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Guo HJ, Wu CC, Li TC. Ultrasound-guided lateral pterygoid muscle botulinum toxin: an injection for recurrent temporomandibular joint dislocation in a brain injury patient. Oral Maxillofac Surg 2022:10.1007/s10006-022-01067-w. [PMID: 35486190 DOI: 10.1007/s10006-022-01067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
Abstract
Botulinum toxin type A (BTX-A) injection using nerve stimulation or electromyography for recurrent temporomandibular joint (TMJ) dislocation has been reported for several years. However, using the available equipment like a nerve stimulator or an electromyograph is uncommon, and ultrasound guidance is convenient and requires no additional resources. In this report, we used ultrasound as a tool to achieve BTX-A injections in a patient with a traumatic brain injury to treat her TMJ dislocation. One week after the injections, she had no more dislocation. She remained symptom free during the 3 months of follow-up, and her clinical symptoms improved without significant complications. This is the first report using ultrasound guidance for BTX-A injections to treat recurrent TMJ dislocation. This treatment is an effective and safe technique that could be performed timely and locally without referral to a center with electromyography facilities.
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Affiliation(s)
- Huai-Jing Guo
- Department of Physical Medicine and Rehabilitation, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei, 106, Taiwan, Republic of China
| | - Chun-Chieh Wu
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan, Republic of China
| | - Tung-Chou Li
- Department of Physical Medicine and Rehabilitation, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei, 106, Taiwan, Republic of China.
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China.
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A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study. Plast Reconstr Surg 2021; 148:785e-790e. [PMID: 34705786 DOI: 10.1097/prs.0000000000008493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lateral pterygoid muscle activity is associated with the pathological mechanisms of some temporomandibular disorders. The authors aimed to define and demonstrate a novel, practical, and safe technique for botulinum toxin type A injection to the lateral pterygoid muscle based on their findings. Their secondary aims were to standardize the injection pattern according to the variations of the lateral pterygoid muscle and its surrounding anatomical structures, and to establish its advantages over intraoral injection. METHODS Twenty cadaver heads were dissected. The lateral pterygoid muscle and its surrounding structures were investigated for anatomical variations. Based on these findings, a standardized extraoral injection protocol was defined and compared with the intraoral technique for accuracy and safety. RESULTS The average depth of the lateral pterygoid plate from the skin surface was 49.9 ± 2.2 mm, and the mean width of the lateral pterygoid plate was 10.5 ± 3.9 mm. The extraoral injection approach based on the location of the maxillary tuberosity, tragus, and lateral pterygoid plate was consistent in all dissections for the accuracy of the intramuscular injection. In the intraoral approach, standardization of the entry point of the needle through the oral mucosa is difficult, which makes adjustment of the depth of the injection challenging while increasing the risk of neurovascular injury. CONCLUSIONS The clinical significance of the lateral pterygoid muscle makes it worthwhile to implement minimally invasive treatments before considering more invasive options. The authors define a safe, accurate, and reliable approach with ease of administration in patients with temporomandibular disorders.
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Santás Alegret M, Fernández García A, Gómez VJ, Olavarria Montes E, Mejía Nieto M, Sánchez Aniceto G. "Management of recurrent temporomandibular dislocation using orthodontic traction screws.". J Craniomaxillofac Surg 2021; 49:1020-1025. [PMID: 34215492 DOI: 10.1016/j.jcms.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/02/2021] [Accepted: 06/20/2021] [Indexed: 11/26/2022] Open
Abstract
Temporomandibular joint dislocation is defined as the loss of joint congruency between the mandibular condyle and the glenoid fossa of the temporal bone. Multiple therapeutic options have been proposed for the treatment of recurrent TMJ dislocation. The aim of this paper is to present two recently treated cases with a modification of Wolford's technique, replacing the Mitek anchors with orthodontic screws. Case series: The first case concerns a 36 year-old women with recurrent temporomandibular dislocation, and the second one a 26 year-old patient with the same diagnosis. In both cases, one 8mm orthodontic screw was placed in the lateral pole of mandibular condyle, sutured with PremiCron® 2/0 to a hole made in the root of each zygomatic arch. At twelve-month follow-up (first patient) and at six-month follow-up (second patient), patients had not presented new episodes of mandibular dislocation and mouth opening range remained stable. This technique can be considered as an alternative to Wolford's technique in treating recurrent temporomandibular dislocation when conservative management fails.
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Affiliation(s)
- Mario Santás Alegret
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain.
| | - Antonio Fernández García
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Vicenç J Gómez
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Eduardo Olavarria Montes
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - María Mejía Nieto
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Gregorio Sánchez Aniceto
- Department of Oral and Maxillofacial Surgery, University Hospital, "12 de Octubre", Avenida de Córdoba s/n, 28041, Madrid, Spain
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Treatment of temporomandibular joint luxation: a systematic literature review. Clin Oral Investig 2019; 24:61-70. [DOI: 10.1007/s00784-019-03126-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
Abstract
Objectives
To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation.
Materials and methods
This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018.
Results
Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients.
Conclusions
In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods.
Clinical relevance
Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.
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Moreno-Hay I, Okeson JP. Single event versus recurrent luxation of the temporomandibular joint. J Am Dent Assoc 2019; 150:225-229. [PMID: 30803494 DOI: 10.1016/j.adaj.2018.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 11/25/2022]
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Evaluation of the Efficacy of Different Concentrations of Dextrose Prolotherapy in Temporomandibular Joint Hypermobility Treatment. J Craniofac Surg 2018. [PMID: 29533255 DOI: 10.1097/scs.0000000000004480] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of this study was to compare and evaluate the efficacy of different concentrations of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. PATIENTS AND METHODS A prospective, randomized clinical trial including patients with subluxation or dislocation was performed. The study comprised 40 patients. Patients were randomly divided into 4 groups: control group, 10% dextrose, 20% dextrose, and 30% dextrose group. Patients in all groups received injections into 4 different areas of each TMJ in 4 sessions at monthly intervals. Visual analog scale of TMJ pain intensity, maximum mouth opening (MMO), joint sounds, and frequency of luxations were recorded preoperatively and postoperatively after 1 month of last injection. The collected data were then statistically analyzed. RESULTS Each group showed postoperatively significant improvement in TMJ pain, significant decrease in both MMO and joint sound. Besides that, TMJ locking was not observed in any patient during the follow-up period. There were no statistically significant differences throughout the study intervals between the groups. CONCLUSION It was concluded that there was no significant difference between control group and dextrose groups and there is no superiority of any concentration of dextrose over the others in TMJ prolotherapy, and all treatment procedures were efficient in improvement of clinical symptoms related to TMJ hypermobility. If dextrose is used as a proliferant, it can be said that 10% dextrose can be sufficient in TMJ hypermobility treatment.
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Renapurkar SK, Laskin DM. Injectable Agents Versus Surgery for Recurrent Temporomandibular Joint Dislocation. Oral Maxillofac Surg Clin North Am 2018; 30:343-349. [DOI: 10.1016/j.coms.2018.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yoshida K. Botulinum Neurotoxin Injection for the Treatment of Recurrent Temporomandibular Joint Dislocation with and without Neurogenic Muscular Hyperactivity. Toxins (Basel) 2018; 10:E174. [PMID: 29693593 PMCID: PMC5983230 DOI: 10.3390/toxins10050174] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to compare treatment outcomes following intramuscular injection of botulinum neurotoxin (BoNT) in patients with recurrent temporomandibular joint dislocation, with and without muscle hyperactivity due to neurological diseases. Thirty-two patients (19 women and 13 men, mean age: 62.3 years) with recurrent temporomandibular joint dislocation were divided into two groups: neurogenic (8 women and 12 men) and habitual (11 women and 1 man). The neurogenic group included patients having neurological disorders, such as Parkinson’s disease or oromandibular dystonia, that are accompanied by muscle hyperactivity. BoNT was administered via intraoral injection to the inferior head of the lateral pterygoid muscle. In total, BoNT injection was administered 102 times (mean 3.2 times/patient). The mean follow-up duration was 29.5 months. The neurogenic group was significantly (p < 0.001) younger (47.3 years) than the habitual group (84.8 years) and required significantly (p < 0.01) more injections (4.1 versus 1.7 times) to achieve a positive outcome. No significant immediate or delayed complications occurred. Thus, intramuscular injection of BoNT into the lateral pterygoid muscle is an effective and safe treatment for habitual temporomandibular joint dislocation. More injections are required in cases of neurogenic temporomandibular joint dislocation than in those of habitual dislocation without muscle hyperactivity.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan.
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Patel J, Nilesh K, Parkar MI, Vaghasiya A. Clinical and radiological outcome of arthrocentesis followed by autologous blood injection for treatment of chronic recurrent temporomandibular joint dislocation. J Clin Exp Dent 2017; 9:e962-e969. [PMID: 28936285 PMCID: PMC5601112 DOI: 10.4317/jced.53812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/07/2017] [Indexed: 11/15/2022] Open
Abstract
Background This study was conducted to evaluate the functional outcome and MRI findings of arthrocentsis followed by autologous blood injection (ABI) into the joint space for management of chronic recurrent TMJ dislocation. Material and Methods Total ten patients with bilateral chronic recurrent condylar dislocation were included in the study. Arthrocentesis of both TMJ was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included; thorough history, clinical examination of TMJ, maximal mouth opening, frequency of dislocation, TMJ radiographs (open and closed mouth position), MRI, recurrence and presence of facial nerve paralysis. Results At the end of 3 months follow-up 8 patients (80%) had successful outcome with no further episodes of dislocation, whereas two patients reported with recurrence. Post-operative MRI showed significant improvement after ABI, compared to pre-operative MRI. There were no degenerative changes to the bony and soft tissue components of TMJ. Conclusions ABI is a simple, safe, minimally invasive and cost-effective technique for treatment of chronic recurrent TMJ dislocation. MRI evaluation showed an improvement in the anatomical and spatial relationship of the osseous and soft tissue components of the TMJ. Key words:TMJ lavage, luxation, fibrosis, magnetic resonance imaging.
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Affiliation(s)
- Jinesh Patel
- MDS (OMFS), Post graduate student, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad
| | - Kumar Nilesh
- MDS (OMFS), Reader, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad
| | - M I Parkar
- MDS (OMFS), Professor & HOD, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad
| | - Alpesh Vaghasiya
- MDS (OMFS), Post graduate student, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad
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Park KS, Lee CH, Lee JW. Use of a botulinum toxin A in dentistry and oral and maxillofacial surgery. J Dent Anesth Pain Med 2017; 16:151-157. [PMID: 28884147 PMCID: PMC5586551 DOI: 10.17245/jdapm.2016.16.3.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 09/23/2016] [Accepted: 09/27/2016] [Indexed: 11/15/2022] Open
Abstract
Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.
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Affiliation(s)
- Kyung-Soo Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Chi-Heun Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
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Botulinum toxin therapy for treatment of spasticity in multiple sclerosis: review and recommendations of the IAB-Interdisciplinary Working Group for Movement Disorders task force. J Neurol 2016; 264:112-120. [PMID: 27787630 DOI: 10.1007/s00415-016-8304-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
Abstract
Botulinum toxin (BT) therapy is an established treatment of spasticity due to stroke. For multiple sclerosis (MS) spasticity this is not the case. IAB-Interdisciplinary Working Group for Movement Disorders formed a task force to explore the use of BT therapy for treatment of MS spasticity. A formalised PubMed literature search produced 55 publications (3 randomised controlled trials, 3 interventional studies, 11 observational studies, 2 case studies, 35 reviews, 1 guideline) all unanimously favouring the use of BT therapy for MS spasticity. There is no reason to believe that BT should be less effective and safe in MS spasticity than it is in stroke spasticity. Recommendations include an update of the current prevalence of MS spasticity and its clinical features according to classifications used in movement disorders. Immunological data on MS patients already treated should be analysed with respect to frequencies of MS relapses and BT antibody formation. Registration authorities should expand registration of BT therapy for spasticity regardless of its aetiology. MS specialists should consider BT therapy for symptomatic treatment of spasticity.
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Srivastava S, Kharbanda S, Pal US, Shah V. Applications of botulinum toxin in dentistry: A comprehensive review. Natl J Maxillofac Surg 2016; 6:152-9. [PMID: 27390488 PMCID: PMC4922224 DOI: 10.4103/0975-5950.183860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The horizons of treatment options in dentistry are broadening rapidly. In this scenario, applications of unconventional treatment options like use of botulinum toxin (BT) are gaining momentum. The use of BT has been popularly accepted in esthetic procedures like management of facial wrinkles; however, it has been documented to be successful in a variety of conditions. Of particular interest to this paper are applications of BT in the maxillofacial region, concerned to dentistry. BT offers a transient, reversible, relatively safe treatment option to many conditions of interest to a dental practitioner. Dental surgeons by their virtue of being extensively aware of the anatomy of faciomaxillary region are a potential pool of operators who can use BT in their armamentarium with minor skill enhancement and thus widen the perspective of alternative, minimally invasive options to refractory conditions or invasive protocols.
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Affiliation(s)
- Sanjeev Srivastava
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Smriti Kharbanda
- Conservative Dentistry and Endodonitcs, Clove Dental, New Delhi, India
| | - U S Pal
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vinit Shah
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Botulinum Toxin Type A as Preoperative Treatment for Immediately Loaded Dental Implants Placed in Fresh Extraction Sockets for Full-Arch Restoration of Patients With Bruxism. J Craniofac Surg 2016; 27:668-70. [PMID: 27092916 DOI: 10.1097/scs.0000000000002566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of the present report was to describe the use of Botulinum toxin type A as preoperative treatment for immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration of patients with bruxism. METHODS Patients with bruxism who were scheduled to receive immediately loaded full-arch implant supported fixed restorations were included in this retrospective clinical report. To reduce the occlusal forces applied in patients with bruxism, Botulinum toxin type A was introduced prior to the implant placement procedure. Patients were followed and implant survival as well as peri-implant bone level was assessed in each periodic follow-up visit. Adverse effects were also recorded. A control group with no use of Botulinum toxin was evaluated as well. RESULTS A total of 26 patients (13 test and 13 control), with bruxism, aged 59.15 ± 11.43 years on average were included in this retrospective report and received immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration. The test group treatment preceded by Botulinum toxin type A injection. Maxillary arches were supported by 8 to 10 implants while the mandibular arch was supported by 6 implants. All surgeries went uneventfully and no adverse effects were observed. The average follow-up time was 32.5 ± 10.4 months (range, 18-51). In the test group, no implant failures were recorded. One patient presented with 1 to 2 mm bone loss around 4 of the implants; the other implants presented with stable bone level. In the control group 1 patient lost 2 implants and another demonstrated 2 mm bone loss around 3 of the implants. CONCLUSIONS The preoperative use of Botulinum toxin in patients with bruxism undergoing full-arch rehabilitation using immediately loaded dental implants placed in fresh extraction sockets seems to be a technique that deserves attention. Further long-term, large-scale randomized clinical trials will help to determine the additional benefit of this suggested treatment modality.
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Abstract
Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation.
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Affiliation(s)
- Naresh Kumar Sharma
- Department of Oral and Maxillofacial Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Akhilesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arun Pandey
- Department of Oral and Maxillofacial Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vishal Verma
- Department of Oral and Maxillofacial Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shreya Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Sevim S, Kaleağası H, Fidancı H. Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases. Mult Scler Relat Disord 2015; 4:403-405. [DOI: 10.1016/j.msard.2015.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 05/16/2015] [Accepted: 06/11/2015] [Indexed: 11/15/2022]
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Sunil Dutt C, Ramnani P, Thakur D, Pandit M. Botulinum toxin in the treatment of muscle specific Oro-facial pain: a literature review. J Maxillofac Oral Surg 2015; 14:171-5. [PMID: 26028831 PMCID: PMC4444670 DOI: 10.1007/s12663-014-0641-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 06/14/2014] [Indexed: 11/27/2022] Open
Abstract
Facial pain associated with temporomandibular joint (TMJ) and surrounding structures has been a challenge to clinicians as far as diagnosis and management is concerned. Complexity of anatomical structures within a small area, function of teeth and surrounding periodontal ligament, action of muscles, pathologies, lack of diagnostic investigations, all these complicate specific diagnosis of TMJ disorders. Various classifications have been designed and studied to help diagnose and treat TMJ related disorders, of which the simplest one is pain from TMJ proper and surrounding muscles. Many treatment modalities to treat pain arising from muscles around TMJ like splints, mouth restriction exercises, injection of sclerosing agents etc. have been used with various degrees of success. Botulinum toxin has been shown to be effective in the treatment of oro-facial pain due to muscular disorders and the same is discussed in detail in this review literature.
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Affiliation(s)
- C. Sunil Dutt
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
| | - Pooja Ramnani
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
| | - Deepak Thakur
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
| | - Manish Pandit
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
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Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation. Int J Oral Maxillofac Surg 2014; 43:1224-8. [DOI: 10.1016/j.ijom.2014.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 03/23/2014] [Accepted: 05/12/2014] [Indexed: 11/20/2022]
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Gulses A, Bayar GR, Aydintug YS, Sencimen M, Erdogan E, Agaoglu R. Histological evaluation of the changes in temporomandibular joint capsule and retrodiscal ligaments following autologous blood injection. J Craniomaxillofac Surg 2013. [DOI: 10.1016/j.jcms.2012.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Emara A, Faramawey M, Hassaan M, Hakam M. Botulinum toxin injection for management of temporomandibular joint clicking. Int J Oral Maxillofac Surg 2013; 42:759-64. [DOI: 10.1016/j.ijom.2013.02.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/19/2013] [Accepted: 02/18/2013] [Indexed: 01/16/2023]
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Torres DE, McCain JP. Arthroscopic electrothermal capsulorrhaphy for the treatment of recurrent temporomandibular joint dislocation. Int J Oral Maxillofac Surg 2012; 41:681-9. [DOI: 10.1016/j.ijom.2012.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 02/24/2012] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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Oh SJ, Im S, Oh J, Hong SH, Park GY. Effect of Botulinum Toxin A on Trismus after Pons Infarction -A case report-. BRAIN & NEUROREHABILITATION 2012. [DOI: 10.12786/bn.2012.5.1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Seon Jeong Oh
- Department of Rehabilitaion Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Sun Im
- Department of Rehabilitaion Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Jeehae Oh
- Department of Rehabilitaion Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Seok Ha Hong
- Department of Rehabilitaion Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Geun-Young Park
- Department of Rehabilitaion Medicine, College of Medicine, The Catholic University of Korea, Korea
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22
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Undt G. Temporomandibular joint eminectomy for recurrent dislocation. Atlas Oral Maxillofac Surg Clin North Am 2011; 19:189-206. [PMID: 21878252 DOI: 10.1016/j.cxom.2011.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Gerhard Undt
- Hospital for Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.
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23
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Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011; 7:10. [PMID: 21676208 PMCID: PMC3127760 DOI: 10.1186/1746-160x-7-10] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 06/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. METHOD AND MATERIALS A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. RESULT A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. CONCLUSION The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.
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Affiliation(s)
- Babatunde O Akinbami
- University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
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24
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de Jong WC, Korfage JAM, Langenbach GEJ. The role of masticatory muscles in the continuous loading of the mandible. J Anat 2011; 218:625-36. [PMID: 21492160 DOI: 10.1111/j.1469-7580.2011.01375.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Muscles are considered to play an important role in the ongoing daily loading of bone, especially in the masticatory apparatus. Currently, there are no measurements describing this role over longer periods of time. We made simultaneous and wireless in vivo recordings of habitual strains of the rabbit mandible and masseter muscle and digastric muscle activity up to ∼25 h. The extent to which habitually occurring bone strains were related to muscle-activity bursts in time and in amplitude is described. The data reveal the masseter muscle to load the mandible almost continuously throughout the day, either within cyclic activity bouts or with thousands of isolated muscle bursts. Mandibular strain events rarely took place without simultaneous masseter activity, whereas the digastric muscle only played a small role in loading the mandible. The average intensity of masseter-muscle activity bouts was strongly linked to the average amplitude of the concomitant bone-strain events. However, individual pairs of muscle bursts and strain events showed no relation in amplitude within cyclic loading bouts. Larger bone-strain events, presumably related to larger muscle-activity levels, had more constant principal-strain directions. Finally, muscle-to-bone force transmissions were detected to take place at frequencies up to 15 Hz. We conclude that in the ongoing habitual loading of the rabbit mandible, the masseter muscle plays an almost non-stop role. In addition, our results support the possibility that muscle activity is a source of low-amplitude, high-frequency bone loading.
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Affiliation(s)
- W C de Jong
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, MOVE Research Institute, Amsterdam, The Netherlands
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25
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Majid O. Clinical use of botulinum toxins in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2010; 39:197-207. [DOI: 10.1016/j.ijom.2009.10.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Revised: 06/15/2009] [Accepted: 10/30/2009] [Indexed: 12/12/2022]
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26
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Neurogenic temporomandibular joint dislocation treated with botulinum toxin: report of 4 cases. ACTA ACUST UNITED AC 2010; 109:e33-7. [DOI: 10.1016/j.tripleo.2009.10.046] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Accepted: 10/21/2009] [Indexed: 11/24/2022]
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27
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Machon V, Abramowicz S, Paska J, Dolwick MF. Autologous Blood Injection for the Treatment of Chronic Recurrent Temporomandibular Joint Dislocation. J Oral Maxillofac Surg 2009; 67:114-9. [PMID: 19070756 DOI: 10.1016/j.joms.2008.08.044] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 08/05/2008] [Accepted: 08/28/2008] [Indexed: 11/30/2022]
Affiliation(s)
- Vladimir Machon
- Department of Head and Neck Surgery, Hospital Homolka, Prague, Czech Republic
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28
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de Leeuw R. Internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am 2008; 20:159-68, v. [PMID: 18343322 DOI: 10.1016/j.coms.2007.12.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article discusses several types of internal derangements of the temporomandibular joint. It includes definitions, clinical characteristics, and management options. Nonsurgical and surgical treatment strategies are discussed taking into consideration the latest evidence-based literature.
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Affiliation(s)
- Reny de Leeuw
- Orofacial Pain Center, University of Kentucky, College of Dentistry, 800 Rose Street, Lexington, KY 40536-0297, USA.
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29
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Abstract
This article reviews three poorly recognized yet relatively common presentations of hyperactive orofacial movement disorders: oromandibular dystonia, orofacial dyskinesia, and drug-induced extrapyramidal syndrome reactions. Orofacial movement disorders are often misdiagnosed as temporomandibular disorders, hence understanding these conditions is pertinent for the practitioner treating orofacial pain. Aspects of epidemiology, etiology, pathophysiology, clinical presentation, and diagnosis are discussed along with treatment considerations for these orofacial movement disorders.
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Affiliation(s)
- Ramesh Balasubramaniam
- Department of Oral Medicine, University of Pennsylvania, School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
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30
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Abstract
Local administration of botulinum toxin (BoTx) inhibits presynaptic acetylcholine release. All cholinergically innervated muscles and glands can be paralyzed accordingly. Studies on the application of BoTx in multiple sclerosis have shown good results for focal spasticity, in particular, of the extremities. The first promising data were published on bladder disorders, especially with regard to detrusor sphincter dyssynergia and detrusor hyperreflexia. Hyperhidrosis, hypersalivation and proctologic symptoms might be other areas of application. Approval, however, has been greatly restricted which limits the therapeutic range of use.
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Affiliation(s)
- Wolfgang H Jost
- Dept. of Neurology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191, Wiesbaden, Germany.
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31
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Bakke M, Møller E, Werdelin LM, Dalager T, Kitai N, Kreiborg S. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement. ACTA ACUST UNITED AC 2005; 100:693-700. [PMID: 16301150 DOI: 10.1016/j.tripleo.2004.11.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Revised: 11/11/2004] [Accepted: 11/17/2004] [Indexed: 11/24/2022]
Abstract
A novel treatment procedure is introduced for severe clicking of the temporomandibular joint (TMJ) associated with anterior disc displacement (ADD), using injections with botulinum toxin (BTX-A) in the lateral pterygoid muscle (LP). It has been suggested that ADD may be caused, precipitated, or maintained by LP activity, but the role of the LP in the dynamics of the TMJ clicking is uncertain. The case report includes 2 women, followed with clinical examinations, TMJ imaging, and electromyography (EMG), in whom local anesthetics in the LP could abolish the clicking for several days. BTX-A block of the LP (30 U Botox, given twice under EMG guidance with 6-month interval) temporarily reduced the action of the muscle, but the clicking was permanently eliminated and did not return during the observation period of 1 year, and a small but distinctive positional improvement in the disc-condyle relationship was obtained. However, the precise mechanisms behind the favourable treatment outcome are unclear.
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Affiliation(s)
- Merete Bakke
- Department of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, School of Dentistry, University of Copenhagen, Denmark.
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32
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33
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Castro WH, Gomez RS, Da Silva Oliveira J, Moura MDG, Gomez RS. Botulinum toxin type A in the management of masseter muscle hypertrophy. J Oral Maxillofac Surg 2005; 63:20-4. [PMID: 15635552 DOI: 10.1016/j.joms.2004.04.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE We sought to evaluate the response of 6 patients with masseter muscle hypertrophy to botulinum toxin type A therapy. PATIENTS AND METHODS Six patients with unilateral or bilateral masseter muscle hypertrophy received intramuscular injection of the botulinum toxin type A. The functional and cosmetic results were evaluated as well as recurrence. RESULTS In all patients, satisfactory regression of the masseter muscle hypertrophy occurred and mild muscular pain was relieved. Recurrence was observed in 2 cases. CONCLUSIONS The use of botulinum toxin type A in masseter muscle hypertrophy therapy was shown to be a successful and safe treatment method. This procedure to control parafunctional activities involving the masticatory muscles of patients appears to be useful.
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Affiliation(s)
- Wagner Henriques Castro
- Department of Oral Surgery and Oral Pathology, School of Dentistry, University of Minas Gerais, Belo Horizonte, Brazil.
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34
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Aquilina P, Vickers R, McKellar G. Reduction of a chronic bilateral temporomandibular joint dislocation with intermaxillary fixation and botulinum toxin A. Br J Oral Maxillofac Surg 2004; 42:272-3. [PMID: 15121281 DOI: 10.1016/j.bjoms.2004.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2004] [Indexed: 11/27/2022]
Abstract
A 71-year-old man was referred to the Department of Oral and Maxillofacial Surgery at Westmead Hospital for investigation of limited jaw movement and facial pain after a cerebrovascular event eight weeks previously. He was found to have bilateral dislocations of the temporomandibular joints (TMJ) and was successfully treated with a combination of intermaxillary fixation (IMF) screws and botulinum toxin A.
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Affiliation(s)
- Peter Aquilina
- Department of Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, Australia
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35
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Martínez-Pérez D, García Ruiz-Espiga P. Recurrent temporomandibular joint dislocation treated with botulinum toxin: report of 3 cases. J Oral Maxillofac Surg 2004; 62:244-6. [PMID: 14762760 DOI: 10.1016/j.joms.2003.04.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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36
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Clark GT. The management of oromandibular motor disorders and facial spasms with injections of botulinum toxin. Phys Med Rehabil Clin N Am 2003; 14:727-48. [PMID: 14580034 DOI: 10.1016/s1047-9651(03)00044-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although much work is yet to be done in this area, nine general conclusions can be derived: 1. Local site-of-injection side effects from botulinum toxin injections are rare, assuming proper technique is used. 2. The two most common medication-related side effects from botulinum toxin orofacial injections are alterations in salivary consistency and inadvertent weakness of the swallowing, speech, and facial muscles. These complications are injection site-specific (eg, more common with lateral pterygoid injections and palatal and tongue muscle injections) and dose-dependent problems. These problems are bothersome but are not contraindications for the therapy if it is needed. 3. The data presented in this article are mostly case series-based and open trial-based information that is promising, but randomized, blinded, controlled trials are needed to establish the true efficacy of this method for the orofacial motor and pain disorders. 4. The novice should begin with injection of muscles he or she can inject with low risk of incorrect placement. The hard-to-find muscles should be avoided when starting out. The novice clinician should inject and dissect a few cadavers to improve injection technique. 5. The general latency for botulinum toxin type A is 1 week, its duration is 2 to 3 months, and it is recommended that injection be done no more than once every 12 weeks to avoid development of antibodies against the toxin. 6. Depending on the target muscle, injection dose is 10 to 50 U of Botox type A per site with a total dose of 200 U in the masticatory system. More than this can be used (400 U maximum) if other sites in the head and neck are included in the injection protocol. 7. Regarding injecting painful muscles that do not exhibit palpable muscle hardness or EMG-determined spasticity or observable involuntary movements but have chronic myofascial trigger points or the patient localizes them as the site of their chronic daily headache pain, botulinum toxin injections might be helpful used in this manner, but conclusive data for this controversial application of botulinum toxin are still missing. 8. Hemifacial spasm has the largest number of open-label, clinical trials, some of which have a 10-year follow-up. The conclusions reached by all of these reports is that treatment of hemifacial spasm with repeated injections of botulinum toxin has been highly successful and that the dose and relative effect of the injections are stable over time. 9. Although EMG-guided injection may be useful, EMG is neither practical nor needed in most situations for orofacial injections because most of the orofacial muscles are easily palpable muscles or have definitive bony landmarks to help with the localization process.
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Affiliation(s)
- Glenn T Clark
- Department of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90024-1762, USA.
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37
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Chikhani L, Dichamp J. [Bruxism, temporo-mandibular dysfunction and botulinum toxin]. ANNALES DE READAPTATION ET DE MEDECINE PHYSIQUE : REVUE SCIENTIFIQUE DE LA SOCIETE FRANCAISE DE REEDUCATION FONCTIONNELLE DE READAPTATION ET DE MEDECINE PHYSIQUE 2003; 46:333-7. [PMID: 12928140 DOI: 10.1016/s0168-6054(03)00115-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Tooth grinding and tooth clenching are unvoluntary mainly nocturnal habits that result in an hypertrophy of masseter and temporalis muscles with an unbalance between opening and closing muscles of the jaw and lead to an alteration of mandibular condyles movements and to hyper pressure in the temporo-mandibular joints (TMJ) which can generate severe pain. Intra muscular injections of botulinum toxin permit to restablish the balance between closing and opening muscles, to relieve pain, to treat masseteric hypertrophy with improvement of face outline and to recover a normal cinetic of temporo-mandibular joints. Moreover, botulinum toxin injections permit to quit habits of tooth grinding and clenching and one single session of injections is curative for 2/3 of the patients. There are no side effects apart from slight diffusion to superficial muscles of the face resulting in a "fixed" smile for about 6 to 8 weeks. So injections of botulinum toxin in masseter and temporalis muscles are an efficient treatment of bruxism and TMJ dysfunction, cheap with no lasting side effect.
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Affiliation(s)
- L Chikhani
- Service de stomatologie et chirurgie maxillo-faciale de l'hôpital européen Georges-Pompidou, 21, rue Leblanc, 75015 Paris, France.
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38
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Ziegler CM, Haag C, Mühling J. Treatment of recurrent temporomandibular joint dislocation with intramuscular botulinum toxin injection. Clin Oral Investig 2003; 7:52-5. [PMID: 12673439 DOI: 10.1007/s00784-002-0187-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2002] [Accepted: 10/22/2002] [Indexed: 10/25/2022]
Abstract
Recurrent dislocation of the mandibular condyle poses a difficult problem for affected patients. In the course of time, dislocations often become more frequent and more difficult to avoid. Even with good patient compliance, conservative treatment is often not sufficient. Operative procedures have also been described for the treatment of temporomandibular joint dislocation. However, these interventions are invasive, involving open arthrotomy with possible complications, and cannot safely guarantee a successful outcome. On the other hand, botulinum toxin injections into the lateral pterygoid muscles offer the option of a predictable and prolonged period without renewed dislocation. We present the results of this treatment carried out in 21 patients with recurrent temporomandibular joint dislocation. Four patients were treated following unsuccessful physical therapy and the use of occlusal splints. The remaining 17 patients were treated for a number of conditions resulting in dislocation, including some with senile dementia and mental impairment in whom compliance with conservative measures was poor or completely absent. Injections were given on a 3-month basis in order to have a sustained effect. Within the study period of 6 months to 3 years, only two of the 21 patients suffered further dislocation. There were no side effects recorded as a result of treatment.
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Affiliation(s)
- Christoph M Ziegler
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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39
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Kuttenberger J, Hardt N. Long-term results following miniplate eminoplasty for the treatment of recurrent dislocation and habitual luxation of the temporomandibular joint. Int J Oral Maxillofac Surg 2003. [DOI: 10.1016/s0901-5027(03)90392-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Jongerius PH, Joosten F, Hoogen FJA, Gabreels FJM, Rotteveel JJ. The treatment of drooling by ultrasound-guided intraglandular injections of botulinum toxin type A into the salivary glands. Laryngoscope 2003; 113:107-11. [PMID: 12514392 DOI: 10.1097/00005537-200301000-00020] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to present the background, procedure, and technique of bilateral ultrasound-guided, single-dose injections of botulinum toxin type A (BTX) into the salivary glands in patients with severe drooling. STUDY DESIGN Clinical trial. METHODS Initially, an in vitro study was performed to determine the volume of the dilution of BTX required for optimal spreading and to gain insight in the spreading pattern of the fluid in the submandibular gland. Subsequently, patients with severe drooling were included in a clinical study. Salivary flow was measured under standardized conditions, and BTX was injected into the submandibular glands with the patient under general anesthesia and with ultrasound guidance as an outpatient procedure or during a short stay at the daytime care unit. RESULTS BTX for each gland should be diluted in a volume of 1 to 1.5 mL saline to achieve adequate spreading within the gland and to diminish the risk of diffusion into surrounding structures. With ultrasound guidance, separate structures surrounding the glands and structures within the glandular parenchyma are well recognized and injection errors can be avoided. CONCLUSIONS With the procedure described, it is possible to accurately inject BTX directly into the glandular parenchyma and to visualize spreading of the fluid in the glandular parenchyma. It is found to be a safe method that guarantees an optimal clinical effect and avoids potentially harmful side effects. We recommend ultrasound guidance if injections of BTX into the salivary glands are considered.
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Affiliation(s)
- Peter H Jongerius
- Department of Rehabilitation, University Medical Center St. Radboud, Nijmegen, The Netherlands.
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41
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42
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Shorey CW, Campbell JH. Dislocation of the temporomandibular joint. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:662-8. [PMID: 10846117 DOI: 10.1067/moe.2000.106693] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- C W Shorey
- Department of Oral Surgery, Medicine, and Pathology, Indiana University, Indianapolis, Indiana 46202, USA
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43
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Abstract
BACKGROUND Dentistry and its related specialties have made exponential increases in the functional and cosmetic treatment of the maxillofacial region. Oral and maxillofacial surgeons historically have been involved in functional and cosmetic rejuvenation of the face, and newer technologies have enhanced the ability to make patients look and feel better. METHODS Cosmetic oral and maxillofacial surgery is being taught in residency programs, is included in the oral and maxillofacial surgery board examinations and represents a part of contemporary oral and maxillofacial surgery. The author discusses common facial rejuvenation procedures with an emphasis on newer treatment technologies. RESULTS Many oral and maxillofacial surgeons have the ability to improve the esthetics of the maxillofacial area and related structures. The large number of aging baby boomers and technological advances in cosmetic facial surgery have made these procedures easier to perform and more popular than ever. CONCLUSION A global diagnosis and treatment plan to include facial esthetics can enhance cosmetic dentistry and serve to frame the work of the restorative dentist. The oral and maxillofacial surgeon can help the dentist and patient pursue both functional and cosmetic improvement with safe and effective procedures. CLINICAL IMPORTANCE All dentists should be aware and abreast of advances in all areas of dentistry and have a basic understanding of available procedures that can benefit their patients. Cosmetic oral and maxillofacial surgery can enhance the work of the restorative dentist and improve facial esthetics, as well as enhance the well-being of the patient.
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