Effect of botulinum toxin A on pain, bite force, and satisfaction of patients with bruxism: A randomized single-blind clinical trial comparing two protocols

Ramalho, Juliana; Palma, Luiz Felipe; Ramalho, Karen Müller; Tedesco, Tamara Kerber; Morimoto, Susana

doi:10.1016/j.sdentj.2022.12.008

Cited by 4 publications

(4 citation statements)

References 26 publications

(66 reference statements)

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“…(2015) [ 59 ] RCT Myofascial pain DC/TMD G1: 39.1 G8: 38.3 G1: 1:10 G8: 1:10 G1: placebo (20) G8: granisetron (20) G1: once a week for 3 weeks G8: once a week for 3 weeks Pain VAS MMO 6 months Low Cigerim and Kaplan (2020) [ 60 ] RCT Myofascial pain DC/TMD G1: 27.0 G9: 27.0 G10: 27.0 G11: 27.0 G1: 1:4 G9: 1:4 G10: 1:4 G11: 1:4 G1: placebo/control = paracetamol (47) G9: naproxen (42) G10: naproxen + codeine (40) G11: naproxen + single-dose dexamethasone (40) G1: every day for 1 week G9: every day for 1 week G10: every day for 1 week G11: every day for 1 week Pain VAS 4 weeks Low Cömert Kiliç (2016) [ 61 ] RCT Osteoarthritis DC/TMD G12: 32 G13: 28 G12: 1:8 G13: 1:3 G12: arthrocentesis + PRP injections (18) G13: arthrocentesis plus HA injection (13) G12: arthrocentesis + 1 mL PRP injection initially, and then four consecutive 1 mL PRP injection in TMJ at monthly intervals G13: arthrocentesis + a single intraarticular injection of HA Pain VAS G12: 11.6 months G13: 12.8 months Some concerns Da Silva Ramalho et al. (2023) [ 62 ] RCT ...…”

Section: Resultsmentioning

confidence: 99%

“…There are several different types of wet needling therapies for TMD-M, and the focus seems to be on botulinum toxin-A (BTX-A) [ 62 – 67 , 69 , 81 ], but other wet needling therapies such as lidocaine [ 75 , 81 , 83 ], magnesium sulfate [ 85 ], granisetron (5-HT 3 receptor antagonist) [ 59 ], platelet-rich plasma (PRP) [ 88 ], and morphine [ 75 ] have been investigated in RCTs as well.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies investigating which effect BTX-A has on pain intensity in patients with TMD-M were found. BTX-A has been shown to be more effective than placebo in reducing local pain of muscular origin in bruxers and patients with TMD-M [ 62 , 63 , 69 , 81 ]. Two studies also reported a long-lasting pain-reducing effect of BTX-A in patients with localized TMD-M [ 63 , 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…The pain-reducing effect in patients with localized TMD-M does not seem to depend on dosage [ 63 ]. Further, it does not depend on whether only the masseter muscle is treated or both the temporal and masseter muscles are treated [ 62 ]. However, when it comes to the patient group with persistent TMD-M, it was shown in a study by Ernberg et al.…”

Section: Resultsmentioning

confidence: 99%

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Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis

Christidis,

Al-Moraissi,

Barjandi

et al. 2023

Drugs

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Objective Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD. Method An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane’s tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose. Conclusions The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient’s individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches. Supplementary Information The online version contains supplementary material available at 10.1007/s40265-023-01971-9.

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