Botulinum toxin is used as an alternative for the treatment of chronic refractory myofascial pain derived from temporomandibular disorders (TMDs). It is important to establish the benefits of botulinum toxin in this type of symptomatology. The aim of the study was to conduct a systematic review in order to evaluate the effects of botulinum toxin in patients with myofascial pain related to temporomandibular disorders. The search was carried out systematically, without limitations of language or year of publication, until February 2021. The databases searched included PubMed, Web of Science, Scopus, The Cochrane Library, and Latin American and Carribean Health Sciences Literature (LILACS). Partial gray literature was searched using Google Scholar, ClinicalTrials.gov, OpenGrey, and the reference lists of selected articles. Randomized controlled clinical trials evaluating the effects of botulinum toxin in the treatment of myofascial pain were included. The risk of bias was assessed with the Cochrane RoB 2.0 tool, and the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to determine the certainty of the scientific evidence. A total of 900 studies were retrieved, out of which only 8 randomized clinical trials were selected. From these 8 studies, the data of a total of 314 patients, predominantly women, between the ages of 18 to 75 years was obtained. After the assessment of the studies with the RoB 2.0 tool, 7 studies showed some concerns regarding the reported results and only one was at a low risk of overall bias. The analysis of the studies has shown that low doses of botulinum toxin are effective in the treatment of refractory myofascial pain associated with temporomandibular disorders. The studies presented medium-to low-certainty evidence..
La toxina botulínica se utiliza como alternativa para el tratamiento del dolor miofascial crónico refractario derivado de los trastornos temporomandibulares (TMD). Es importante establecer los beneficios de la toxina botulínica en este tipo de sintomatología. El objetivo del estudio fue realizar una revisión sistemática para evaluar los efectos de la toxina botulínica en pacientes con dolor miofascial relacionado con trastornos temporomandibulares. La búsqueda se realizó de manera sistemática, sin limitaciones de idioma o año de publicación, hasta febrero de 2021. Las bases de datos buscadas incluyeron PubMed, Web of Science, Scopus, The Cochrane Library y Latin American and Caribbean Health Sciences Literature (LILACS). Se buscó literatura gris parcial utilizando Google Scholar, ClinicalTrials.gov, OpenGrey y las listas de referencias de los artículos seleccionados. Se incluyeron ensayos clínicos controlados aleatorios que evaluaron los efectos de la toxina botulínica en el tratamiento del dolor miofascial. El riesgo de sesgo se evaluó con la herramienta Cochrane RoB 2.0 y se utilizó el enfoque The Grading of Recommendations Assessment, Development and Evaluation (GRADE) para determinar la certeza de la evidencia científica. Se recuperaron un total de 900 estudios, de los cuales solo se seleccionaron 8 ensayos clínicos aleatorizados. De estos 8 estudios se obtuvieron los datos de un total de 314 pacientes, predominantemente mujeres, entre las edades de 18 a 75 años. Después de la evaluación de los estudios con la herramienta RoB 2.0, 7 estudios mostraron algunas preocupaciones con respecto a los resultados informados y solo uno tenía un bajo riesgo de sesgo general. El análisis de los estudios ha demostrado que dosis bajas de toxina botulínica son eficaces en el tratamiento del dolor miofascial refractario asociado a trastornos temporomandibulares. Los estudios presentaron evidencia de certeza media a baja.
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