Department of Oral Medicine, College of Dentistry, Wonkwang University, Daejeon 35233, Korea.
Department of Orofacial Pain and Oral Medicine, Yonsei University Dental Hospital, Seoul 03722, Korea.
Toxins (Basel). 2020 Mar 9;12(3):168. doi: 10.3390/toxins12030168.
The purpose of this study is to evaluate the effects of botulinum toxin type A (BoNT-A) for managing sleep bruxism (SB) in a randomized, placebo-controlled trial. Thirty SB subjects were randomly assigned into two groups evenly. The placebo group received saline injections into each masseter muscle, and the treatment group received BoNT-A injections into each masseter muscle. Audio-video-polysomnographic recordings in the sleep laboratory were made before, at four weeks after, and at 12 weeks after injection. Sleep and SB parameters were scored according to the diagnostic and coding manual of American Academy of Sleep Medicine. The change of sleep and SB parameters were investigated using repeated measures analysis of variance (RM-ANOVA). Twenty-three subjects completed the study (placebo group 10, treatment group 13). None of the SB episode variables showed a significant time and group interaction ( > 0.05) except for electromyography (EMG) variables. The peak amplitude of EMG bursts during SB showed a significant time and group interaction ( = 0.001). The injection decreased the peak amplitude of EMG bursts during SB only in the treatment group for 12 weeks ( < 0.0001). A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.
本研究旨在通过随机、安慰剂对照试验评估肉毒杆菌毒素 A（BoNT-A）治疗磨牙症（SB）的效果。30 例 SB 患者被平均随机分为两组。安慰剂组接受每块咬肌注射生理盐水，治疗组接受每块咬肌注射 BoNT-A。在注射前、注射后 4 周和 12 周进行睡眠实验室的视听多导睡眠描记术记录。根据美国睡眠医学学会的诊断和编码手册对睡眠和 SB 参数进行评分。使用重复测量方差分析（RM-ANOVA）研究睡眠和 SB 参数的变化。23 名受试者完成了研究（安慰剂组 10 名，治疗组 13 名）。除肌电图（EMG）变量外，没有任何 SB 发作变量显示出显著的时间和组间交互作用（>0.05）。SB 期间 EMG 爆发的峰值幅度显示出显著的时间和组间交互作用（=0.001）。仅在治疗组中，注射在 12 周时降低了 SB 期间 EMG 爆发的峰值幅度（<0.0001）。单次 BoNT-A 注射不能减少 SB 的发生。然而，通过降低咬肌的强度，它可以成为治疗 SB 的有效方法。
