The use of botulinum toxin-a in the treatment of muscular temporomandibular joint disorders

Çalış, Aylin Sipahi; Çolakoğlu, Zafer; Günbay, Sevtap

doi:10.1016/j.jormas.2019.02.015

Cited by 33 publications

(26 citation statements)

References 14 publications

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“…In contrast, no significant decrease was observed for the MBF in our study. Sipahi Calis et al[ 24 ] also reported that MBF did not change significantly after treatment in their patients. This fact could be attributed to the reference points and dosage of the BoNT-A injection and also to the method of MBF measurement.…”

Section: Discussionmentioning

confidence: 87%

Effects of ultrasound-assisted botulinum neurotoxin-A injection in patients with bruxism and masseter hypertrophy

Dıraçoğlu¹,

Şahbaz²,

Alptekin³

et al. 2021

Turk J Phys Med Rehab

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Objectives: This study aims to explore effects of ultrasound-assisted injection of the botulinum neurotoxin-A (BoNT-A) on muscle thickness (MT) in patients with masseter hypertrophy. Patients and methods: Between December 2018 and December 2019, a total of 20 patients (3 males, 17 females; mean age: 28±6.9 years; range, 18 to 42 years) with bruxism who underwent BoNT-A injections were reviewed retrospectively. The patients were treated using individualized injection dosages and sites. Assessment methods included length between the tragus and the angle of the mouth, maximal bite force, and MT of the masseter muscle. Follow-up data were collected from the hospital electronic database. Results: There were 26 masseter muscles with masseter hypertrophy in 20 patients. There was a significant difference in ultrasonographic measurements of the relaxed and contracted masseter muscles between the baseline and two weeks, one month and three months after the treatment (p<0.05). In the ultrasonographic measurement of the relaxed masseter muscle, post-treatment third month values significantly differed from the second week values. The differences in the measurement of the line between the tragus and the angle of the mouth between the baseline and two weeks, one month and three months after the treatment were statistically significant (p<0.05). In the maximal bite force measurements, no significant difference was observed between the baseline and post-intervention measurements (p>0.05). Conclusion: The MT decreases after a single dose of BoNT-A injection in patients with masseter muscle hypertrophy and ultrasonography is a convenient imaging modality for BoNT-A injection to the masseter.

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Section: Discussionmentioning

confidence: 87%

Effects of ultrasound-assisted botulinum neurotoxin-A injection in patients with bruxism and masseter hypertrophy

Dıraçoğlu¹,

Şahbaz²,

Alptekin³

et al. 2021

Turk J Phys Med Rehab

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“…As previously discussed, while some patients develop resolution of symptoms within 1–18 months ( 5 , 10 , 19 - 23 , 27 , 52 , 53 ), up to 88% of patients continue to experience symptoms ( 2 , 5 , 19 , 24 , 53 - 55 ). Botulinum toxin has had multiple applications in otolaryngology, including dystonia of the larynx ( 56 ), laryngeal granulomas ( 57 ), laryngeal joint dislocation ( 58 ), cricopharyngeal spasm ( 57 ), posterior glottic synechiae ( 59 ), blepharospasm ( 60 ), hemifacial spasm ( 60 ), temporomandibular joint disorders ( 61 ), and oromandibular dystonia ( 60 ). BTA treatments generally last for 3 to 6 months ( 62 , 63 ).…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin A for the treatment of first bite syndrome—a systematic review

Shaikh¹,

Jafary²,

Behnke³

et al. 2022

Gland Surg

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Background: First bite syndrome (FBS) is a rare post-surgical complication resulting in peri-parotid pain after the first bite of meals. Intra-parotid Botulinum toxin A may offer relief for these symptoms. There is no consensus on the optimal dosage, timing to symptom improvement, need for repeat injections, and safety of this treatment. The objective of this systematic review was to assess the efficacy and safety of intra-parotid Botulinum toxin A injection in treating FBS. Methods: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar were searched from the inception until July 2020. Case reports, case series, prospective and retrospective trials in which patients with post-surgical FBS were treated with intra-parotid botulinum toxin A injection were included. The primary outcome was improvement of FBS symptoms. Secondary outcomes were time to symptom improvement and complications. Risk of bias was assessed with National Institute of Health (NIH) Quality Assessment Tools.Results: Search results yielded 41 studies. Thirty-three articles were excluded after screening titles, abstracts, and full texts, yielding eight studies, from which 22 patients were included. No studies included a control. All studies were of lower quality and had at least moderate risk of bias. The initial botulinum toxin A injection dose ranged from 10-75 U. Time from surgical treatment to injection ranged from 1 month to 3 years. Seven studies, containing 17 patients, reported individual patient outcomes. Clinical improvement was reported in 16 patients lasting between 1-30 months post injection. Eight of 8 (100%) patients receiving at least 40 U botulinum toxin A had symptom improvement. Ten of 22 (45.5%) patients received a second botulinum toxin A injection due to return of pain at a mean of 3.8 months after the first injection. Seven of 22 (38.1%) patients had complete symptom resolution at a mean of 12.1 months. There were no reported injection complications, including: facial paralysis, infection, injection site reaction, and allergic reaction.Discussion: There are no controlled studies comparing intra-parotid botulinum toxin A to observation for FBS. However, botulinum toxin A appears to be a potentially safe, effective treatment.

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“…Ernberg et al performed the injections, using an audioamplified device to guarantee intramuscular administration [ 25 ]. Patel et al used EMG 27-gauge monopolar electrode needles for administering the botulinum toxin [ 34 ], while Sipahi-Calis et al deposited BTX in line with reflex measurements in electromyography guidelines [ 13 ]. All of the abovementioned trials used EMG for assessment of the superficial muscles, masseter and temporalis, apart from Patel’s et al—they described the access to the LPM due to usage of an EMG electrode needle, which allows for deeper tissues penetration.…”

Section: Discussionmentioning

confidence: 99%

“…Myofascial pain treatments vary from conservative methods, including exercises, physiotherapy (manual therapy and transcutaneous electrical nerve stimulation, low level laser therapy), biofeedback, occlusal appliance therapy or pharmacotherapy (muscle relaxants, tricyclic antidepressants), to invasive, including dry needling, wet needling with the use of various substances or even acupuncture [ 1 ]. In many clinical trials, needling methods were used when all available conservative treatments failed or as a supporting treatment [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Nowak

Chęciński²,

Nitecka-Buchta

et al. 2021

IJERPH

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(1) Background: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. (2) Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. (3) Results: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. (4) Conclusions: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.

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The use of botulinum toxin-a in the treatment of muscular temporomandibular joint disorders

Cited by 33 publications

References 14 publications

Effects of ultrasound-assisted botulinum neurotoxin-A injection in patients with bruxism and masseter hypertrophy

Effects of ultrasound-assisted botulinum neurotoxin-A injection in patients with bruxism and masseter hypertrophy

Botulinum toxin A for the treatment of first bite syndrome—a systematic review

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

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