A clinical evaluation of botulinum toxin-A injections in the temporomandibular disorder treatment.

Hyun-Suk Kim,Pil-Young Yun,Young-Kyun Kim

doi:10.1186/s40902-016-0051-7

Abstract

BackgroundThis study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).MethodsA total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis.ResultsThe results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment.ConclusionsWithin the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.

Highlights

This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)
The purpose of this study was to clinically evaluate the effect of botulinum toxin injection in treating TMD arising from both intra-articular and extra-articular pathologies based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) which provides a comprehensive assessment
RDC/TMD Axis I criteria were used to diagnose the TMDs, and they were further classified under the TMD subtypes proposed by the Japanese Society for the Temporomandibular Joint (JSTMJ) in 2001: type I, masticatory muscle disorder; type II, capsule-ligament disorder; type III, disc disorder; type IV, degenerative joint diseases, osteoarthritis, and osteoarthrosis; and type V, cases not included in types I–IV [5]

Summary

Introduction

This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Temporomandibular disorders (TMD), musculoskeletal disorders of the masticatory system, are common clinical labels for pain in the orofacial area. Causes of TMD symptoms are often complex and idiopathic, and problems involve extra-articular and intra-articular pathologic conditions or a combination of the both. Since myofascial pains and mouth opening limitation are the most frequent symptoms in masticatory muscle disorders, directing treatments at the muscular components of TMD could yield therapeutic gains. Noninvasive conservative treatments such as counseling, soft diet, behavior medicine, physiotherapy, oral appliances, pharmacotherapy, and botulinum toxin injections are reported to be effective as first-line therapies for extra-articular pathologic conditions [2]

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