Effect of botulinum toxin treatment in patients with bruxism and orofacial pain - randomized double-blind clinical trial

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.8206

Keywords:

A-type botulinum toxin; Facial pain; Dentistry; Bruxism; Ear-jaw articulation; Temporomandibular joint dysfunction.

Abstract

Introduction: Bruxism is defined as a parafunctional chewing activity characterized by the clenching and / or grinding of teeth that occurs both during sleep and during the surveillance period. Methods: Thirty female patients between 18 and 40 years old who had bruxism and orofacial pain were selected and randomized into two groups: control group (n = 15), where individuals received 0.05 ml of sterile saline solution that was applied to the bundle anterior temporal muscles and 0.2 ml for each masseter muscle, and an experimental group (n = 15), individuals received 20 units of A-botulinum toxin (Botox®) applied to each masseter muscle and 5 units of A-botulinum toxin applied to the anterior bundle of each temporal muscle. Patients were called back for reevaluation every thirty days. At these moments, they underwent an evaluation of the load force and electromyography. Results: At 30, 60, 90 and 120 days, a decrease in electromyographic activity was observed in the A-botulinum toxin group (p <0.001). In the experimental group, the left masseter muscle showed no significant difference between the variable load cell and time (p = 0.968), nor between electromyography versus load (p = 0.072), with a statistically significant difference between time and electromyography. (coef = 0.322; p <0.001). Conclusion: The intramuscular application of botulinum toxin type A in patients with bruxism has proved to be an effective method for hyperactivity of the masseter muscle in patients with bruxism, improving and decreasing the levels of muscle contraction.

Author Biographies

Marcelo Caetano Parreira da Silva, Universidade Federal de Uberlândia

Tutor in residency in maxillofacial surgery and traumatology at Hospital de Clínicas de Uberlândia

Cristóvão Marcondes de Castro Rodrigues, Universidade Federal de Uberlândia

Resident in Oral and Maxillofacial Surgery and Traumatology - Hospital de Clínicas, Federal University of Uberlândia (HC-UFU), Uberlândia, Minas Gerais, Brazil.

Cristiano Elias Figueiredo, Universidade Federal de Uberlândia

Oral and Maxillofacial Surgery and Traumatology - Hospital de Clínicas, Federal University of Uberlândia (HC-UFU), Uberlândia, Minas Gerais, Brazil.

Danyella Carolyna Soares dos Reis , Universidade Federal de Uberlândia

Graduation in Dentistry from the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

Vinícius Lima de Almeida, Universidade Federal de Uberlândia

Hospital de Clínicas da Universidade Federal de Uberlândia

Sergio Vitorino Cardoso, Universidade Federal de Uberlândia

Teacher of Graduation in Dentistry at the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

Alexandre Coelho Machado, Universidade Federal de Uberlândia

Teacher of Graduation in Dentistry at the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

Paulo Vinicius Soares, Universidade Federal de Uberlândia

Teacher of Graduation in Dentistry at the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

Luiz Renato Paranhos, Universidade Federal de Uberlândia

Teacher of Graduation in Dentistry at the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

References

Aloé, F. (2009). Sleep Bruxism Neurobiology. Sleep Science, 2(1), 40-48.

Aoki, K. R. (2004). Botulinum toxin: a successful therapeutic protein. Current Medicinal Chemistry, 11(23), 3085-3092.

Awan, K. H., Patil, S., Alamir, A. W. H., Maddur, N., Arakeri, G., Carrozzo, M., & Brennan, P. A. (2019). Botulinum toxin in the management of myofascial pain associated with temporomandibular dysfunction. Journal of Oral Pathology & Medicine, 48(3), 192–200.

Bader, G., & Lavigne, G. J. (2000). Sleep bruxism: overview of an oromandibular sleep movement disorder. Sleep Medicine Reviews, 4(1): 27-43.

Baker, J. S., & Nolan, P. J. (2017). Effectiveness of botulinum toxin type A for the treatment of chronic masticatory myofascial pain. The Journal of the American Dental Association, 148(1), 33–39.

Canales, G. D. L. T., Câmara-Souza, M. B., Amaral, C. F., Garcia, R. C. M. R., & Manfredini D (2017). Is there enough evidence to use botulinum toxin injections for bruxism management? A systematic literature review. Clinical Oral Investigations, 21(3), 727-734.

Carruthers, J., & Carruthers, A. (2007). The evolution of botulinum neurotoxin type A for comestic applications. Journal of Cosmetic and Laser Therapy, 9(3), 186-193.

Chen, S. (2012). Clinical uses of botulinum neurotoxins: Current indications, limitations and future developments. Toxins (Basel), 4(10), 913-939.

Ernberg, M., Hedenberg-Magnusson, B., List, T., & Svensson, P. (2011) Efficacy of botulinum toxin type A for treatment of persistent myofascial TMD pain: a randomized, controlled, double-blind multicenter study. Pain, 152(9), 1988-1996.

Ferrario V. F., Sforza, C., Tartaglia G. M., & Dellavia, C. (2002). Immediate effect of a stabilization splint on masticatory muscle activity in temporomandibular disorder patients. Journal of Oral Rehabilitation, 29(9), 810-815.

Freund, B., Schwartz, M., & Symington, J. M. (1999). The use of botulinum toxin for the treatment of temporomandibular disorders: preliminary findings. Journal of Oral and Maxillofacial Surgery, 57(8), 916-920.

Goldstein, L. B. (2000). The use of surface electromyography in objective measurement of the muscle function in facial pain/temporomandibular dysfunction patients. The Functional Orthodontist, 17(3), 26-9.

Guarda-Nardini, L., Stecco, A., Stecco, C., Masiero, S., & Manfredini, D. (2012). Myofascial pain of the jaw muscles: comparison of short-term Effectiveness of botulinum toxin injections and fascial manipulation technique. The Journal of Craniomandibular & Sleep Practice, 30(2), 95-102.

Guarda-Nardini, L., Manfredini, D., Salamone, M., Salmaso, L., Tonello, S., & Ferronato, G. (2008). Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study. Cranio: the journal of craniomandibular practice, 26(2), 126-135.

Harada, T., Ichiki, R., Tsukiyama, Y., & Koyano, K. (2006). The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. Journal of Oral Rehabilitation, 33(7), 482-488.

Jadhao, V. A., Lokhande, N., Habbu, S. G., Sewane, S., Dongare, S., & Goyal, N. (2017). Efficacy of botulinum toxin in treating myofascial pain and occlusal force characteristics of masticatory muscles in bruxism. Indian Journal of Dental Research, 28(5), 493-497.

Kato, T., Montplaisir, J. Y., Guitard, F., Sessle, B. J., Lund, J. P., & Lavigne, G. J. (2003). Evidence that experimentally induced sleep bruxism is a consequence of transient arousal. Journal of Dental Research, 82(4), 284-288.

Kurtoglu, C., Gur, O. H., Kurkcu, M., Sertdemir, Y., Guler-Uysal, F., & Uysal, H. (2008). Effect of botulinum toxin-A in myofascial pain patients with or without functional disc displacement. Journal of Oral and Maxillofacial Surgery, 66(8),1644-1651.

Laskin, D. M. (2018). The use of botulinum toxin in the treatment of myofascial pain in masticatory muscles. Oral and Maxillofacial Surgery Clinics of North America,30(3), 287-289.

Lee, S. J., McCall, W. D. Jr., Kim, Y. K., Chung, S. C., & Chung, J. W. (2010). Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 89(1), 16-23.

Lew, M. F. (2002). Review of the FDA-Approved Uses of Botulinum Toxins, Including Data Suggesting Efficacy in Pain Reduction. The Clinical Journal of Pain, 18(6), S142–S146.

Litham, W. J. (2004). What it botulinum toxin and how does it works? In: Lipham WJ Cosmetic and clinical application of Botulinum toxin. Thorofare: Slack, p. 5-9.

Lobbezoo, F., Van DerZaag, J., & Naeije, M. (2006). Bruxism: its multiple causes and its effects on dental implants – an updated review. Journal of Oral Rehabilitation, 33(4), 293-300.

Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar, P., Glaros, A. G., Kato, T., & Santiago, V. et al. (2018). International consensus on the assessment of bruxism: Report of a work in progress. Journal of Oral Rehabilitation, 45(11), 837-844.

Majid, O. W. (2010). Clinical use of botulinum toxins in oral and maxillofacial surgery. International Journal of Oral and Maxillofacial. Surgery, 39(3), 197-207.

Sposito, M. M. M. (2009). Botulinic Toxin Type A: action mechanism. Acta Fisiatrica, 16(1), 25-37.

Nixdorf, D. R., Heo, G., & Major, P. W. (2002). Randomized controlled trial of botulinum toxin A for chronic myogenous orofacial pain. Pain, 99(3), 465-473.

Ommerborn, M. A., Schneider, C., Giraki, M., Schäfer, R., Handschel, J., Franz, M.,Wolfgang, H., et al. (2007). Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity. European Journal of Oral Sciences, 115(1), 7-14.

Ommerborn, M. A., Taghavi, J., Singh, P., Handschel, J., Depprich, R. A., & Raab, W. H. (2011). Therapies most frequently used for the management of bruxism by a sample of German dentists. The Journal of Prosthetic Dentistry, 105(3), 194-202.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Disponível em: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Roldán-Barraza, C., Janko, S., Villanueva, J., Araya, I., & Lauer, H. C. (2014). A systematic review and meta-analysis of usual versus psychosocial interventions in the treatment of myofascial temporomandibular disorder pain. Journal of Oral & Facial Pain and Headache, 28, 205-222.

Santos, J., Recco, P., Mota, G., Holanda, A. V., & Junior, V. E. S. (2017). Treatment of orofacial pain through acupuncture in patients with bruxism: a review study. Revista da Faculdade de Odontologia da Universidade de Passo Fundo, 22(1), 96-100.

Saletu, A., Parapatics. S., Saletu, B., Anderer, P., Prause, W., Putz, H., Adelbauer, J., et al. (2005). On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology, 51(4), 214-225.

Silberstein, S. (2004). Botulinum neurotoxins: orings and basic mechanisms of action. Pain practice: the official journal of World Institute of Pain. 4 Suppl 1:S19-26.

Venancio, R. A., Alencar, F. G. Jr., & Zamperini, C. (2009). Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. Cranio 27(1), 46-53.

Von Lindern, J. J., Niederhagen, B., Bergé, S., & Appel, T. (2003). Type A botulinum toxin in the treatment of chronic facial pain associated with masticatory hyperactivity. Journal of Oral and Maxillofacial Surgery, 61(7), 774-778.

Yu, C-C., Philip, K-T. C., & Chen, Y-R. (2007). Botulinum Toxin A for Lower Facial Contouring: A Prospective Study. Aesthetic Plastic Surgery, 31(5), 445–451.

Zhang, T., Adatia, A., Zarin, W., Moitri, M., Vijenthira, A., Chu, R., Thabane, L., K., et al. (2011). The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta-analysis. Inflammopharmacology, 19(1), 21-34.

Zhang, L-D., Liu, Q., Zou, D. R., & Yu, L. F. (2016). Occlusal force characteristics of masseteric muscles after intramuscu-lar injection of botulinum toxin A (BTX – A) for treatment of temporomandibular disorder. The British Journal of Oral and Maxillofacial Surgery, 54(7), 736-740.

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Published

13/09/2020

How to Cite

SILVA, M. C. P. da; RODRIGUES, C. M. de C.; FIGUEIREDO, C. E.; REIS , D. C. S. dos; ALMEIDA, V. L. de; CARDOSO, S. V. .; MACHADO, A. C.; SOARES, P. V.; PARANHOS, L. R. Effect of botulinum toxin treatment in patients with bruxism and orofacial pain - randomized double-blind clinical trial. Research, Society and Development, [S. l.], v. 9, n. 9, p. e917998206, 2020. DOI: 10.33448/rsd-v9i9.8206. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/8206. Acesso em: 22 nov. 2024.

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Health Sciences