Post graduate student, Department of Oral Rehabilitation, University of Otago School Dentistry, Dunedin, NewZealand.
Associate Professor, Department of Oral Rehabilitation, University of Otago, Dunedin, New Zealand.
Braz Dent J. 2021 Jul-Aug;32(4):31-44. doi: 10.1590/0103-6440202104127.
To evaluate efficacy and safety of Botulinum toxinA for improving esthetics in the facial complex and correlating them to the dosage and side effects through a systematic review.
A literature search was performed using PubMed, Medline, Web of Sciences, and Scopus databases. Quality of studies was appraised through the GRADE system. This review follows the 'Preferred reporting items for systematic review and meta-analysis protocols' (PRISMA-P) 2015 statement. Efficacy was analyzed through improvement rate and effect sizes. Graphical comparison of efficacy and ocular adverse effects (adverse effects around the eye) at various anatomical locations was made by calculating the average improvement rate and adverse events.
Twenty-five studies were included in this systematic review after application of the inclusion criteria. Moderate to severe cases in glabellar, lateral canthal, and forehead regions showed higher improvement rates between 20U to 50U, with an effect lasting up to 120 days. Gender and age seemed to have a direct effect on efficacy. Headaches were the most common adverse effect, followed by injection site bruising; all adverse effects resolved within 3-4 days.
Treatment with Botulinum toxinA to enhance esthetics of facial complex is efficient and safe at all recommended dosages. Presence of complexing proteins influenced the efficacy of BoNT-A. undesirable muscular adverse effects around the eyes were more predominant when treating the glabellar region. There was no correlation found between the BoNT-A dosage and side effects, however, an increase in dosage did not always lead to an increase in efficacy.
通过系统评价评估肉毒毒素 A 改善面部复杂性的疗效和安全性，并将其与剂量和副作用相关联。
使用 PubMed、Medline、Web of Sciences 和 Scopus 数据库进行文献检索。通过 GRADE 系统评估研究质量。本综述遵循“系统评价和荟萃分析方案的首选报告项目”（PRISMA-P）2015 声明。通过改善率和效应量分析疗效。通过计算平均改善率和不良反应，对不同解剖部位的眼部不良反应（眼部周围不良反应）的疗效进行图形比较。
应用纳入标准后，本系统评价共纳入 25 项研究。在眉间、外眦和额部等中重度病例中，20U 至 50U 之间的改善率较高，效果可持续长达 120 天。性别和年龄似乎对疗效有直接影响。头痛是最常见的不良反应，其次是注射部位瘀伤；所有不良反应均在 3-4 天内消退。
肉毒毒素 A 治疗可有效改善面部复杂性的美观，所有推荐剂量均安全有效。复合蛋白的存在影响 BoNT-A 的疗效。治疗眉间区域时，眼睛周围的不良肌肉不良反应更为明显。BoNT-A 剂量与副作用之间没有相关性，但增加剂量并不总是能提高疗效。
