Oromandibular dystonia after dental treatments: a report of two cases

Abstract

(J Korean Assoc Oral Maxillofac Surg 2012;38:379-83) Oromandibular dystonia (OMD) is a rare focal form of dystonia caused by prolonged muscles spasms in the mouth, face, and jaw. OMD can develop after dental treatment, as poorly aligned dentures or multiple tooth extraction may cause an impairment of proprioception in the oral cavity, leading to the subsequent development of dystonia. These repetitive involuntary jaw movements may interfere with chewing, swallowing, and speaking. We report here two cases of OMD after dental procedures.

Oromandibular Dystonia - A Purely Clinical Diagnostic Case Report

“…Central nervous system (CNS) trauma, neuroleptic exposure, hypoxic brain damage, metabolic disorders, and ischemic or demyelinating lesions in the upper brain stem can be related to OMD [7]. It has been suspected that dental and oral surgery interventions or treatments can be associated with the onset of dystonia [10][11][12][13][14][15][16]. In the present case, the patient was apparently asymptomatic concerned to the repetitive jaw movements yet noticed the change in occlusion following the dental extraction (a month before).…”

Chemodenervation for Oromandibular Dystonia Utilizing Botulinum Toxins

“…Clinically, these inappropriate movements can present as dysphonia, dysphagia, and difficulty in mastication [12]. Patients with OMD frequently present to dentists for dentures and are frequently underrecognized [13,14].…”

“…A meta-analysis published in 2018 reviewed the published literature and selected nine studies of BTX-A for inclusion after excluding several cases reports and case series as well as some small studies which did not report safety outcomes [14]. A total of 387 patients with isolated OMD were selected for the meta-analysis after excluding patients injected for other indications concomitantly.…”

“…Overall, a 27% complication rate was noted, with the most common side effect being dysphagia. Other side effects included jaw weakness, weak smile, nasal regurgitation, jaw tremors, mouth dryness, dysarthria, lip numbness, and pain at the injection site [14].…”

Management of Oromandibular Dystonia: A Case Report and Literature Update

“…To quantitatively assess the muscular contractions and to find the extent of muscle involvement electromyographic study of the bilateral temporalis and masseter was done. Electromyography activity was typically reflected as significant high frequency and high-voltage activity of motor unit potentials with either sustained or short-duration bursts of discharge patterns (fasciculations) at rest, which were normally electrically inactive [ 3 ] in the right side temporalis and masseter muscle ( Figure 3 ).…”