Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Toxins (Basel). 2022 May 28;14(6):374. doi: 10.3390/toxins14060374.
The physiological homeostasis of the masticatory complex in short-faced patients is too robust to be disintegrated and reconstructed due to the powerful masseter muscle. This study innovatively introduced the botulinum toxin-A (BTX-A) into the field of dental occlusal treatment, providing a novel and minimally invasive therapy perspective for the two major clinical problems in these patients (low treatment efficiency and high rates of complications). In total, 10 adult patients with skeletal low angle seeking occlusal treatment (age: 27.0 ± 6.1 years; 4 males and 6 females) were administered 30−50 U of BTX-A in each masseter muscle and evaluated before and 3 months after injection based on cone-beam computed tomography (CBCT). We found a significant reduction in the thickness of the masseter muscle (MMT) (p < 0.0001). With regards to occlusion, we found a significant increase in the height of the maxillary second molar (U7-PP) (p < 0.05) with significantly flattened occlusal curves (the curve of Spee [COS] (p < 0.01), and the curve of Wilson [COW] (p < 0.05)). Furthermore, the variations in the temporomandibular joint exhibited a significant reduction in the anterior joint space (AJS) (p < 0.05) and superior joint space (SJS) (p < 0.05). In addition, the correlation analysis of the masticatory complex provided the basis for the following multiple regression equation: MMT = 10.08 − 0.11 COW + 2.73 AJS. The findings from our pilot study indicate that BTX-A, as a new adjuvant treatment attempt of occlusal therapy for short-faced patients, can provide a more favorable muscular environment for subsequent occlusal therapy through the adjustment of the biting force and may contribute to the reconstruction of healthier homeostasis of the masticatory complex. However, further research is required to establish the reliability and validity of these findings.
短面患者咀嚼复合体的生理平衡非常强大，以至于由于强大的咬肌，它不会被破坏和重建。本研究创新性地将肉毒毒素-A (BTX-A) 引入口腔咬合治疗领域，为这些患者的两大临床问题（治疗效率低和并发症发生率高）提供了一种新颖的微创治疗视角。共有 10 名寻求咬合治疗的成人短面患者（年龄：27.0 ± 6.1 岁；男性 4 名，女性 6 名），每块咬肌注射 30-50U 的 BTX-A，在注射前和 3 个月后，通过锥形束 CT（CBCT）进行评估。我们发现咬肌厚度（MMT）明显减少（p < 0.0001）。关于咬合，我们发现上颌第二磨牙（U7-PP）高度显著增加（p < 0.05），同时咬合曲线明显变平（Spee 曲线 [COS]（p < 0.01）和 Wilson 曲线 [COW]（p < 0.05））。此外，颞下颌关节的变化表现为前关节间隙（AJS）（p < 0.05）和上关节间隙（SJS）（p < 0.05）显著减少。此外，咀嚼复合体的相关分析为以下多元回归方程提供了基础：MMT = 10.08-0.11 COW + 2.73 AJS。我们的初步研究结果表明，BTX-A 作为短面患者咬合治疗的一种新辅助治疗尝试，通过调整咬合力量，可以为随后的咬合治疗提供更有利的肌肉环境，有助于重建咀嚼复合体更健康的生理平衡。然而，需要进一步的研究来建立这些发现的可靠性和有效性。
