Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Overview

Journal Toxins (Basel)

Publisher MDPI

Specialty Toxicology

Date 2022 Aug 25

PMID 36006207

Authors

Victoria Sitnikova

Antti Kamppi

Olli Teronen

Pentti Kemppainen

Affiliations

Soon will be listed here.

Abstract

Botulinum toxin type A (BoNT-A) is increasingly used in treating masticatory muscle pain disorder; however, safe doses and reinjection intervals still need to be established. The purpose of this randomized clinical trial was to evaluate the degree and duration of the impairment of masticatory muscle performance. Fifty-seven subjects were randomly divided into two groups: one of which received BoNT-A first ( = 28) while the other received saline first ( = 29), with the cross-over being in week 16, and a total follow-up period of 32 weeks. A total dose of 50 U of BoNT-A was injected in the masseter and temporal muscles bilaterally. Electromyographic (EMG) activity and bite forces were assessed. A significant reduction in EMG activity was observed up to week 18 ( ≤ 001), with total recovery at week 33. A significant reduction in maximum bite force was observed up to week 11 ( ≤ 005), with total recovery at week 25. In conclusion, when treating masticatory muscle pain disorder with 50 U of BoNT-A, a reinjection interval of 33 weeks can be considered safe since the recovery of muscle function occurs by that time.

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References

de Lima M, Rizzatti Barbosa C, Gaviao M, Caria P . Is low dose of botulinum toxin effective in controlling chronic pain in sleep bruxism, awake bruxism, and temporomandibular disorder?. Cranio. 2021; 42(4):421-428. DOI: 10.1080/08869634.2021.1973215. View

Pihut M, Wisniewska G, Majewski P, Gronkiewicz K, Majewski S . Measurement of occlusal forces in the therapy of functional disorders with the use of botulinum toxin type A. J Physiol Pharmacol. 2010; 60 Suppl 8:113-6. View

Bettis T, Kim B, Hamrick M . Impact of muscle atrophy on bone metabolism and bone strength: implications for muscle-bone crosstalk with aging and disuse. Osteoporos Int. 2018; 29(8):1713-1720. PMC: 7861141. DOI: 10.1007/s00198-018-4570-1. View

Yamauchi P, Lowe N . Botulinum toxin types A and B: comparison of efficacy, duration, and dose-ranging studies for the treatment of facial rhytides and hyperhidrosis. Clin Dermatol. 2004; 22(1):34-9. DOI: 10.1016/j.clindermatol.2003.11.005. View

Kahn A, Kun-Darbois J, Bertin H, Corre P, Chappard D . Mandibular bone effects of botulinum toxin injections in masticatory muscles in adult. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 129(2):100-108. DOI: 10.1016/j.oooo.2019.03.007. View

Lee C, Kim S, Kim Y, Han J, Choi S, Lee S . Electrophysiologic change and facial contour following botulinum toxin A injection in square faces. Plast Reconstr Surg. 2007; 120(3):769-778. DOI: 10.1097/01.prs.0000271068.71399.ae. View

Kemppainen P, Waltimo A, Waltimo T, Kononen M, Pertovaara A . Differential effects of noxious conditioning stimulation of the cheek by capsaicin on human sensory and inhibitory masseter reflex responses evoked by tooth pulp stimulation. J Dent Res. 1997; 76(9):1561-8. DOI: 10.1177/00220345970760090801. View

Kurtoglu C, Gur O, Kurkcu M, Sertdemir Y, Guler-Uysal F, Uysal H . Effect of botulinum toxin-A in myofascial pain patients with or without functional disc displacement. J Oral Maxillofac Surg. 2008; 66(8):1644-51. DOI: 10.1016/j.joms.2008.03.008. View

Zhang H, Lian Y, Xie N, Chen C, Zheng Y . Single-dose botulinum toxin type a compared with repeated-dose for treatment of trigeminal neuralgia: a pilot study. J Headache Pain. 2017; 18(1):81. PMC: 5552618. DOI: 10.1186/s10194-017-0793-3. View

10.

Macfarlane T, Glenny A, Worthington H . Systematic review of population-based epidemiological studies of oro-facial pain. J Dent. 2002; 29(7):451-67. DOI: 10.1016/s0300-5712(01)00041-0. View

11.

Zhang H, Lian Y, Ma Y, Chen Y, He C, Xie N . Two doses of botulinum toxin type A for the treatment of trigeminal neuralgia: observation of therapeutic effect from a randomized, double-blind, placebo-controlled trial. J Headache Pain. 2014; 15:65. PMC: 4194456. DOI: 10.1186/1129-2377-15-65. View

12.

Balanta-Melo J, Toro-Ibacache V, Kupczik K, Buvinic S . Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings. Toxins (Basel). 2019; 11(2). PMC: 6409568. DOI: 10.3390/toxins11020084. View

13.

Suvinen T, Malmberg J, Forster C, Kemppainen P . Postural and dynamic masseter and anterior temporalis muscle EMG repeatability in serial assessments. J Oral Rehabil. 2009; 36(11):814-20. DOI: 10.1111/j.1365-2842.2009.01999.x. View

14.

Fricton J . The relationship of temporomandibular disorders and fibromyalgia: implications for diagnosis and treatment. Curr Pain Headache Rep. 2004; 8(5):355-63. DOI: 10.1007/s11916-996-0008-0. View

15.

De la Torre Canales G, Lorenzi Poluha R, Lora V, Ferreira D, Stuginski-Barbosa J, Bonjardim L . Botulinum toxin type A applications for masticatory myofascial pain and trigeminal neuralgia: what is the evidence regarding adverse effects?. Clin Oral Investig. 2019; 23(9):3411-3421. DOI: 10.1007/s00784-019-03026-4. View

16.

Kim N, Park R, Park J . Botulinum toxin type A for the treatment of hypertrophy of the masseter muscle. Plast Reconstr Surg. 2010; 125(6):1693-1705. DOI: 10.1097/PRS.0b013e3181d0ad03. View

17.

Johansson A, Unell L, Carlsson G, Soderfeldt B, Halling A . Gender difference in symptoms related to temporomandibular disorders in a population of 50-year-old subjects. J Orofac Pain. 2003; 17(1):29-35. View

18.

Ahlberg J, Kovero O, Hurmerinta K, Zepa I, Nissinen M, Kononen M . Maximal bite force and its association with signs and symptoms of TMD, occlusion, and body mass index in a cohort of young adults. Cranio. 2003; 21(4):248-52. DOI: 10.1080/08869634.2003.11746258. View

19.

Ernberg M, Hedenberg-Magnusson B, List T, Svensson P . Efficacy of botulinum toxin type A for treatment of persistent myofascial TMD pain: a randomized, controlled, double-blind multicenter study. Pain. 2011; 152(9):1988-1996. DOI: 10.1016/j.pain.2011.03.036. View

20.

Jadhao V, Lokhande N, Habbu S, Sewane S, Dongare S, Goyal N . Efficacy of botulinum toxin in treating myofascial pain and occlusal force characteristics of masticatory muscles in bruxism. Indian J Dent Res. 2017; 28(5):493-497. DOI: 10.4103/ijdr.IJDR_125_17. View