Effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with temporomandibular dysfunction

Abstract

Background. Temporomandibular joint dysfunction (TMD) is a term that describes problems in the masticatory system, including the temporomandibular joint, the dento-muscular system and the supporting bones. Injection of botulinum toxin, as a noninvasive technique, might be useful in decreasing symptoms such as muscular spasm, dystonia, migraine headaches and TMD. Therefore, the aim of the present study was to evaluate the effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with TMD. Methods. A total of 61 patients were consecutively included in the present study in 2016‒2017. All the subjects received a 50-unit injection of Dysport botulinum toxin in the masseter muscles using an extraoral injection technique. The results of the injection were evaluated in terms of pain severity using VAS, clinical evaluations of the joint click through palpation and by determining the inter-incisal distance. The patients underwent follow-up examinations at 1-week, 3-month and 6-month intervals after injection. Data were analyzed with appropriate statistical tests. Results. Comparison of pain severity and articular clicks at different intervals showed decreases in these parameters over time, with significant differences between the time intervals (P<0.05). Comparison of mouth opening at different intervals showed increases in mouth opening over time. Conclusion. The results of the present study showed that injection of botulinum toxin can be used in patients with TMD as a non-invasive treatment modality

The use of botulinum toxin in the management of bruxism and facial arthromyalgia syndrome

“…In our study, the effects on the perceived pain were not conclusive in all patients at one-month post-injection, but a decrease in painful symptoms was obvious in all included patients after three months. This is consistent with the findings of other authors stating that pain was significantly reduced in patients undergoing botulinum toxin injections, with a denoting increase in their life quality (6,12,13,15).…”

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

“…However, in other studies, the puncture target spots were marked in a standardized manner, uniform for all the study participants with the anatomical landmarks adopted as the guidelines. Approaches suggested in the analyzed material include injections as follows: across 2 cm skin surface over the most prominent area of the muscle after clenching [ 27 ]; regularly across the muscle mass [ 42 ]; into area over the greatest cross-section surface of both masseter bellies [ 35 ]; regularly along the long axis of the masseter muscle [ 26 ]; or regularly in the lower part of the muscle [ 21 ]. Although simple, those methods are only applicable for easily accessible muscles—temporal and masseter.…”

A review on the history, use, and new developments of abobotulinumtoxinA (Dysport)

“…At every time point, there was a significant reduction in pain severity compared with baseline ( p < .001). The authors additionally noted that there was a significant reduction in the number of patients who experienced articular clicking after treatment 51 . One prospective study assessed the outcome of botulinum injections in 62 patients who failed to respond to conservative treatment measures to manage masticatory myofascial pain.…”

“…The authors additionally noted that there was a significant reduction in the number of patients who experienced articular clicking after treatment. 51 One prospective study assessed the outcome of botulinum injections in 62 patients who failed to respond to conservative treatment measures to manage masticatory myofascial pain. Patients received 50 U of abobotulinumtoxinA in up to three sites and pain was assessed using VAS.…”