Department of Oral and Maxillofacial Surgery, Konya Oral and Teeth Health Hospital, Konya, Turkey.
Department of Oral and Maxillofacial Surgery, Medipol University, Istanbul, Turkey.
Niger J Clin Pract. 2021 Mar;24(3):412-417. doi: 10.4103/njcp.njcp_251_20.
Bruxism is a parafunctional habit, usually performed in sleep, by rhythmic and involuntary teeth being squeezed or squeaked. The most common methods of treatment are the use of occlusal splints.
The aim of this study was to compare the efficacy of occlusal splinting with botulinum toxin administration in the treatment of TMJ pain.
For this purpose, 40 patients with bruxism were divided into two groups and one group was treated with occlusal splint and the other group received masseter muscle botulinum toxin injection. Then, the participants in both groups were evaluated in terms of pain, functional movement, and maximum bite force change at 2 weeks, 6 weeks, 3 months, and 6 months. Mann-Whitney U test was used to examine the differences between two independent groups. While Friedman test was used for differences between dependent groups, the Wilcoxon test was used for the differences between two repetitive measurements. Chi-square test was used to examine the relationship between categorical variables. Results: When pain was evaluated, both methods were effective in pain reduction, botulinum toxin injection was found to be less effective in reducing pain but no difference was found between the two methods. The maximum bite force decreased in the 2 and 6 weeks and increased in the 3 and 6 months in patients receiving botulinum toxin. In patients using occlusal splints, there was no change until the 3 month and an increase was seen in the 6 month. In this study, it was observed that low dose BTX-A and occlusal splint use were effective in eliminating bruxism-related pain but not superior to each other.
According to these results, low dose botulinum toxin can be considered as an alternative treatment in patients who cannot use occlusal splint for various reasons.
磨牙症是一种副功能习惯，通常在睡眠中发生，表现为牙齿有节奏地、无意识地紧咬或磨牙。最常见的治疗方法是使用咬合夹板。
本研究旨在比较咬合夹板与肉毒毒素注射治疗颞下颌关节疼痛的疗效。
为此，将 40 名磨牙症患者分为两组，一组接受咬合夹板治疗，另一组接受咬肌肉毒毒素注射。然后，在 2 周、6 周、3 个月和 6 个月时，通过疼痛、功能运动和最大咬合力变化对两组患者进行评估。采用 Mann-Whitney U 检验比较两组间的差异。采用 Friedman 检验比较组内差异，采用 Wilcoxon 检验比较两组重复测量间的差异。采用卡方检验分析分类变量间的关系。结果：在评估疼痛时，两种方法均能有效减轻疼痛，但肉毒毒素注射在减轻疼痛方面效果较差，两种方法之间无差异。接受肉毒毒素注射的患者在 2 周和 6 周时最大咬合力下降，在 3 个月和 6 个月时增加。使用咬合夹板的患者在 3 个月前没有变化，在 6 个月时增加。本研究观察到，低剂量 BTX-A 和咬合夹板的使用在消除磨牙症相关疼痛方面是有效的，但彼此之间没有优势。
根据这些结果，低剂量肉毒毒素可作为因各种原因不能使用咬合夹板的患者的替代治疗方法。
