Shabaan Alshaimaa Ahmed, Kassem Islam, Aboulmagd Inass, Amer Islam A, Shaaban Ahmed, Abd-El-Ghafour Mohamed, Refahee Shaimaa Mohsen
Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
Consultant Oral and Maxillofacial Surgery, Main University Hospital, Alexandria University, Alexandria, Egypt.
Clin Oral Investig. 2024 Dec 17;29(1):18. doi: 10.1007/s00784-024-06051-0.
To evaluate and compare the effectiveness of the ultrasound-guided intra-oral and extra-oral transcutaneous injection techniques on the clinical outcome variables in patients with myofascial trigger points within the masseter muscle.
This prospective randomized trial included 42 patients diagnosed with myofascial pain. Patients were randomly allocated into one of two groups based on the technique of trigger point injection: intraoral and extraoral injection technique groups. Each trigger point was injected with 0.1 ml of botulinum-A toxin guided by ultrasound. Pain intensity, mouth opening, and patient quality of life were monitored six months post-injection.
The pain scores were significantly higher in the extraoral group during all follow-up assessments, whereas the MMO was considerably greater in the intraoral group up to three months of follow-up (p < 0.008). However, the difference in MMO ceased to be statistically non-significant after six months of follow-up (p = 0.927). Additionally, the patient's quality of life score was significantly higher in the intraoral group compared to the extraoral group (p < 0.001) at both the three- and six-month follow-ups.
The intraoral injection technique might be an effective treatment modality for myofascial trigger points in the masseter muscle. It produces pain relief, increases mouth opening, and enhances the overall quality of life compared to the extraoral injection technique.
The intraoral injection technique for myofascial trigger points is more effective than the extraoral technique; it reduces the need for additional injections, saves money, and enhances patients' quality of life.
Clinicaltrials.gov (NCT05673655).
评估并比较超声引导下经口内和口外经皮注射技术对咬肌肌筋膜触发点患者临床结局变量的有效性。
这项前瞻性随机试验纳入了42例被诊断为肌筋膜疼痛的患者。根据触发点注射技术，患者被随机分为两组：口内注射技术组和口外注射技术组。在超声引导下，每个触发点注射0.1毫升A型肉毒毒素。在注射后6个月监测疼痛强度、张口度和患者生活质量。
在所有随访评估中，口外组的疼痛评分显著更高，而在随访至3个月时，口内组的最大张口度明显更大（p < 0.008）。然而，随访6个月后，最大张口度的差异不再具有统计学意义（p = 0.927）。此外，在3个月和6个月的随访中，口内组患者的生活质量评分均显著高于口外组（p < 0.001）。
口内注射技术可能是治疗咬肌肌筋膜触发点的一种有效治疗方式。与口外注射技术相比，它能缓解疼痛、增加张口度并提高整体生活质量。
用于肌筋膜触发点的口内注射技术比口外技术更有效；它减少了额外注射的需求，节省了费用，并提高了患者的生活质量。
Clinicaltrials.gov（NCT05673655）。
