Ghavimi Mohammad Ali, Yazdani Javad, Afzalimehr Atena, Ghoreyshizadeh Arezoo, Dehnad Seyed Vahid
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
J Dent Res Dent Clin Dent Prospects. 2019 Spring;13(2):128-132. doi: 10.15171/joddd.2019.020. Epub 2019 Aug 14.
Temporomandibular joint dysfunction (TMD) is a term that describes problems in the masticatory system, including the temporomandibular joint, the dento-muscular system and the supporting bones. Injection of botulinum toxin, as a noninvasive technique, might be useful in decreasing symptoms such as muscular spasm, dystonia, migraine headaches and TMD. Therefore, the aim of the present study was to evaluate the effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with TMD. A total of 61 patients were consecutively included in the present study in 2016‒2017. All the subjects received a 50-unit injection of Dysport botulinum toxin in the masseter muscles using an extraoral injection technique. The results of the injection were evaluated in terms of pain severity using VAS, clinical evaluations of the joint click through palpation and by determining the inter-incisal distance. The patients underwent follow-up examinations at 1-week, 3-month and 6-month intervals after injection. Data were analyzed with appropriate statistical tests. Comparison of pain severity and articular clicks at different intervals showed decreases in these parameters over time, with significant differences between the time intervals (P<0.05). Comparison of mouth opening at different intervals showed increases in mouth opening over time. The results of the present study showed that injection of botulinum toxin can be used in patients with TMD as a non-invasive treatment modality.
颞下颌关节紊乱病(TMD)是一个描述咀嚼系统问题的术语,包括颞下颌关节、牙-肌肉系统和支持骨骼。注射肉毒杆菌毒素作为一种非侵入性技术,可能有助于减轻诸如肌肉痉挛、肌张力障碍、偏头痛和TMD等症状。因此,本研究的目的是评估注射肉毒杆菌毒素对减轻TMD患者咀嚼肌症状和体征的效果。2016年至2017年共有61例患者连续纳入本研究。所有受试者均采用口外注射技术在咬肌注射50单位的Dysport肉毒杆菌毒素。根据视觉模拟评分法(VAS)评估疼痛严重程度、通过触诊对关节弹响进行临床评估并测定切牙间距离,以此来评估注射结果。患者在注射后1周、3个月和6个月进行随访检查。采用适当的统计学检验对数据进行分析。不同时间间隔的疼痛严重程度和关节弹响比较显示,这些参数随时间下降,各时间间隔之间存在显著差异(P<0.05)。不同时间间隔的开口度比较显示,开口度随时间增加。本研究结果表明,注射肉毒杆菌毒素可作为TMD患者的一种非侵入性治疗方式。