor episodes between the injection sites (i.e., the masseter muscle injection only versus injection of both masseter and temporalis muscles). METHODS SubjectsThe protocol of this study was undertaken with the approval of Korea Food & Drug Administration and Institutional Review Board of the Yonsei University Dental Hospital. All subjects were informed of the nature of the study, and written consent was obtained from each participant.Twenty-four subjects (M: 10; F: 14, age: 20.2-38.7 years) were selected from among outpatients at the Department of Orofacial Pain and Oral Medicine, Yonsei University Dental Hospital. A...

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Section: Bont-a Injectionmentioning

confidence: 87%

Section: Subjective Symptomsmentioning

confidence: 99%

Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation

Shim

Lee

Kato

et al. 2014

Journal of Clinical Sleep Medicine

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“…Adverse event profiles associated with botulinum toxin treatment for masseter hypertrophy reportedly include swelling, bruising, injection site pain, headache, change in bite force, speech disturbance, muscle pain, facial asymmetry, xerostomia and prominent zygoma [18]. In our study, one patient complained of transient injection site pain after BTX-B injection.…”

Section: Discussionmentioning

confidence: 84%

RimabotulinumtoxinB versus OnabotulinumtoxinA in the Treatment of Masseter Hypertrophy: A 24-Week Double-Blind Randomized Split-Face Study

et al. 2013

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Background: Masseter hypertrophy can be ameliorated by botulinum toxin. Objective: To compare the efficacy and safety of RimabotulinumtoxinB (BTX-B) and OnabotulinumtoxinA (BTX-A) in the treatment of masseter hypertrophy. Methods: Sixteen women with bilateral masseter hypertrophy received single injections of BTX-A or BTX-B at a dose ratio of 1:50 or 1:70 in a 24-week double-blind randomized split-face study. Results: Both BTX-A and BTX-B produced significant improvements in masseter hypertrophy. The maximum volume reduction, as determined by computed tomography scanning, at week 12 was comparable between BTX-A and BTX-B at a dose ratio of 1:70 (15.6 and 14.2%, respectively). At week 24, only masseters treated with BTX-A maintained a significant volume reduction. Investigator ratings and patient satisfaction scores paralleled objective computed tomography measurements. Conclusion: Both BTX-A and BTX-B are effective in the treatment of masseter hypertrophy. BTX-B, at a dose ratio of 1:70, has a comparable efficacy but a shorter duration of action than BTX-A.

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“…10 More quantitative clinical studies have indicated that, at comparable time points, 60% to 80% of control force is still present. 31,32 Unlike our study, human bite force was measured with the subjects voluntarily clenching at a maximal force, a highly subjective procedure. This study, by isolating each masseter muscle, allowed a more reliable measure of muscular force production without the influence of other variables such as patient cooperation and of uninjected muscles of mastication such as the temporalis and medial pterygoid.…”

Section: Discussionmentioning

confidence: 98%

Botulinum neurotoxin type A in the masseter muscle: Effects on incisor eruption in rabbits

Navarrete¹,

Rafferty

Liu

et al. 2013

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction Botulinum neurotoxins are responsible for the paralytic food poisoning, botulism. Commercial formulations such as botulinum neurotoxin type A are increasingly used for various conditions, including cosmetic recontouring of the lower face by injection of the large masseter muscles. The paralysis of a major muscle of mastication lowers occlusal force and thus might affect tooth eruption. The purpose of this study was to investigate the effects of unilateral masseter muscle injection of botulinum neurotoxin type A on the rate of eruption of incisors in a rabbit model. We hypothesized that the teeth would overerupt in an underloaded environment. Methods Forty rabbits were injected with either botulinum neurotoxin type A or saline solution in 1 masseter muscle. Mastication and muscle force production were monitored, and incisor eruption rate was assessed by caliper measurement of grooved teeth. Results The injection of saline solution had no effect. The masseter muscle injected with botulinum neurotoxin type A showed a dramatic loss of force 3 weeks after injection despite apparently normal mastication. Incisor eruption rate was significantly decreased for the botulinum neurotoxin type A group, an effect attributed to decreased attrition. Conclusions This study has implications for orthodontics. Although findings from ever-growing rabbit incisors cannot be extrapolated to human teeth, it is clear that botulinum neurotoxin type A caused a decrease in bite force that could influence dental eruption.

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Muscle Weakness After Repeated Injection of Botulinum Toxin Type A Evaluated According to Bite Force Measurement of Human Masseter Muscle

Abstract: MBF was significantly lower after booster injection of BTX-A into the human masseter muscle, but it gradually recovered in a predictable pattern, and the degree of discomfort experienced by the subjects had little effect on normal mastication.

Cited by 52 publications

References 24 publications

Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation

Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation

RimabotulinumtoxinB versus OnabotulinumtoxinA in the Treatment of Masseter Hypertrophy: A 24-Week Double-Blind Randomized Split-Face Study

Botulinum neurotoxin type A in the masseter muscle: Effects on incisor eruption in rabbits

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