Abstract
The purpose of this study is to evaluate the effects of botulinum toxin type A (BoNT-A) for managing sleep bruxism (SB) in a randomized, placebo-controlled trial. Thirty SB subjects were randomly assigned into two groups evenly. The placebo group received saline injections into each masseter muscle, and the treatment group received BoNT-A injections into each masseter muscle. Audio–video–polysomnographic recordings in the sleep laboratory were made before, at four weeks after, and at 12 weeks after injection. Sleep and SB parameters were scored according to the diagnostic and coding manual of American Academy of Sleep Medicine. The change of sleep and SB parameters were investigated using repeated measures analysis of variance (RM-ANOVA). Twenty-three subjects completed the study (placebo group 10, treatment group 13). None of the SB episode variables showed a significant time and group interaction (p > 0.05) except for electromyography (EMG) variables. The peak amplitude of EMG bursts during SB showed a significant time and group interaction (p = 0.001). The injection decreased the peak amplitude of EMG bursts during SB only in the treatment group for 12 weeks (p < 0.0001). A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.
Highlights
In the International Classification of Sleep Disorders, 3rd edition [1], sleep bruxism (SB) is defined as stereotyped oromandibular activity during sleep characterized by teeth grinding and clenching
There was no significant difference between the groups
This study showed that a single botulinum toxin type A (BoNT-A) injection decreased the masseter muscle intensity during
Summary
In the International Classification of Sleep Disorders, 3rd edition [1], sleep bruxism (SB) is defined as stereotyped oromandibular activity during sleep characterized by teeth grinding and clenching. SB is common, with a prevalence of 7.4% of the adult population [2]. SB has been recognized as a risk factor related to teeth and dental prosthesis destruction, and pain in the masticatory structures [3,4]. Dental problems are associated with a significant amount of force during SB, averaging 66% of maximal clenching power [5]. There are treatment modalities for the management of SB, such as an occlusal splint, behavioral approaches, and pharmacological management. The occlusal splint is considered to be the first choice
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