RESUMO
OBJECTIVE: The objective of the study was to conduct a systematic review of the literature assessing the effects of botulinum toxin (BoNT-A) injections in the management of bruxism. MATERIALS AND METHODS: Search for articles involved the PubMed, Scopus, Web of Science, Embase, Cochrane, Scielo and Lilacs databases. Specific terms were used and the search carried out from 1980 to March 2016 by three independent researchers. Randomized controlled studies (RCTs), prospective and before-after studies that applied BoNT-A at the masseter and/or temporalis muscles were included. RESULTS: Three RCTs and two uncontrolled before-after studies out of 904 identified citations were included in this review. All five articles dealt with sleep bruxism and featured a small sample size. None of them was about awake bruxism. Two randomized clinical trials were double-blinded, with a control group using saline solution. Two studies used polysomnography/electromyography for sleep bruxism diagnosis, whilst others were based on history taking and clinical examination. All studies using subjective evaluations for pain and jaw stiffness showed positive results for the BoNT-A treatment. In contrast, the two studies using objective evaluations did not demonstrate any reduction in bruxism episodes, but a decrease in the intensity of muscles contractions. CONCLUSION: Despite the paucity of works on the topic, BoNT-A seems to be a possible management option for sleep bruxism, minimizing symptoms and reducing the intensity of muscle contractions, although further studies are necessary especially as far as the treatment indications for bruxism itself is concerned. CLINICAL RELEVANCE: BoNT-A has been increasingly diffused in dentistry over recent years, being also used for pain management in patients with bruxism. Nonetheless, there is no consensus about its effects in this disorder.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Bruxismo/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Toxinas Botulínicas Tipo A/administração & dosagem , Eletromiografia , Humanos , Injeções , Músculo Masseter/efeitos dos fármacos , Fármacos Neuromusculares/administração & dosagem , Polissonografia , Músculo Temporal/efeitos dos fármacosRESUMO
OBJECTIVE: The aim was to examine the effect of blocking trigger points in the temporal muscles of patients with masticatory myofascial pain syndrome, fibromyalgia and headache. METHOD: Seventy patients with one trigger point were randomly divided into 3 groups: injection with saline or anesthetic and non-injected (control). RESULTS: Pain was reduced in 87.71% patients injected with saline and 100% injected with anesthetic. Similar results were obtained for headache frequency. With regard to headache intensity, the injection groups differed from the control group, but not between themselves. CONCLUSION: Treatment with injection at trigger points decreased facial pain and frequency and intensity of headache. Considering the injected substance there was no difference.
Assuntos
Anestésicos Locais/administração & dosagem , Fibromialgia/tratamento farmacológico , Transtornos da Cefaleia/tratamento farmacológico , Síndromes da Dor Miofascial/tratamento farmacológico , Músculo Temporal/efeitos dos fármacos , Pontos-Gatilho , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Injeções Intramusculares/métodos , Pessoa de Meia-Idade , Medição da Dor , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Objective : The aim was to examine the effect of blocking trigger points in the temporal muscles of patients with masticatory myofascial pain syndrome, fibromyalgia and headache.Method : Seventy patients with one trigger point were randomly divided into 3 groups: injection with saline or anesthetic and non-injected (control).Results : Pain was reduced in 87.71% patients injected with saline and 100% injected with anesthetic. Similar results were obtained for headache frequency. With regard to headache intensity, the injection groups differed from the control group, but not between themselves.Conclusion : Treatment with injection at trigger points decreased facial pain and frequency and intensity of headache. Considering the injected substance there was no difference.
Objetivo : Comparar o efeito terapêutico do bloqueio de pontos-gatilho na musculatura temporal com soro fisiológico e anestésico em pacientes com síndrome da dor miofascial mastigatória, fibromialgia e cefaleia, entre sí e com controles não-infiltrados.Método : Setenta pacientes que apresentaram pelo menos um ponto-gatilho na musculatura temporal foram aleatoriamente divididas em 3 grupos: infiltração com soro fisiológico, infiltração com anestésico e controle (não-infiltradas).Resultados : Houve redução na intensidade de dor na face em 87,71% dos pacientes infiltrados com soro fisiológico e em 100% dos pacientes infiltrados com anestésico, mas não no grupo controle. Houve similaridade dos resultados considerando a frequência da cefaléia. Quanto à intensidade da cefaléia, tanto a infiltração com soro fisiológico, quanto com anestésico foram efetivos e sem diferença significativa entre sí, ao contrário do grupo controle.Conclusões : O tratamento com infiltração diminui a dor na face, bem com a frequência e a intensidade da cefaléia. Quando considerado a substância infiltrada não há diferenças no tratamento.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Anestésicos Locais/administração & dosagem , Fibromialgia/tratamento farmacológico , Transtornos da Cefaleia/tratamento farmacológico , Síndromes da Dor Miofascial/tratamento farmacológico , Pontos-Gatilho , Músculo Temporal/efeitos dos fármacos , Método Duplo-Cego , Injeções Intramusculares/métodos , Medição da Dor , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
PURPOSE: Post-traumatic oromandibular dystonia (PTOD) is a disorder whose symptoms can include bruxism, muscle pain, and involuntary muscle contraction, among others. The use of onabotulinumtoxinA (ObT-A) is helpful in controlling the symptoms of patients with PTOD. The aim of this study was to evaluate the use of ObT-A in the treatment of PTOD. MATERIALS AND METHODS: In this prospective case-series study, the population consisted exclusively of patients diagnosed with PTOD, without distinction by age or gender, from January 2007 to December 2010. The patients were diagnosed with PTOD and treated with ObT-A infiltration (primary predictor) at the Department of Maxillofacial Surgery at the Hospital Clínico Mutual de Seguridad (Santiago, Chile). The primary outcome variables were bruxism, muscle pain, and involuntary muscle contraction. The data were obtained through questionnaires registered in tables at each control. Systat 13.1 was used for statistical analysis. The statistical test used to compare patients' evolution over time was the test of signs. RESULTS: Thirty male patients 18 to 65 years old diagnosed with PTOD were treated with ObT-A infiltrations. The signs and symptoms associated with oromandibular dystonia (bruxism, muscle pain, and involuntary muscle contraction) were decreased in all patients after ObT-A infiltrations. CONCLUSIONS: The positive results and the absence of complications recommend the use of the infiltration protocol presented in this study for the treatment of PTOD.
Assuntos
Inibidores da Liberação da Acetilcolina/uso terapêutico , Toxinas Botulínicas Tipo A/uso terapêutico , Lesões Encefálicas/complicações , Distonia/tratamento farmacológico , Músculos da Mastigação/efeitos dos fármacos , Inibidores da Liberação da Acetilcolina/administração & dosagem , Adolescente , Adulto , Idoso , Toxinas Botulínicas Tipo A/administração & dosagem , Bruxismo/tratamento farmacológico , Distonia/etiologia , Dor Facial/tratamento farmacológico , Seguimentos , Humanos , Injeções Intramusculares , Masculino , Músculo Masseter/efeitos dos fármacos , Pessoa de Meia-Idade , Contração Muscular/efeitos dos fármacos , Estudos Prospectivos , Espasmo/tratamento farmacológico , Músculo Temporal/efeitos dos fármacos , Fatores de Tempo , Adulto JovemRESUMO
This study aimed to comparatively analyse the electromyographic activity of the masseter and temporal muscles at rest and during mandible postural clinical conditions (right and left laterality, protrusion and maximum voluntary contraction), right and left maximum molar bite forces and the masticatory efficiency of individuals with schizophrenia or mood disorders - all medicated (medicated groups) compared with control group (healthy volunteers) via electromyography. Individuals were distributed into three groups: Group I (Schizophrenia - 20 individuals), Group II (mood disorders - 20 individuals) and Group III (Control - 40 individuals). Basically, the results were only statistically significant for the clinical mandible conditions and bite force. The most unsatisfactory results were observed in the medicated groups in relation to the control group. The group with mood disorders obtained the most unsatisfactory results compared with the group with schizophrenia. It was suggested by these observations that the association of mood disorders and schizophrenia with medication has negatively affected the stomatognathic system in relation to controls when the electromyography and bite force were used for the analysis.