Jadhao Varsha A, Lokhande Nitin, Habbu Shweta G, Sewane Sagar, Dongare Shailesh, Goyal Neha
Department of Dentistry, Government Medical College, Akola, Maharashtra, India.
Department of Conservative and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India.
Indian J Dent Res. 2017 Sep-Oct;28(5):493-497. doi: 10.4103/ijdr.IJDR_125_17.
The present study was conducted in patients with bruxism to evaluate the effect of botulinum toxin type A (BTX-A) (Botox, Allergan, Inc., Irvine, CA, USA) in the treatment of myofascial pain and the occlusal force characteristics of masticatory muscles.
Twenty-four diagnosed with bruxism were randomly divided into three groups (n = 8) and treated by bilateral intramuscular injection of BTX-A and placebo-treated with saline placebo injections and control group where no injections were given. The clinical parameters such as pain at rest and during chewing were assessed and occlusal force analysis system to measure the distribution of occlusal force in bruxism patients. All the three groups were assessed at baseline time and at 1 week, 3 months, and 6 months follow-up appointments. Descriptive analysis showed that improvements in parameters such as pain at rest; pain during chewing clinical outcome variables were higher in the botox treated group than in the placebo-treated subjects.
The pain at rest and at chewing decreased in the BTX-A group while remaining constant in the placebo group and control group. There was a significant change in maximum occlusal force in the BTX-A group compared with the other two groups (P < 0.05, post hoc Bonferroni test, no exact P value), and there was no significant difference between the placebo and control groups (post hoc Bonferroni test, no exact P value).
Results from the present study supported the efficacy of BTX-A to reduce myofascial pain symptoms in bruxers, and effective in reducing the occlusal force.
本研究针对磨牙症患者开展，旨在评估A型肉毒毒素（BTX-A）（保妥适，美国加利福尼亚州欧文市艾尔建公司）治疗肌筋膜疼痛的效果以及咀嚼肌的咬合力特征。
24名被诊断为磨牙症的患者被随机分为三组（每组n = 8），分别接受双侧肌肉注射BTX-A治疗、用生理盐水安慰剂注射的安慰剂治疗以及不进行注射的对照组治疗。评估静息时和咀嚼时的疼痛等临床参数，并使用咬合力分析系统测量磨牙症患者的咬合力分布。在基线期以及随访的1周、3个月和6个月时对所有三组进行评估。描述性分析表明，静息时疼痛等参数的改善；与安慰剂治疗组相比，肉毒毒素治疗组咀嚼时疼痛等临床结局变量更高。
BTX-A组静息时和咀嚼时的疼痛减轻，而安慰剂组和对照组保持不变。与其他两组相比，BTX-A组的最大咬合力有显著变化（P < 0.05，事后邦费罗尼检验，无确切P值），安慰剂组和对照组之间无显著差异（事后邦费罗尼检验，无确切P值）。
本研究结果支持BTX-A减轻磨牙症患者肌筋膜疼痛症状的疗效，并有效降低咬合力。
