A clinical evaluation of botulinum toxin-A injections in the temporomandibular disorder treatment

Hyun-Suk Kim, Pil-Young Yun, Young-Kyun Kim, Hyun-Suk Kim, Pil-Young Yun, Young-Kyun Kim

Abstract

Background: This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).

Methods: A total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis.

Results: The results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment.

Conclusions: Within the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.

Keywords: Botulinum toxin type A; Research diagnostic criteria for temporomandibular disorder; Temporomandibular disorder.

References

    1. Fricton JR, Kroening RJ, Hathaway K. TMJ and craniofacial pain: diagnosis and management. 1. St. Louis, Tokyo: Ishiyaku EuroAmerica, Inc.; 1988. pp. 27–37.
    1. Guarda-Nardini L, Manfredini D, Salamone M, et al. Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study. Cranio. 2008;26:126–35.
    1. Bjornland T, Gjaerum AA, Moystad O. Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injections compared with injection with sodium hyaluronate. J Oral Rehabil. 2007;34:583–9. doi: 10.1111/j.1365-2842.2007.01759.x.
    1. Chung JW, Chung SC (2002) Research Diagnostic Criteria for Temporomandibular Disorders RDC/TMD. .
    1. Shibuya Y, Takeuchi J, Ikehata N, et al. A clinical study of temporomandibular joint disorders—an analysis based on the Japanese subtype classification. Kobe J Med Sci. 2007;53:63–70.
    1. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6:301–55.
    1. Yap AUJ, Dworkin SF, Chua EK, et al. Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients. J Orofac Pain. 2003;17:21–8.
    1. Meunier FA, Schiavo G, Molgo J. Botulinum neurotoxins: from paralysis to recovery of functional neuromuscular transmission. J Physiol Paris. 2002;96:105–13. doi: 10.1016/S0928-4257(01)00086-9.
    1. The wealthy dentist, survey (2009) 2009.
    1. Ludlow CL, Hallett M, Rhew K, et al. Therapeutic use of botulinum toxin. N Engl J Med. 1992;326:349–50. doi: 10.1056/NEJM199201303260516.
    1. Fu KY, Chen HM, Sun ZP, Zhang ZK, Ma XC. Long-term efficacy of botulinum toxin type A for the treatment of habitual dislocation of the temporomandibular joint. Brit J Oral Maxillofac Surg. 2010;48:281–4. doi: 10.1016/j.bjoms.2009.07.014.
    1. Ranoux D, Attal N, Morain F, Bouhassira D. Botulinum toxin type A induces direct analgesic effects in chronic neuropathic pain. Ann Neurol. 2008;64:274–84. doi: 10.1002/ana.21427.
    1. Thiele RB, Marcoot RM. Functional therapy for fractures of the condyloid process in adults. J Oral Maxillofac Surg. 1985;43:226–8. doi: 10.1016/0278-2391(85)90167-3.
    1. Sidebottom AJ, Patel AA, Amin J. Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study. Br J Oral Maxillofac Surg. 2013;51:199–205. doi: 10.1016/j.bjoms.2012.07.002.
    1. Dressler D, Adib Saberi F. Botulinum toxin: mechanisms of action. Eur Neurol. 2005;53:3–9. doi: 10.1159/000083259.
    1. Binder WJ, Brin MF, Blitzer A, Pogoda JM. Botulinum toxin type A (BOTOX) for treatment of migraine. Semin Cutan Med Surg. 2001;20:93–100. doi: 10.1053/sder.2001.24423.
    1. Binder WJ, Brin MF, Blitzer A, Schoenrock LD, Pogoda JM. Botulinum toxin type A (Botox) for treatment of migraine headaches: an open-label study. Otolaryngol Head Neck Surg. 2000;123:669–76. doi: 10.1067/mhn.2000.110960.
    1. Gale EN, Dixon DC. A simplified psychologic questionnaire as a treatment planning aid for patients with temporomandibular joint disorders. J Prosthet Dent. 1989;61:235–8. doi: 10.1016/0022-3913(89)90381-8.
    1. Suvinen TI, Reade PC. Temporomandibular disorders: a critical review of the nature of pain and its assessment. J Orofac Pain. 1995;9:317–39.
    1. Cimino R, Michelotti A, Stradi R, Farinaro C. Comparison of clinical and psychologic features of fibromyalgia and masticatory myofascial pain. J Orofac Pain. 1998;12:35–41.
    1. Rollman GB, Gillespie JM. The role of psychosocial factors in temporomandibular disorders. Curr Rev Pain. 2000;4:71–81. doi: 10.1007/s11916-000-0012-8.
    1. Michelotti A, Cioffi I, Festa P, Scala G, Farella M. Oral parafunctions as risk factors for diagnostic TMD subgroups. J Oral Reahbil. 2010;37:157–62. doi: 10.1111/j.1365-2842.2009.02033.x.

Source: PubMed

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