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

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 Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

2022 ◽  
pp. 98-100
Author(s):  
A. A. Sultanov ◽  
Y. Y. Pervov ◽  
A. K. Yatsenko ◽  
M. A. Sultanova ◽  
D. O. Drozdova
Keyword(s):  
Physical Examination ◽  
Temporomandibular Joint ◽  
Orthodontic Treatment ◽  
Clinical Case ◽  
Mouth Opening ◽  
Integrated Approach ◽  
Masticatory Muscles ◽  
Temporomandibular Joint Dysfunction ◽  
The Right ◽  
Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

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 An additional lysis procedure during arthrocentesis of the temporomandibular joint

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Keon-Mo Lee ◽  
Wan-Hee Jang ◽  
Myoung-Sang You ◽  
Bu-Kyu Lee
Keyword(s):  
Temporomandibular Joint ◽  
Arthroscopic Surgery ◽  
Mouth Opening ◽  
Invasive Procedure ◽  
Joint Space ◽  
Temporomandibular Joint Disorders ◽  
Invasive Procedures ◽  
The Mean ◽  
Mechanical Lysis ◽  
Over Time

Abstract Background Arthrocentesis of the temporomandibular joint (TMJ) is an easy, highly efficient, minimally invasive procedure for treating temporomandibular joint disorders (TMDs). However, in some cases of mouth opening limitation (MOL), routine arthrocentesis is ineffective due to severe fibrotic adhesion in the superior joint space of the TMJ. In this condition, mechanical lysis of the adhesions might be needed to resolve the MOL, as well as other symptoms, such as chronic pain. Currently, this can be achieved by arthroscopic surgery or open TMJ surgery. The objective of this study was to introduce and evaluate our trial of the adhesion lysis procedure during arthrocentesis of the TMJ using normal 18-gauge needles. Results In this study, 40 patients with MOL due to disc derangement underwent conventional arthrocentesis at first and then physical detachment was conducted using the same needle. The change in maximum mouth opening (MMO) and the pain at the TMJ were recorded before, during, and after treatment according to our protocol. The mean increase in MMO after conventional arthrocentesis was 6.6 ± 4.2mm. The mean increase in MMO after the detachment procedure with the same needle was 4.2 ± 2.0 mm. The MMO in ten patients was significantly increased after the detachment procedure than after arthrocentesis alone. In all cases, the pain intensity in the TMJ significantly decreased over time, whereas the MMO increased over time. No adverse effect was observed in all joints during our observation periods. Conclusion We confirmed that our simple lysis procedure with the same needle of the arthrocentesis of the TMJ could not only improve the MMO more than after a conventional arthrocentesis but also resolve severe adhesion of the joint space that was ineffective by conventional arthrocentesis. Although this additional lysis procedure is simple, it might reduce the number of cases of more invasive procedures such as arthroscopic surgery or open TMJ surgery.

The role of elastic bands (kinesiotapes) in complex therapy of patients with temporomandibular joint osteoarthrosis

2021 ◽  
pp. 75-85
Author(s):  
E. A. Bulycheva ◽  
M. A. Postnikov ◽  
D. S. Bulycheva
Keyword(s):  
Temporomandibular Joint ◽  
Exercise Therapy ◽  
Comparison Group ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Pain Scale ◽  
Main Group ◽  
Treatment Methods ◽  
Elastic Bands ◽  
Opening Width

Introduction. Temporomandibular joint (TMJ) arthrosis is a chronic disease, characterized by dystrophic and degenerative changes in TMJ with aseptic inflammatory process. The prevelence of TMJ arthrosis in patients with a history of other TMJ disorders varies between 32-39 % of cases. Complex treatment of TMJ arthrosis includes pharmacotherapy, physiotherapy, exercise therapy for TMJ and massage of the masticatory muscles, manual therapy, prosthodontics, but these treatment methods are not always lead to a desired result.The aim of the study is to improve the traditional treament method of patients suffering from TMJ arthrosis by using elastic tapes (kinesiotapes).Materials and methods. 68 patients were examined at the «Galaxy» Beauty Institute Clinic (St. Petersburg) and FSBEI HE SamSMU MOH Russia (Samara). Comparison group of patients was prescribed pharmacotherapy, exercise therapy for TMJ and massage of masticatory muscles, while for the main group of patients the same therapy was enhanced by elastic bands. The effectiveness of therapy was evaluated using a visual-analog pain scale (VAS), mouth opening width and electromyography of the masticatory muscles.Results. Noticeable positive effect in the main group of patients was observed on the 21th day of treatment. By this time patients noticed significant decrease in pain intensity from 8,77±0,8 to 5,19±0,5 (Z1-4=-5,88; p1-4=0,0015) points as well as increase in mouth opening width from 21-23 to 33-35 mm. Similar changes in the comparison group of patients were achieved only by the beginning of fifth week of treatment (Z1-6=-5,58; p1-6=0,0015). The range of mouth opening width increased from 21-23 to 27-29 mm. Amplitude of masticatory muscles biopotentials in maximum intercuspation in patients of the main group almost approached to the normal results by the beginning of the fourth week. In patients of the comparison group the amplitude of masticatory muscles biopotentials remained reduced even by the end of observations (42 day of the study).Conclusion. Thus, the combination of elastic bands applications with conventional treatment methods of TMJ arthrosis greatly increases the effectiveness of therapy and allows to relief pain and normalize bioelectric activity of masticatory muscles in a relatively short time. Due to the simplicity of elastic bands application it is possible to teach patients the technique of self-applying bands and recommend to use them as a prevention of relapse of TMJ arthrosis.

scholarly journals The Effects of Botulinum Toxin-A Injection on Lateral Pterygoid Muscle in Patients with Painful Temporomandibular Joint Click: A Randomized Clinical Trial Study

2021 ◽  
Author(s):  
Fahimeh Rezazadeh ◽  
Negin Esnaashari ◽  
Azita Azad ◽  
Sara Emad
Keyword(s):  
Botulinum Toxin ◽  
Temporomandibular Joint ◽  
Repeated Measures ◽  
Botulinum Toxin A ◽  
Temporomandibular Disorder ◽  
Medical Science ◽  
Case Series ◽  
Pain Severity ◽  
Toxin A ◽  
Significant Difference

Abstract Background: The aim of this study was to investigate the effect of Botulinum toxin-A (BTX-A) injection in lateral pterygoid (LP) muscle and analyze the efficacy of this treatment modality in reducing Temporomandibular disorder (TMD) symptoms. TMD is the main cause of nondental pain in the orofacial area. The most common symptoms of temporomandibular disorder are joints pain and sound and limitation of jaw function. Botulinum toxin (BTX) injection in LP temporarily paralysesis the muscle. BTX injection is considered as a potential treatment for TMD, due to its pain relieving characteristic and its ability to reduce muscle activity. However, these evidences are mostly case series and more studies are required to prove its efficacy. Methods: Thirty-eight patients (19 women and 19 men, mean age: 26.53 years) with painful unilateral temporomandibular joint click and LP muscle tenderness entered the study. They were divided into two groups; one received extraoral Botax injection in LP muscle, and the other was injected by placebo. Pain severity, jaw’s range of movement, click severity and Helkimo-Index, were taken recorded at first and also in follow upin first visit and in one week, one month and three months after intervention. Data were analyzed using Repeated measures ANOVA and t-test.Results: The result showed that click severity was not significantly different between BTX and placebo groups (p=0.07). Pain and Helkimo index were decreased significantly in BTX group (p=0.00 and P=0.006 respectively); however, there was no significant difference when compared between the two groups (P=0.22 and p=1 respectively). There was a significant difference in lateral movements between the groups (p=0.00) but not in protrusion movement (p=0.095).Conclusions: It can be concluded that although some studies state that BTX injection can make the click sound disappear, in this study we did not find a significant difference between two groups. Furthermore, our results showed that click and pain severity were decreased, but the difference was not statistically significant. Therefore, further studies with more dosage of BTX and higher participants seem to be necessary.Trial registration: The local Ethics Committee of Shiraz University of Medical Science approved this research under Ethics code: IR.SUMS.REC. 2018/10/01 and IRCT number: IRCT20130521013406N3.

scholarly journals Effectiveness of Physical Therapy in the Correction of the Functional Status of the Temporomandibular Joint in Arthrosis

2021 ◽  
Vol 6 (6) ◽  
pp. 188-193
Author(s):  
M. G. Aravitska ◽  
◽  
L. M. Sheremeta ◽  
S. I. Danylchenko ◽  
Dovgan O. V. ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Main Group ◽  
Control Group ◽  
Maxillofacial Region ◽  
Therapeutic Exercises ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

The purpose of the study was to evaluate the effect of a physical therapy program on the state of functioning of the maxillofacial region in patients with arthrosis of the temporomandibular joint. Materials and methods. The study involved 33 people with arthrosis of the temporomandibular joint of the II-III degrees, which were divided into 2 groups – control and main. The control group consisted of 18 people who received arthrosis therapy only with non-steroidal anti-inflammatory drugs. The main group consisted of 15 people who additionally underwent the developed program of physical therapy (therapeutic exercises, massage, post-isometric relaxation, kinesiotaping of the masticatory muscles, neck muscles, cervical-collar zone; paraffin therapy course for the temporomandibular joint area, patient education). Complaints of patients, the intensity of pain in the temporomandibular joint on a visual analogue scale, the amount of mouth opening were determined, and auscultation of the joint was performed. Results and discussion. After the completion of the treatment course (for patients of the control group) and physical therapy (for the patients of the main group), pain in the temporomandibular joint did not manifest itself at rest and during movement. This is explained, in particular, by the fact that the basis of conservative treatment of arthrosis is the use of non-steroidal anti-inflammatory drugs with analgesic effects. At the same time, the usage of physical therapy, in comparison with medications, in the main group was statistically significant (p <0.05) in relation to control patients, it improved the functional activity of the jaw area and the functioning of the temporomandibular joint, which was manifested by a decrease in the number of persons with complaints of pathological sounds during jaw movements and their auscultatory detection, discomfort when chewing, as well as an increase in the magnitude of opening the mouth. Restoration of the condition of patients with diseases of the maxillofacial region, and, in particular, the temporomandibular joint, is an urgent problem not only for dentists, but also for specialists in the field of rehabilitation, in particular, physical therapists. The objectives of physical therapy in patients with arthrosis of the temporomandibular joint are to reduce the load on the joint, eliminate and reduce pain, synovitis, myalgia, improve joint function, stimulate and activate metabolic processes in cartilaginous and bone tissues, normalize blood flow, and thus improve quality of life. Conclusion. Physical therapy means improve the functional ability of the temporomandibular joint in the complex recovery of patients with arthrosis statistically significantly better than monotherapy with non-steroidal anti-inflammatory drugs

scholarly journals Non-invasive treatment modalities of limited mouth opening due to diseases and internal disorders of the temporomandibular joint

2021 ◽  
Vol 107 (3) ◽  
pp. 76-81
Author(s):  
M. Drogomyretska ◽  
◽  
R. Mirza ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Resonance Imaging ◽  
Invasive Treatment ◽  
Limited Mouth Opening ◽  
Open Mouth ◽  
Non Invasive ◽  
Patient Complaints

Abstract. Magnetic resonance imaging is widely used in the presence of such patient complaints as clicking, locking and pain in the temporomandibular joint. The different problems in the treatment of temporomandibular joint pathology, which is accompanied by limited mouth opening, requires certain recommendations for magnetic resonance imaging, supported by current classifications. The purpose of the study: to substantiate the need for the use of an individual mandibular fixator, made before magnetic resonance imaging in the open mouth position to systematization of the treatment outcomes. Materials and methods. On the basis of clinical examination and objectification of the temporomandibular joint status by magnetic resonance imaging the results of treatment of diseases and internal disorders of the temporomandibular joint, which can be obtained by a dentist-gnathologist using non-invasive methods, was analyzed. To obtain images after treatment of the temporomandibular joint an individual mandibular fixator was used, which provided the possibility of evidencebased determination of the articular head position in the open mouth state. To systematize the analysis results of magnetic resonance imaging of the temporomandibular joint, the most convenient classification was chosen. Results. From a clinical sight, the gnathological treatment of temporomandibular joint dislocation without reposition is considered effective if the distance between the incisors, at maximum mouth opening, is 41–50 mm, the articular head is located at the apex of articular tubercle, and in the questioning and isometric tests the patient complaints are absent. Conclusions. The most effective non-invasive treatment of limited mouth opening is possibly with early ambulation, i.e. from three to seven months after onset. Key words: temporomandibular joint, gnathologist, magnetic resonance imaging.

Restricted Mouth Opening in Head and Neck Cancer: Etiology, Prevention, and Treatment

2020 ◽  
Vol 16 (10) ◽  
pp. 643-653
Author(s):  
Waseem A. Abboud ◽  
Sharon Hassin-Baer ◽  
Eran E. Alon ◽  
Iris Gluck ◽  
Alex Dobriyan ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Temporomandibular Joint ◽  
Neck Cancer ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Joint Involvement ◽  
Cancer Etiology ◽  
Medical Specialties ◽  
Hardware Failure

Restricted mouth opening or trismus is often encountered in patients with head and neck cancer. The restriction may be the presenting sign of malignancy, a sequela of tumor site or growth, an adverse effect of oncologic treatment, or a first sign of tumoral recurrence. In general, any insult to the temporomandibular joint, masticatory muscles, or their neural innervation may cause limitation in mouth opening. The etiologies leading to trismus are as follows: myospasm secondary to tumor infiltration; reflectory myospasm; radiation-induced myositis and myofibrosis; temporomandibular joint involvement with tumor; unfavorable postsurgical scarring; muscle and joint atrophy secondary to immobilization; pain; jaw fracture and hardware failure; and infection. Preventive measures should be implemented before, during, and after treatment. These measures include identification of high-risk patients, utilization of dose-sculpting radiation techniques whenever possible, performing reconstruction at the same time of resective surgery whenever feasible, and initiating mobilization exercises as early as possible. When trismus develops, treatments are often challenging and disappointing. These include physical therapy, mouth opening appliances, drug therapy, and release surgery. All medical specialties dealing with head and neck cancer should be familiar with the diagnosis and prevention of trismus and make an effort to ensure patients are referred to the appropriate care when needed. Trismus should not be considered a trivial sequela of head and neck cancer.

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