Editor's Summary, Q &amp; A, Reviewer's Critique

Tsai, Chi-Yang; Chiu, Wan‐Chun; Liao, Yi-Hsuan; Tsai, Chih-Mong

doi:10.1016/j.ajodo.2008.10.002

Cited by 13 publications

(2 citation statements)

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“…Considering that muscle contraction drives the mechano-transduction and molecular signaling required for bone homeostasis, what happens to mandibular bone when masticatory muscles are paralyzed? Pre-clinical evidence showed that masticatory muscle atrophy induced by BoNT/A impairs craniofacial bone development by reducing the size of particular regions of mandible (such as mandibular condyle) and altering its morphology, when compared with normally developed individuals [55,56,57,58,59,60,61]. However, the adverse effects of this intervention in adult individuals remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

Balanta‐Melo

Toro‐Ibacache

Kupczik

et al. 2019

Toxins

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The injection of botulinum toxin type A (BoNT/A) in the masticatory muscles, to cause its temporary paralysis, is a widely used intervention for clinical disorders such as oromandibular dystonia, sleep bruxism, and aesthetics (i.e., masseteric hypertrophy). Considering that muscle contraction is required for mechano-transduction to maintain bone homeostasis, it is relevant to address the bone adverse effects associated with muscle condition after this intervention. Our aim is to condense the current and relevant literature about mandibular bone loss in fully mature mammals after BoNT/A intervention in the masticatory muscles. Here, we compile evidence from animal models (mice, rats, and rabbits) to clinical studies, demonstrating that BoNT/A-induced masticatory muscle atrophy promotes mandibular bone loss. Mandibular bone-related adverse effects involve cellular and metabolic changes, microstructure degradation, and morphological alterations. While bone loss has been detected at the mandibular condyle or alveolar bone, cellular and molecular mechanisms involved in this process must still be elucidated. Further basic research could provide evidence for designing strategies to control the undesired effects on bone during the therapeutic use of BoNT/A. However, in the meantime, we consider it essential that patients treated with BoNT/A in the masticatory muscles be warned about a putative collateral mandibular bone damage.

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Section: Introductionmentioning

confidence: 99%

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

Balanta‐Melo

Toro‐Ibacache

Kupczik

et al. 2019

Toxins

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show abstract

“…BTX as a neurotoxin reversibly induces muscle paralysis and effectively reduces muscle power [22]. When BTX is administered into a masticatory muscle, such as the masseter or temporalis muscle, of growing animals, decreased growth of the maxillofacial bone is observed and the size of bone is significantly reduced [23]. In this study, BTX was injected into the anterior belly of the digastric muscle, and the BTX-injected group showed significant changes in the width of the maxillofacial bone compared to the saline-injected control group ( P < 0.05, Table 1).…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin A injection into the anterior belly of the digastric muscle increased the posterior width of the maxillary arch in developing rats

Ahn

Kim

et al. 2019

Maxillofac Plast Reconstr Surg

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Background The purpose of this study was to evaluate the effects of botulinum toxin A (BTX) injection into the anterior belly of the digastric muscle on a growing rat. Methods Ten Sprague Dawley rats were used in this study. When the rats were 13 days old, 0.5 units of BTX was injected into the anterior belly of the digastric muscle for the experimental group ( n = 5). For the control, the same volume of normal saline was injected ( n = 5). The rats were sacrificed at 60 days old, and the skulls were harvested for micro-computed tomography (μCT) analysis. Results In anthropometric analysis, the zygomatic arch and mandibular bi-condylar width were significantly lower in the experimental group than those in the control group ( P = 0.025 and 0.027, respectively). The maxillary point width was significantly higher in the experimental group than that in the control group ( P = 0.020). Conclusion BTX injection into the anterior belly of the digastric muscle had effects on the maxillofacial bony width in growing rats.

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Therapeutic application of Botulinum Toxin A in patients with local muscle dystonia and oral dyskinesia

Orlova

Soikher²,

Сойхер³

et al. 2010

J. Stomat. Occ. Med.

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Botulinum Toxin Type A has been introduced as new therapeutic regime in neurological, cosmetic, urinary, gastrointestinal and pain-related conditions. The use of Botulinum Toxin A in craniomandibular disorders is discussed controversially.Local muscle dystonia is defined as movement disorder in combination with sustained muscle contractions. Contortion, repetitive movements and atypical posture are frequently seen symptoms in such cases. The movements are involuntary and often painful. A single muscle or a group of muscles, even the whole body may be involved. Oral dyskinesias are involuntary repetitive movements of the mouth and face. Severe bruxism can be included in this form of movement disorder.Within this study, patients diagnosed with severe bruxism or local muscle dystonia including oral dyskinesia were examined with electromyography before and after treatment. Subjects were randomly allocated to either myo-relaxation medication and relaxation splint therapy or to Botulinum Toxin A injection therapy. Surface EMG parameters of chewing and neck muscles were used to judge the treatment effects. A positive impact of BTA on EMG-characteristics, reflecting the functional condition of facial muscles, had been detected. BTA injections seem to have a positive effect in patients with bruxism and local muscle dystonia. An increased quantity of mandibular movements and a better coordination can be observed after BTA injection. In comparison with a standard myo relaxation therapy, the effects of BTA treatment are more distinct and long standing.BTA appears to be a promising therapeutic regime in patients with focal muscle dystonia and oral dyskinesia. A confirmed diagnosis and lege artis application by experienced clinicians constitute as sine qua non. Further studies are required to improve our knowledge in Botulinum Toxin A treatment of muscle dystonia and dyskinesia.

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Editor's Summary, Q & A, Reviewer's Critique

Cited by 13 publications

References 0 publications

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings

Botulinum toxin A injection into the anterior belly of the digastric muscle increased the posterior width of the maxillary arch in developing rats

Therapeutic application of Botulinum Toxin A in patients with local muscle dystonia and oral dyskinesia

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