Clinical Aspects of the Use of Botulinum Toxin Type A in the Treatment of Dysfunction of the Masticatory System.

Abstract

The purpose of this work is to present a new, still experimental method of treating temporomandibular disorders (TMD) by injecting botulinum toxin Type A (TBX-A), using its effects not as a toxin but as a medication. The mechanism of TBX-A, indications and contraindications for its use, as well as possible side effects, are discussed. Temporomandibular disorders are of concern to approximately 70-80% of the population. The effect of botulinum toxin depends on blocking the release of acetylcholine from a presynaptic neuromuscular synapse and, in the autonomous system, blocking its release from post-ganglionic cholinergic neurons. In cases of long-term TMJ disorders, muscle activity increases and spastic contractions may even appear. TBX-A offers an opportunity for a normal social and family life for many patients suffering from masticatory system disorders (MSD), who have been isolated from the environment by pain. The study is based on a review of the literature and the authors' own experiences during several attempts to treat patients by this method. TBX-A is a safe medicine when the injection is performed by a well-trained physician.