Division of Oral Rehabilitation, School of Dentistry, Scientific University of the South (Universidad Científica del Sur), Lima, Peru.
Division of Orthodontics School of Dentistry, Scientific University of the South (Universidad Científica del Sur), Lima, Peru.
Dent Med Probl. 2022 Apr-Jun;59(2):271-280. doi: 10.17219/dmp/145759.
Botulinum toxin is used as an alternative for the treatment of chronic refractory myofascial pain derived from temporomandibular disorders (TMDs). It is important to establish the benefits of botulinum toxin in this type of symptomatology. The aim of the study was to conduct a systematic review in order to evaluate the effects of botulinum toxin in patients with myofascial pain related to temporomandibular disorders. The search was carried out systematically, without limitations of language or year of publication, until February 2021. The databases searched included PubMed, Web of Science, Scopus, The Cochrane Library, and Latin American and Carribean Health Sciences Literature (LILACS). Partial gray literature was searched using Google Scholar, ClinicalTrials.gov, OpenGrey, and the reference lists of selected articles. Randomized controlled clinical trials evaluating the effects of botulinum toxin in the treatment of myofascial pain were included. The risk of bias was assessed with the Cochrane RoB 2.0 tool, and the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to determine the certainty of the scientific evidence. A total of 900 studies were retrieved, out of which only 8 randomized clinical trials were selected. From these 8 studies, the data of a total of 314 patients, predominantly women, between the ages of 18 to 75 years was obtained. After the assessment of the studies with the RoB 2.0 tool, 7 studies showed some concerns regarding the reported results and only one was at a low risk of overall bias. The analysis of the studies has shown that low doses of botulinum toxin are effective in the treatment of refractory myofascial pain associated with temporomandibular disorders. The studies presented mediumto low-certainty evidence..
肉毒毒素被用作治疗源自颞下颌紊乱（TMD）的慢性难治性肌筋膜疼痛的替代方法。确定肉毒毒素在这种症状学中的益处很重要。本研究旨在进行系统评价，以评估肉毒毒素在与颞下颌紊乱相关的肌筋膜疼痛患者中的疗效。检索无语言或出版年限限制，检索截止日期为 2021 年 2 月。检索的数据库包括 PubMed、Web of Science、Scopus、The Cochrane Library 和拉丁美洲和加勒比健康科学文献（LILACS）。使用 Google Scholar、ClinicalTrials.gov、OpenGrey 和选定文章的参考文献列表搜索部分灰色文献。纳入评估肉毒毒素治疗肌筋膜疼痛效果的随机对照临床试验。使用 Cochrane RoB 2.0 工具评估偏倚风险，并使用推荐评估、制定与评价（GRADE）方法确定科学证据的确定性。共检索到 900 篇研究，其中仅选择了 8 项随机临床试验。从这 8 项研究中，共获得了 314 名患者的数据，主要是女性，年龄在 18 至 75 岁之间。使用 RoB 2.0 工具对研究进行评估后，有 7 项研究对报告的结果存在一些关注，只有一项研究存在总体偏倚的低风险。对研究的分析表明，低剂量肉毒毒素治疗与颞下颌紊乱相关的难治性肌筋膜疼痛有效。研究结果的证据确定性为中低。
