Clinical aspects of mastication myalgia—an overview

Barjandi, Golnaz; Svedenlöf, Johanna; Jasim, Hajer; Collin, Malin; Hedenberg-Magnusson, Britt; Christidis, Nikolaos; Ernberg, Malin

doi:10.3389/fpain.2023.1306475

Cited by 3 publications

(4 citation statements)

References 114 publications

(159 reference statements)

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“…Only two SRs showed a positive effect of BoNT-A [45,46], but only in half of the included RCTs in one of the reviews [46]. Although mandibular movements often are reduced in patients with M-TMD [17] as a consequence to the pain, BoNT-A does not seem to improve the range of mandibular movements, in accordance with a previous network-meta analysis showing that neither dry needling or wet needling with BoNT has a positive effect on mandibular movements [18]. One can only speculate as to why the effect on mandibular movements did not follow the pain-reducing effects shown in these SRs.…”

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

“…M-TMD is the most common (45%) diagnosis among the TMD diagnoses and is characterized by regional pain and increased tenderness in the masticatory muscles, diminished masticatory performance, and restricted jaw movements [17]. Although several treatment approaches have been shown to be successful in the management of M-TMD [17][18][19][20][21], persistence of pain in the masticatory muscles is common [22]. Results from well conducted randomized placebo-controlled clinical trials (RCTs) on the effects of BoNT-A on persistent M-TMD differ, but those showing positive effects of BoNT-A indicate improvements in pain levels, somatosensory alterations, muscle tenderness, jaw mobility, and psychological wellbeing [23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

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Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews

De la Torre Canales,

Câmara-Souza,

Ernberg

et al. 2024

Drugs

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Objective Temporomandibular disorders (TMDs) encompass several conditions that cause pain and impair function of the masticatory muscles (M-TMDs) and temporomandibular joints. There is a large interest among clinicians and researchers in the use of botulinum toxin-A (BoNT-A) as a treatment for M-TMD. However, due to the lack of consistent evidence regarding the efficacy as well as adverse events of BoNT-A, clinical decision making is challenging. Therefore, this umbrella review aimed to systematically assess systematic reviews (SRs) evaluating BoNT-A treatment effects on pain intensity, mandibular movements, and adverse events in patients with M-TMDs. Method An electronic search was undertaken in the databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Epistemonikos, ClinicalTrials.gov, and ICTRP to identify SRs investigating BoNT-A effects on M-TMDs, published from the inception of each database until 6 December 2023. The quality of evidence was rated according to the critical appraisal checklist developed by the umbrella review methodology working group. Only high-quality SRs were included. Results In total, 18 SRs were included. BoNT-A was shown to be more effective than placebo to reduce pain intensity, but not compared to standard treatments. Additionally, BoNT-A was not superior to placebo or standard treatments regarding improvement of mandibular movements. BoNT-A was considered to have a higher risk for adverse events on muscle and bony tissue compared with other treatments. Conclusion The synthesis in this umbrella review provides the highest level of evidence present. Taken together, there are indications of effectiveness of BoNT-A for treatment of M-TMDs, supported by moderate evidence. However, considering the risk of causing serious adverse events, treatment with BoNT-A is recommended to be the last treatment alternative. Supplementary Information The online version contains supplementary material available at 10.1007/s40265-024-02048-x.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews

De la Torre Canales,

Câmara-Souza,

Ernberg

et al. 2024

Drugs

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“…In some patients, administration of nonsteroidal anti-inflammatory drugs (NSAIDs) for a week (along with drugs to protect the stomach) and a strict soft diet can already bring some relief. Barjandi [ 25 ] et al’s literature review demonstrated that naproxen and ibuprofen are the first choice of NSAIDs in patients at risk for cardiovascular diseases, and if the patient is at risk for gastrointestinal bleeding, celecoxib should be chosen [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

An Algorithm for Jaw Pain among Divers

Vivacqua,

Fan,

Gürtler

et al. 2024

JCM

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Background: Temporomandibular disease (TMD) is commonly seen, and divers also experience pain in the temporomandibular joint (TMJ) or masticatory muscles. This article aims to provide a tool for diving physicians or medical professionals involved in diving medicine since jaw pain among divers is a pertinent subject and can be challenging to evaluate without some background in dentistry or maxillofacial surgery. Method: A basic algorithm was developed to provide a tool to differentiate jaw pains experienced by divers. Three brief case studies were developed, and five diving physicians were tasked with diagnosing the cases using the algorithm. Additionally, simple exercises and massage techniques that can benefit patients with TMD, particularly immediately after diving, are outlined. Results: All five diving physicians successfully diagnosed the cases using the algorithm. However, three of them were unable to diagnose the first case (disc luxation) without consulting the algorithm. Nevertheless, all physicians acknowledged the utility of the algorithm. Conclusions: Jaw pain in divers can stem from diverse causes, but effective treatment options exist. Our study findings provide valuable insights to assist diving physicians in making accurate diagnoses and guiding appropriate patient management, which may include referrals to specialists such as dentists, maxillofacial surgeons, or orthodontists.

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Temporalis Muscle Changes Following Botulinum Toxin A Injections in Masseter Hypertrophy Patients: A Randomized Triple-Blinded Trial

de Souza Nobre,

de Oliveira Resende Machado,

Poluha

et al. 2024

Aesth Plast Surg

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Background This study aimed to elucidate the effects of botulinum toxin A (BoNT-A) treatment for patients diagnosed with masseter hypertrophy on the temporalis muscle, with a particular focus on assessing alterations in muscle thickness, electromyographic (EMG) activity, and the development of muscle pain. Methods The present randomized triple-blinded clinical trial enrolled 26 female participants aged between 25 and 50 years complaining about masseter hypertrophy. Participants received 75U of BoNT-A (abobotulinumtoxinA) in both masseter muscles and after three months were randomized to receive a second treatment session of saline solution (S-BoNT-A) or BoNT-A (M-BoNT-A). Longitudinal assessments included temporalis muscle thickness through ultrasound, EMG activity, subjective pain, and masseter prominence severity after one, three, and six months of the first injection session. Muscle thickness, EMG, and subjective pain were analysed using two-way ANOVA with repeated measures and post hoc Sidak test, and for masseter prominence severity, Friedman and Mann–Whitney tests were used. Results Regarding inter-group comparisons, a higher muscle thickness (p < 0.02) and a higher EMG activity (p < 0.01) were found in the M-BoNT-A group at the 6-month follow-up. For subjective pain assessments, inter-group comparisons showed a higher prevalence of painful regions in M-BoNT-A group at the 6-month follow-up (p < 0.02). No significant differences were found in masseter prominence severity at the 6 months assessment between groups. Conclusion BoNT-A treatment for masseter hypertrophy lead to structural and functional changes in the temporalis muscle, presenting higher changes after multiple injections of this treatment. Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Clinical aspects of mastication myalgia—an overview

Cited by 3 publications

References 114 publications

Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews

Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews

An Algorithm for Jaw Pain among Divers

Temporalis Muscle Changes Following Botulinum Toxin A Injections in Masseter Hypertrophy Patients: A Randomized Triple-Blinded Trial

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