The effect of botulinum toxin A on patients with persistent idiopathic dentoalveolar pain—A systematic review

Abstract

Background It has been suggested that botulinum toxin A (BONT‐A) is a safe and effective treatment in relieving pain in patients with persistent idiopathic dentoalveolar pain (PIDP). Objectives This study aimed to systematically evaluate all the available studies investigating the pain‐relieving effects of BONT‐A in patients with PIDP. Methods A systematic search with specific search terms was made in PubMed, Web of Science and Scopus. Two authors screened titles and abstracts and selected eligible studies for inclusion in the systematic review. The quality of the studies was evaluated by the 12 items Quality Assessment Tool for Observational studies (Pre‐Post) Studies with No Control Group, and the level of evidence was assessed according to GRADE. Results Three observational studies of 3695 identified were included (445 overlapping studies; 3247 excluded studies). All studies were uncontrolled observational studies investigating the pain‐relieving effect of BONT‐A in patients with PIDP. The included studies had a fair quality (moderate risk of bias) and insufficient level of evidence. The pain reducing effect by BONT‐A injections was in average 50% or more in two studies, in one study 3 out of 4 patients became almost pain free. Conclusions This systematic review shows that presently the level of scientific evidence is insufficient to evaluate the pain‐relieving effect of BONT‐A injections in patients with PIDP. There are indications that BONT‐A injections could be a possible management option for patients with PIDP that seems to be safe and with few adverse events. There is a need for well‐designed placebo‐controlled, double‐blind RCTs.

Multidimensional Effectiveness of Botulinum Toxin in Neuropathic Pain: A Systematic Review of Randomized Clinical Trials

“…Although BoNT has been suggested as an effective treatment to counter neuropathic pain [ 29 , 30 , 31 , 32 , 33 , 34 , 35 ], evidence in the literature is mainly focused on the unidimensional evaluation of pain, with different systematic reviews assessing the Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS). Conversely, given the psychosocial and functional burden of neuropathic pain, a multidimensional assessment of this condition is needed, in order to promote a patient-centered approach.…”

Botulinum toxin in the rehabilitation of painful syndromes: multiperspective literature analysis, lexical analysis and systematic review of randomized controlled trials

“…Particular conditions, like pelvic dysfunction or temporomandibular joint abnormalities, present other predominant journal categories or departments. 63 , 64 Interestingly, the journal category of health services is not highly represented, although the relevant impacts of the BTX in the medical and economic management. These impacts concern the drug cost and the critical socio-economic effects of the disabilities due to the conditions related to BTX.…”

Treatment of Persistent Idiopathic Dentoalveolar Pain with Venlafaxine: A Multicentric Retrospective Study on Its Effectiveness and Safety

“…3,4 The clinical manifestations of PIDP include persistent pain with a usually moderate intensity in the intraoral dentoalveolar area. 5 The pain is typically described as deep, dull, and pressure-like but with considerable variation in manifestation across patients. 1 A subset of patients may also present with sensory abnormalities to cold, touch, and have pin-prick sensations on the affected side, and some patients may experience increased pain in response to percussion and/or palpation in the affected tooth or the dentoalveolar region.…”