Botulinum Toxin for Treating Temporomandibular Disorders: What is the Evidence?

Overview

Journal J Oral Facial Pain Headache

Specialties Dentistry
Neurology
Psychiatry

Date 2022 Mar 17

PMID 35298571

Authors

Robert Delcanho

Matteo Val

Luca Guarda Nardini

Daniele Manfredini

Affiliations

Soon will be listed here.

Abstract

Aims: To systematically review the scientific literature for evidence concerning the clinical use of botulinum toxin (BTX) for the management of various temporomandibular disorders (TMDs).

Methods: A comprehensive literature search was conducted in the Medline, Web of Science, and Cochrane Library databases to find randomized clinical trials (RCT) published between 2000 and the end of April 2021 investigating the use of BTX to treat TMDs. The selected articles were reviewed and tabulated according to the PICO (patients/problem/population, intervention, comparison, outcome) format.

Results: A total of 24 RCTs were selected. Nine articles used BTX injections to treat myofascial pain, 4 to treat temporomandibular joint (TMJ) articular TMDs, 8 for the management of bruxism, and 3 to treat masseter hypertrophy. A total of 411 patients were treated by injection of BTX. Wide variability was found in the methods of injection and in the doses injected. Many trials concluded superiority of BTX injections over placebo for reducing TMD pain levels and improving maximum mouth opening; however, this was not universal.

Conclusion: There is good scientific evidence to support the use of BTX injections for treatment of masseter hypertrophy and equivocal evidence for myogenous TMDs, but very little for TMJ articular disorders. Studies with improved methodologic design are needed to gain better insight into the utility and effectiveness of BTX injections for treating both myogenous and TMJ articular TMDs and to establish suitable protocols for treating different TMDs.

Citing Articles

The Role of Botulinum Toxin for Masseter Muscle Hypertrophy: A Comprehensive Review.

Ferrillo M, Sommadossi E, Raciti L, Calafiore D, Mezian K, Tarantino V Toxins (Basel). 2025; 17(2).

PMID: 39998108 PMC: 11860558. DOI: 10.3390/toxins17020091.

Ultrasound-Guided Botulinum Toxin-A Injections into the Masseter Muscle for Both Medical and Aesthetic Purposes.

Popescu M, Beiu C, Iliescu C, Racovita A, Berteanu M, Iliescu M Toxins (Basel). 2024; 16(10).

PMID: 39453189 PMC: 11511025. DOI: 10.3390/toxins16100413.

Intramuscular Botulinum Toxin as an Adjunct to Arthrocentesis with Viscosupplementation in Temporomandibular Disorders: A Proof-of-Concept Case-Control Investigation.

Guarda Nardini L, Manfredini D, Colonna A, Ferrari Cagidiaco E, Ferrari M, Val M Toxins (Basel). 2024; 16(8).

PMID: 39195774 PMC: 11359951. DOI: 10.3390/toxins16080364.

Efficacy and Safety of Botulinum Toxin in the Management of Temporomandibular Symptoms Associated with Sleep Bruxism: A Systematic Review.

Buzatu R, Luca M, Castiglione L, Sinescu C Dent J (Basel). 2024; 12(6).

PMID: 38920857 PMC: 11203296. DOI: 10.3390/dj12060156.

Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews.

De la Torre Canales G, Camara-Souza M, Ernberg M, Al-Moraissi E, Grigoriadis A, Lorenzi Poluha R Drugs. 2024; 84(7):779-809.

PMID: 38900335 PMC: 11289222. DOI: 10.1007/s40265-024-02048-x.

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