Botulinum Neurotoxin Type-A for the Treatment of Atypical Odontalgia

Cuadrado, María‐Luz; García-Moreno, Héctor; Arias, José-Antonio; Pareja, Juan A.

doi:10.1093/pm/pnw040

Cited by 31 publications

(61 citation statements)

References 19 publications

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“…Other therapeutic modalities, such as the local injection of anesthetics, 11 have also demonstrated inconsistent results. A therapeutic alternative could be the local injection of botulinum toxin, considering this was found to be effective in a case series of four patients published in 2016 by our own research group, 12 as well as one case report. 13 …”

Section: Introductionmentioning

confidence: 99%

OnabotulinumtoxinA injections for atypical odontalgia: an open-label study on nine patients

García-Sáez

Gutiérrez-Viedma

González‐García

et al. 2018

JPR

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BackgroundAtypical odontalgia (AO) manifests as continuous pain in the region of one or several teeth, in the absence of signs of dental pathology. Currently, there is insufficient evidence to establish treatment guidelines for AO. The aim of this study was to describe the effectiveness and safety of treatment with OnabotulinumtoxinA (OnabotA) on a series of patients with AO.MethodsNine patients with AO (four males and five females, aged between 31 and 77 years) received injections of OnabotA in the region of pain. The dosage used in each procedure ranged between 10 and 30 U, spread between 4 and 12 injection sites along the gums (n=9), the lips (n=3), and the hard palate (n=1). The median follow-up time was 27 months (interquartile range, IQR 20–40) and the median number of injection sessions per patient was seven (IQR 4.5–9). The assessment variables included the change in the maximal intensity of pain on a 0–10 numerical rating scale (NRS), the response latency, and the duration of the effect.ResultsAll patients experienced a significant improvement, with ≥50% of reduction in the intensity of the maximal pain. The median of reduction of maximal pain after treatment was six points on the NRS (IQR 5–8.5). The response latency was 2–15 days and the duration of the effect was 2–6 months. No significant adverse reactions were registered.ConclusionOnabotA may be a safe and effective option for the treatment of AO.

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Section: Introductionmentioning

confidence: 99%

OnabotulinumtoxinA injections for atypical odontalgia: an open-label study on nine patients

García-Sáez

Gutiérrez-Viedma

González‐García

et al. 2018

JPR

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“…In 2008, Antonucci et al [ 55 ] suggested that the effects of BoNT/A might be due to retrograde transport or to the effect of transcytosis. Beneficial effects of BoNT/A were also observed in numerous clinical studies under neuropathic pain [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 30 , 31 , 38 , 39 , 56 , 57 ]. Several studies, including those conducted by our group, have shown that intraplantar injections of BoNT/A are also effective for treating neuropathic pain [ 31 , 35 , 36 , 38 , 40 , 58 ].…”

Section: Mechanism-based Evidence For the Analgesic Actions Of Bonmentioning

confidence: 63%

“…This is the case for botulinum toxin A (BoNT/A), the use and application of which is increasing and becoming more widespread with time. BoNT/A is one of seven different BoNT types originating from Clostridium botulinum and is the most poisonous substance known to man [ 10 ], but, paradoxically, it has been widely used in the clinic, and its importance as a therapeutic agent is rising [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. The well-defined mechanism of BoNT/A action is based on preventing release of the neurotransmitter acetylcholine from presynaptic nerve terminals through fragmentation of the protein SNAP-25 [ 19 ].…”

Section: The Therapeutic Effect Of Bont/a—powerful Analgesic Agentmentioning

confidence: 99%

Botulinum Toxin Type A—A Modulator of Spinal Neuron–Glia Interactions under Neuropathic Pain Conditions

Rojewska

Piotrowska

Popiołek-Barczyk

et al. 2018

Toxins

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Neuropathic pain represents a significant clinical problem because it is a chronic condition often refractory to available therapy. Therefore, there is still a strong need for new analgesics. Botulinum neurotoxin A (BoNT/A) is used to treat a variety of clinical diseases associated with pain. Glia are in continuous bi-directional communication with neurons to direct the formation and refinement of synaptic connectivity. This review addresses the effects of BoNT/A on the relationship between glia and neurons under neuropathic pain. The inhibitory action of BoNT/A on synaptic vesicle fusion that blocks the release of miscellaneous pain-related neurotransmitters is known. However, increasing evidence suggests that the analgesic effect of BoNT/A is mediated through neurons and glial cells, especially microglia. In vitro studies provide evidence that BoNT/A exerts its anti-inflammatory effect by diminishing NF-κB, p38 and ERK1/2 phosphorylation in microglia and directly interacts with Toll-like receptor 2 (TLR2). Furthermore, BoNT/A appears to have no more than a slight effect on astroglia. The full activation of TLR2 in astroglia appears to require the presence of functional TLR4 in microglia, emphasizing the significant interaction between those cell types. In this review, we discuss whether and how BoNT/A affects the spinal neuron–glia interaction and reduces the development of neuropathy.

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“…Se han publicado dos series de casos por parte del grupo de Cuadrado y col, uno de ellos con cuatro casos de OA 16 y, posteriormente, una extensión a nueve pacientes con un alivio significativo del dolor. En este último estudio 17 se incluyeron nueve pacientes con dolor dentoalveolar crónico, que habían recibido tratamiento con antidepresivos, antiepilépticos, antiinflamatorios no esteroideos y opioides durante más de seis meses, sin respuesta satisfactoria.…”

Section: Discussionunclassified

OnabotulinumtoxinA in the treatment of atypical odontalgia: description of a clinical case

López-Bravo¹,

Jarauta-Salvador²,

Lecina-Monge³

et al. 2019

An Sist Sanit Navar

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Botulinum Neurotoxin Type-A for the Treatment of Atypical Odontalgia

Abstract: The responses to BoNTA injections in this series agree with those previously observed in neuropathic pain. BoNTA injections may be a safe and effective option for the treatment of AO.

Cited by 31 publications

References 19 publications

OnabotulinumtoxinA injections for atypical odontalgia: an open-label study on nine patients

OnabotulinumtoxinA injections for atypical odontalgia: an open-label study on nine patients

Botulinum Toxin Type A—A Modulator of Spinal Neuron–Glia Interactions under Neuropathic Pain Conditions

OnabotulinumtoxinA in the treatment of atypical odontalgia: description of a clinical case

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