scholarly journals Assessing the effectiveness of botulinum toxin injections into masticatory muscles in the treatment of temporomandibular disorders

2018 ◽  
Vol 24 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Alexis Kahn ◽  
Helios Bertin ◽  
Pierre Corre ◽  
Morgan Praud ◽  
Arnaud Paré ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Temporomandibular Disorders ◽  
Myofascial Pain ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
University Hospital ◽  
Duration Of Action ◽  
Beneficial Effects ◽  
Duration Of Effect ◽  
The Mean

Introduction: Temporomandibular disorders (TMD) are a common and invalidating disease sometimes difficult to treat. Current international recommendations favour reversible and non-invasive treatments, including the injection of botulinum toxin (BTX) into masticatory muscles. There is no strong evidence of its effectiveness. Objective: The main goal of this study was to assess the effectiveness of BTX six months following injection, in terms of pain, mouth opening, improvement of symptoms and duration of effect. Materials and methods: A retrospective study carried out at Nantes University Hospital between 2014 and 2016. Results: Thirty-four patients were included. The mean age was 37 years (17–76) and seventy six percents were female. Eighty percent of patients reported a significant improvement, notably in cases of arthralgia, which decreased in 8/18 (44%) patients (p < 0.05). The mean duration of measured efficacy was 4.2 months. Discussion: Significant improvement in cases of arthralgia and a tendency for improvement in cases of myalgia, with a mean duration of action of 4.2 months. Although BTX injection do not guarantee complete resolution of myofascial pain, it have been shown to have beneficial effects on some symptoms have been shown. Conclusion: Botulinum toxin should be considered as an alternative treatment when other conservative methods fail to yield satisfactory results. A thorough multicentre assessment is necessary in the future to scientifically validate its use.

scholarly journals The Effectiveness of Physical Therapy in Patients with Generalized Joint Hypermobility and Concurrent Temporomandibular Disorders—A Cross-Sectional Study

2021 ◽  
Vol 10 (17) ◽  
pp. 3808
Author(s):  
Małgorzata Kulesa-Mrowiecka ◽  
Joanna Piech ◽  
Tadeusz S. Gaździk
Keyword(s):  
Temporomandibular Disorders ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Mouth Opening ◽  
Linear Measurement ◽  
Cross Sectional Study ◽  
Masticatory Muscles ◽  
Joint Hypermobility ◽  
Cross Sectional ◽  
Generalized Joint Hypermobility

Temporomandibular disorders (TMD) consist of a group of symptoms such as: pain of temporomandibular joints, masticatory muscles or surrounding tissues, dysfunctions of TMJs’ mobility, and crepitation. The Hypermobility Joint Syndrome (HJS) manifests in the flaccidity of joint structures, an increase in the range of joint motion, and occurs more often in the young and women. The aim of this study was to present the occurrence of HJS among patients with myogenic TMD and disc displacement with reduction. The secondary goal was to assess the effectiveness of physiotherapy directed to TMD with coexisting HJS. The study involved 322 patients with symptoms of TMD. HJS was diagnosed using the Beighton Scale, which confirmed its occurrence in 26 cases. 79 subjects (7 males and 72 females; mean age, 33.9 ± 10.4 years) were selected and divided into two groups: HJS + TMD (n = 26; 2 males and 24 females; mean age, 27.1 ± 9.4 years) and TMD (n = 53; 5 males and 48 females; mean age, 37.4 ± 9.2 years). These patients completed 3-week physiotherapy management. Before and after physiotherapy, the myofascial pain severity on Numeric Pain Rating Scale, linear measurement of maximum mouth opening, and opening pattern, were assessed. To demonstrate differences between the results, the level of significance for statistical analysis was set at α = 0.05. A statistically significant improvement was obtained in decreasing myofascial pain in both groups. Coordination of mandibular movements was achieved in both groups. Generalized joint hypermobility occurred among patients with TMD. Physiotherapy directed to TMD was effective in reducing myofascial pain and restoring TMJ’s coordination also in patients with HJS.

(Preprint)

2018 ◽  
Author(s):  
Dr Malathi Dayalan ◽  
Dr Sudeshna Sharma ◽  
Dr Shweta Poovani ◽  
Dr Saher Altaf
Keyword(s):  
Myofascial Pain ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Matched Pair ◽  
Masticatory Muscle ◽  
Muscle Disorders ◽  
Occlusal Contact ◽  
Group I ◽  
Group Ii

BACKGROUND Masticatory system is a complex functional unit, primarily engaged in chewing, swallowing and breathing functions, and some parts are involved in taste recognition and determination of food consistency. Sophisticated functional performances of speech and emotional expressions are specifically human qualities. Irregularities in occlusion appears to be the precipitating factor in the pathogenesis of myofascial pain dysfunction syndrome. Tek- Scan III records the bite length, number, distribution, timing, duration and the relative force of each tooth contact. It also records the sequence of occlusal contacts in terms of time and the associated force with each occlusal contact. The aim of this study was to treat masticatory muscle disorders with occlusal equilibration, and compare the efficacy of treatment outcomes between selective grinding and stabilization splints using Tek-Scan III. OBJECTIVE Objective of this study was to compare the efficacy of occlusal equilibration achieved through selective griding and stabilization splints using Tek-Scan III. METHODS In this in vivo study, 40 patients with masticatory muscle disorders were selected based on the inclusion and exclusion criteria. The occlusal discrepancies were analyzed using Tek-Scan III. The selected 40 subjects were then randomly divided into 2 groups based on the treatment they recieved; Group I – Selective grinding group (20) and Group II – Stabilization splint group (20). Comparison of pre-treatment and post treatment results were evaluated in terms of pain, mouth opening, left and right side force percentage as recorded through Tek-Scan III and reduction of disclusion time. Statistical analysis was carried out with Kolmogorov Smirnov test, Wilcoxon matched pair test and Mann-Whitney U test. RESULTS Wilcoxon matched pairs test demonstrated that there was statistically significant results ( p = 0.0007) in both the groups for reduction of disclusion time, elimination of pain and improved mouth opening. Patients in Group I showed better results as compared to Group II in terms of disclusion time, pain and mouth opening. CONCLUSIONS Occlusal equilibration brought about by reducing the disclusion time using the Tek- Scan III reduced the symptoms of pain in masticatory muscles. Patients in group I (Selective grinding) however showed better results when compared to patients in group II (Stabilization splints).

scholarly journals Tratamento de disfunções temporomandibulares com toxina botulínica tipo A

2018 ◽  
Vol 23 (2) ◽  
Author(s):  
Geovana De Oliveira Polette Petrolli ◽  
Pamella Monteiro Mendes ◽  
Fernanda Angeloni De Souza ◽  
Matheus Coelho Blois
Keyword(s):  
Botulinum Toxin ◽  
Myofascial Pain ◽  
Masticatory Muscles

 Introdução: a disfunção temporomandibular (DTM) abrange muitos problemas clínicos nas articulações, na musculatura e em outras regiões da oroface. A ori­gem multifatorial e sua etiologia envolvem fatores psi­cocomportamentais, oclusais e neuromusculares, seu diagnóstico é realizado pela anamnese detalhada, com a identificação dos fatores predisponentes, iniciadores e perpetuantes, e pelo exame físico, que consiste em palpação da musculatura, mensuração da movimenta­ção ativa e verificação dos ruídos articulares. Objetivo: sistematizar as evidências científicas e verificar a eficá­cia do tratamento de disfunções temporomandibulares de origem muscular com a toxina botulínica do tipo A (TBX-A). Materiais e método: a busca bibliográfica foi realizada nas bases de dados PubMed e SciELO, com os descritores: “myofascial pain”, “botulinum toxin” e “masticatory muscles”. Foram analisados ensaios clíni­cos randomizados, que apresentaram tratamento para DTM com a utilização da TBX-A em pacientes de am­bos os sexos. A qualidade metodológica dos artigos se­lecionados foi verificada de acordo com a escala de Ja­dad. Considerações finais: observou-se que o tratamen­to para a DTM por meio da TBX-A auxilia no tratamento de dores orofaciais permanentes como coadjuvante, aliado a tratamentos conservadores. Os estudos que de­monstraram resultados clínicos significativos utilizaram uma dose total de 100 U de TBX-A, sendo 30 U nos músculos masseteres e 20 U nos músculos temporais, bilateralmente.

scholarly journals Temporomandibular joint dysfunction in Parkinson's Disease: an integrative literature review

Revista CEFAC ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 702-711 ◽  
Author(s):  
Taysa Vannoska de Almeida Silva ◽  
Maria das Graças Wanderley de Sales Coriolano ◽  
Carla Cabral dos Santos Accioly Lins
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Temporomandibular Joint ◽  
Myofascial Pain ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Masticatory Muscles ◽  
Therapeutic Interventions ◽  
Temporomandibular Joint Dysfunction ◽  
Language Restriction

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.

scholarly journals Acupuncture in Temporomandibular Disorders Painful Symptomatology: An Evidence-Based Case Report

2020 ◽  
Vol 14 (04) ◽  
pp. 692-696
Author(s):  
Lia Dietrich ◽  
Igor Vinícius Santos Rodrigues ◽  
Marcelo Dias Moreira de Assis Costa ◽  
Roberta Furtado Carvalho ◽  
Gisele Rodrigues da Silva
Keyword(s):  
Case Report ◽  
Chinese Medicine ◽  
Temporomandibular Disorders ◽  
Myofascial Pain ◽  
Scientific Evidence ◽  
Muscle Relaxation ◽  
Mouth Opening ◽  
Evidence Based ◽  
Complementary Treatment ◽  
Emotional Balance

AbstractTemporomandibular dysfunction (TMD) is complex and multifactorial. Its etiology involves various factors, such as malocclusion, psychological patterns, parafunctional habits, and the temporomandibular joint anatomy. Symptoms include myofascial pain, joint clicking, mouth opening limitation, headaches, earaches, and neck pain, comprising one of the greatest causes of nondental pain. Acupuncture has been used to treat these conditions by acting locally both in muscle relaxation and pain management as well as reaching physical, mental, and emotional balance. The aim of this study is to present a brief literature review reporting the efficacy of acupuncture on TMDs and a case report in which the painful symptomatology of TMD was treated with a systemic protocol, based on scientific evidence and concepts of traditional Chinese medicine. Acupuncture may be a complementary treatment for TMD, and in this case report, it eliminated the patient’s painful symptomatology.

scholarly journals Therapeutic uses and efficacy of botulinum toxin in orofacial medicine

2018 ◽  
Vol 24 (1) ◽  
pp. 11-21
Author(s):  
Kinz Bayet ◽  
Luc Chikhani ◽  
Anne-Laure Ejeil
Keyword(s):  
Botulinum Toxin ◽  
Cosmetic Surgery ◽  
Myofascial Pain ◽  
Scientific Evidence ◽  
Good Practice ◽  
Mouth Opening ◽  
Randomized Controlled ◽  
Therapeutic Uses ◽  
Levator Labii Superioris ◽  
High Level

Introduction: Botulinum toxin, primarily known for its use in cosmetic surgery, is also used for therapeutic purposes in many medical fields. It works as a muscle relaxant and inhibits glandular secretions. In the orofacial sphere, the use of this toxin is proposed in particular for disabling myofascial pain and aberrant salivary disorders. Methodology: A critical analysis of the literature, based on PUBMED data, concerning the orofacial indications of botulinum toxin was carried out. Results: The literature is abundant regarding the therapeutic interest of this toxin for several oral pathologies, but scientific merits vary markedly from one indication to another. Discussion: The musculorelaxant and antisecretory action of this toxin appears to be demonstrated in the case of bruxism, limitation of the mouth opening and in hypersialorrhea. On the other hand, its medical benefit is still not supported by scientific evidence for masseter hypertrophy, tonicity of the levator labii superioris muscles, sialocele fistulae and Frey's syndrome. Conclusion: Additional high-level studies, unbiased, randomized controlled trials, are required to eliminate the uncertainties that persist about the clinical impact of botulinum toxin and to justify the development of recommendations for good practice valid and credible.

scholarly journals The use of occlusal splints in temporomandibular disorders - an overview.

2020 ◽  
Vol 3 (2) ◽  
pp. 3-8
Author(s):  
Andreea Kui ◽  
Silvia Pop ◽  
Smaranda Buduru ◽  
Marius Negucioiu
Keyword(s):  
Temporomandibular Disorders ◽  
Mouth Opening ◽  
Clinical Situation ◽  
Masticatory Muscles ◽  
The State ◽  
Common Symptom ◽  
Occlusal Splints ◽  
Temporomandibular Joints ◽  
Closed Lock ◽  
State Of Art

AbstractTemporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.

scholarly journals Oral Splints: the Crutches for Temporomandibular Disorders and Bruxism?

1998 ◽  
Vol 9 (3) ◽  
pp. 345-361 ◽  
Author(s):  
T.T. Dao ◽  
GJ Lavigne
Keyword(s):  
Temporomandibular Disorders ◽  
Myofascial Pain ◽  
Sleep Bruxism ◽  
Masticatory Muscles ◽  
Definitive Treatment ◽  
Future Research ◽  
Controlled Clinical Trial ◽  
Electromyographic Activity ◽  
Therapeutic Value ◽  
Oral Behavior

Despite the extensive use of oral splints in the treatment of temporomandibular disorders (TMD) and bruxism, their mechanisms of action remain controversial. Various hypotheses have been proposed to explain their apparent efficacy (i.e., true therapeutic value), including the repositioning of the condyle and/or the articular disc, reduction in the electromyographic activity of the masticatory muscles, modification of the patient's "harmful" oral behavior, and changes in the patient's occlusion. Following a comprehensive review of the literature, it is concluded that any of these theories is either poor or inconsistent, while the issue of true efficacy for oral splints remains unsettled. However, the results of a controlled clinical trial lend support to the effectiveness (i.e., the patient's appreciation of the positive changes which are perceived to have occurred during the trial) of the stabilizing splint in the control of myofascial pain. In light of the data supporting their effectiveness but not their efficacy, oral splints should be used as an adjunct for pain management rather than a definitive treatment. For sleep bruxism, it is prudent to limit their use as a habit management aid and to prevent/limit dental damage potentially induced by the disorder. Future research should study the natural history and etiologies of TMD and bruxism, so that specific treatments for these disorders can be developed.

scholarly journals Effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with temporomandibular dysfunction

2019 ◽  
Vol 13 (2) ◽  
pp. 128-132
Author(s):  
Mohammad Ali Ghavimi ◽  
Javad Yazdani ◽  
Atena Afzalimehr ◽  
Arezoo Ghoreyshizadeh ◽  
Seyed Vahid Dehnad
Keyword(s):  
Botulinum Toxin ◽  
Temporomandibular Joint ◽  
Statistical Tests ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Pain Severity ◽  
Injection Technique ◽  
Invasive Treatment ◽  
Symptoms And Signs ◽  
Over Time

Background. Temporomandibular joint dysfunction (TMD) is a term that describes problems in the masticatory system, including the temporomandibular joint, the dento-muscular system and the supporting bones. Injection of botulinum toxin, as a noninvasive technique, might be useful in decreasing symptoms such as muscular spasm, dystonia, migraine headaches and TMD. Therefore, the aim of the present study was to evaluate the effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with TMD. Methods. A total of 61 patients were consecutively included in the present study in 2016‒2017. All the subjects received a 50-unit injection of Dysport botulinum toxin in the masseter muscles using an extraoral injection technique. The results of the injection were evaluated in terms of pain severity using VAS, clinical evaluations of the joint click through palpation and by determining the inter-incisal distance. The patients underwent follow-up examinations at 1-week, 3-month and 6-month intervals after injection. Data were analyzed with appropriate statistical tests. Results. Comparison of pain severity and articular clicks at different intervals showed decreases in these parameters over time, with significant differences between the time intervals (P<0.05). Comparison of mouth opening at different intervals showed increases in mouth opening over time. Conclusion. The results of the present study showed that injection of botulinum toxin can be used in patients with TMD as a non-invasive treatment modality

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