Comprehensive evaluation of botulinum toxin treatment outcomes of a patient with persistent myofascial orofacial pain

Sitnikova, Victoria; Kämppi, Antti; Teronen, Olli

doi:10.1002/ccr3.4731

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…The injections were performed according to the techniques reported in previous research [13,37]. Each patient received a once-off treatment of 50 units of BoNT-A (Xeomin ® , supplied by Merz Pharmaceuticals GmbH, Frankfurt, Germany).…”

Section: Injectionsmentioning

confidence: 99%

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Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Sitnikova

Kämppi

Teronen

2022

Toxins

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Botulinum toxin type A (BoNT-A) is increasingly used in treating masticatory muscle pain disorder; however, safe doses and reinjection intervals still need to be established. The purpose of this randomized clinical trial was to evaluate the degree and duration of the impairment of masticatory muscle performance. Fifty-seven subjects were randomly divided into two groups: one of which received BoNT-A first (n = 28) while the other received saline first (n = 29), with the cross-over being in week 16, and a total follow-up period of 32 weeks. A total dose of 50 U of BoNT-A was injected in the masseter and temporal muscles bilaterally. Electromyographic (EMG) activity and bite forces were assessed. A significant reduction in EMG activity was observed up to week 18 (p ≤ 001), with total recovery at week 33. A significant reduction in maximum bite force was observed up to week 11 (p ≤ 005), with total recovery at week 25. In conclusion, when treating masticatory muscle pain disorder with 50 U of BoNT-A, a reinjection interval of 33 weeks can be considered safe since the recovery of muscle function occurs by that time.

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Section: Injectionsmentioning

confidence: 99%

“…EMG and bite force measurements were performed with equipment that demonstrated reliability and repeatability in previous studies [35][36][37]. The examination was conducted in the same space and under the same conditions.…”

Section: Treatment Outcomesmentioning

confidence: 99%

Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Sitnikova

Kämppi

Teronen

2022

Toxins

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“…Psychological distress and widespread pain are significant determinants in perceived temporomandibular pain and bruxism [37] . TMD are neuromuscular and musculoskeletal disorders that affect the jaw and muscles of mastication causing pain [38] . Common symptoms include facial pain, migraine, pain and tenderness in the masticatory muscles, reduced jaw mobility, and pain and sounds in temporomandibular joint [39] .…”

Section: Temporomandibular Disordersmentioning

confidence: 99%

Increase in bruxism cases during COVID pandemic

Sandoval¹,

Rodríguez²,

Fierro³

et al. 2022

Int. J. Appl. Dent. Sci.

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Introduction: Bruxism is currently a very common disorder in patients and there has been an increase in cases since COVID started. Studies and clinical cases have shown that different adverse effects occur as a result. Objective: To provide information about bruxism during the pandemic. It also explains the adverse effects that occur with this disorder: attrition, prosthetic complications, and temporomandibular disorders. Methods: An electronic article search was carried out through the PubMed and Mendeley databases, using the keywords: "bruxism", "COVID", "anxiety", Boolean operators were used as AND and OR. Results: Since the pandemic generated psychological stress, more patients developed bruxism. One of the effects in patients with bruxism is attrition, which occurs due to the grinding and clenching of the teeth. As much force is exerted on the teeth to suffer from this disorder prosthetic treatments tend to present complications. Bruxism and temporomandibular disorders have a great relationship since one lead to the other, signs include facial pain, headache, muscle pain, among others. Conclusion:The pandemic has caused an increase of the cases of patients with bruxism due to the stress generated, which has adverse effects such as attrition, prosthodontics complications and temporomandibular disorders. It is important to detect this disorder in the patients before it starts to damage dental health and to know how to manage the cases depending on the problems they have.

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Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial

Sitnikova,

Kämppi,

Kämppi

et al. 2024

Pain Practice

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BackgroundInjections of botulinum toxin type A (BoNT‐A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)‐related myofascial pain (MFP). BoNT‐A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo‐controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT‐A.MethodsSixty‐six subjects were randomized into two groups, one which received BoNT‐A first and a second which received a saline solution (SS) first. Follow‐ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain‐related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated.ResultsThe within‐group analysis showed a significant improvement in pain intensity and pain‐related disability after BoNT‐A (p < 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between‐group analysis of pain‐related variables revealed no differences between groups at any time. Nonetheless, BoNT‐A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16‐week follow‐ups favoring BoNT‐A.ConclusionsInjections of 50 U of BoNT‐A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious.

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Comprehensive evaluation of botulinum toxin treatment outcomes of a patient with persistent myofascial orofacial pain

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 3 publications

References 20 publications

Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Increase in bruxism cases during COVID pandemic

Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial

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