Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial

• Published in: Pain practice 2024-11, Vol.24 (8), p.1014-1023
• Main Authors: Sitnikova, V., Kämppi, A., Kämppi, L., Alvesalo, E., Burakova, M., Kemppainen, P., Teronen, O.
• Format: Article
• Language: English
• Subjects: Adult; botulinum toxin type A; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - therapeutic use; Cross-Over Studies; Double-Blind Method; Electromyography; Female; Humans; Male; Middle Aged; myofascial pain; Myofascial Pain Syndromes - drug therapy; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - therapeutic use; orofacial pain; Pain Measurement - methods; temporomandibular disorder; Temporomandibular Joint Disorders - drug therapy; Treatment Outcome; Young Adult
• ISSN: 1530-7085; 1533-2500; 1533-2500
• DOI: 10.1111/papr.13396

Background Injections of botulinum toxin type A (BoNT‐A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)‐related myofascial pain (MFP). BoNT‐A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo‐controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT‐A. Methods Sixty‐six subjects were randomized into two groups, one which received BoNT‐A first and a second which received a saline solution (SS) first. Follow‐ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain‐related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. Results The within‐group analysis showed a significant improvement in pain intensity and pain‐related disability after BoNT‐A (p