Katz Howard
Dentofacial Treatment Center of San Diego, San Diego, California, USA.
Singapore Dent J. 2005 Dec;27(1):7-12.
A variety of factors, such as stress, hormones, diet, drugs, trauma, and certain neuromuscular diseases, can lead to an increase in sympathetic muscle tone, which results in masticatory muscle hypertonicity and parafunction. Dentists have traditionally attempted to treat and prevent this transient disease with methods that are expensive, risky, irreversible, and not evidence-based. There is a need for a conservative reversible noninvasive treatment that is quick, easy, relatively inexpensive, long acting, and effective. Botulinum toxin, a natural protein, is one of the most potent biological substances known. Masticatory muscle relaxation can be reliably achieved by injecting measured doses of botulinum toxin into specific sites in the major muscles of mastication. A reduction in dystonia and pain with optimization of function is easily achievable with a site- and dose-specific injection protocol. The use of botulinum toxin offers the dentist an extremely effective tool to add to the armamentarium for treating conditions that derive from masticatory and other pericranial muscular conditions, and offers the general dentist who is not an expert in gnathology and occlusion a safe, effective treatment for controlling the symptoms of masticatory muscle hypertonicity.
多种因素，如压力、激素、饮食、药物、创伤和某些神经肌肉疾病，可导致交感神经肌肉张力增加，进而导致咀嚼肌高张力和功能异常。传统上，牙医一直试图用昂贵、有风险、不可逆且无循证依据的方法来治疗和预防这种短暂性疾病。因此，需要一种保守、可逆、无创的治疗方法，这种方法要快速、简便、相对便宜、长效且有效。肉毒杆菌毒素是一种天然蛋白质，是已知最有效的生物物质之一。通过将定量的肉毒杆菌毒素注射到咀嚼主要肌肉的特定部位，可以可靠地实现咀嚼肌松弛。采用特定部位和剂量的注射方案，很容易实现肌张力障碍减轻、疼痛缓解以及功能优化。肉毒杆菌毒素的使用为牙医提供了一种极其有效的工具，可补充到治疗咀嚼肌及其他颅周肌肉疾病的手段中，也为非口腔颌面学和咬合学专家的普通牙医提供了一种安全、有效的方法来控制咀嚼肌高张力的症状。
