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Choi YJ, Hu HW, Kim SB, Lee JH, Kim ST, Kim HJ. Sihler's staining of the anterior belly of digastric muscle for botulinum toxin injection. Surg Radiol Anat 2024:10.1007/s00276-024-03440-8. [PMID: 39014212 DOI: 10.1007/s00276-024-03440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE The anterior belly of the digastric muscle (ABDM) is the target of botulinum toxin injection; however, anatomical considerations related to the injection point are absent. This study used Sihler's staining to analyze the intramuscular nerve distribution of ABDM to identify the most effective botulinum toxin injection points. METHODS We used 12 specimens from 6 embalmed cadavers in this study. The specimens were manually dissected to preserve the mylohyoid nerve and subjected to Sihler's staining. From the gnathion to and hyoid bone, the ABDM was divided into three equal parts, distinguishing the anterior, middle, and posterior thirds. RESULTS Only a branch of the mylohyoid nerve entered the ABDM, and its entry point was located in the middle-third region in all cases. The nerve endings were concentrated in the middle third (100%), followed by the anterior third (58.3%) and were not observed in the posterior third. CONCLUSION The landmarks used in this study (gnathion and hyoid bone) are easily palpable on the skin surface, allowing clinicians to target the most effective injection site (middle third of ABDM). These results provide scientific and anatomic evidence for injection points, and will aid in the management of ABDM injection procedures in clinical practice.
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Affiliation(s)
- You-Jin Choi
- Department of Anatomy, School of Medicine, Konkuk University, Chungju, Korea
| | - Hye-Won Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Soo-Bin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Ji-Hyun Lee
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Korea
| | - Seong-Taek Kim
- Department of Orofacial Pain & Oral Medicine, Yonsei University College of Dentistry, Seoul, Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
- Department of Electric & Electronical Engineering, College of Engineering, Yonsei University Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Yue Y, Guo X, Lai C, Jin X. Double Chin Concerns after En Bloc Mandibular U-Shaped Osteotomy: Submental-Cervical Soft Tissue Changes and Anterior Belly of Digastric Muscle Assessment. Aesthetic Plast Surg 2024; 48:2025-2033. [PMID: 38536429 DOI: 10.1007/s00266-024-03955-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/16/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To assess submental-cervical soft tissue changes after en bloc mandibular U-shaped osteotomy and examine alterations in the anterior belly of digastric muscle (ABDM). METHODS A retrospective study analyzed 20 patients who underwent en bloc mandibular U-shaped osteotomy from 2018 to 2023. Preoperative (Tp) and long-term follow-up (Tf) CT data were collected for analysis, measuring mandibular volume, soft tissue thickness at menton (Mes) and cervicale (C), and ABDM parameters (length, cross-sectional area (CSA), volume, distance from centroid point to the mandibular margin). Correlation analyses were performed to investigate the connection between soft tissue thickness changes, ABDM changes, and mandibular osteotomy volume. RESULTS Long-term follow-up revealed a significant increase in soft tissue thickness at the Mes and C points after U-shaped mandibular osteotomy, especially at the C point. The adaptive length of ABDM decreased, CSA increased, and volume decreased, but the ABDM centroid point shifted downward relative to the mandibular margin, indicating drooping protrusion. The increment of soft tissue thickness was moderately positively correlated with the amount of osteotomy, and the decrement of ABDM length and volume were slightly positively correlated with the amount of osteotomy. CONCLUSION The degree of soft tissue relaxation after U-shaped osteotomy is related to the extent of osteotomy. Notably, the protrusion of ABDM relative to the mandibular margin affects submental-cervical contour aesthetics. Prior to U-shaped osteotomy, it is crucial to assess the soft tissue condition of the patient's lower face, and the individualized design of the osteotomy volume should be carried out cautiously and safely. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yingying Yue
- Craniomaxillofacial Surgery Department 1 of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoshuang Guo
- Craniomaxillofacial Surgery Department 1 of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chenzhi Lai
- Craniomaxillofacial Surgery Department 1 of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolei Jin
- Craniomaxillofacial Surgery Department 1 of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Grillo R, Reis BAQ, Brozoski MA, Traina AA, Melhem-Elias F. Optimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101639. [PMID: 37729964 DOI: 10.1016/j.jormas.2023.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE This study aimed to comprehensively review the literature and provide a practical guide for optimizing drug regimens and supplementation related to orthognathic surgery. METHODS The authors conducted a thorough review of the existing literature, following the PRISMA-ScR guidelines. Various types of studies except case reports and reviews were included. The study applied specific inclusion criteria, focusing on perioperative and/or postoperative drugs, medications, or supplementation related to orthognathic surgery. RESULTS This guide included 78 studies on various medications in orthognathic surgery. It encompasses clinical trials, cohort studies, cross-sectional studies, prospective and retrospective studies. The topics covered include antibiotics, analgesics, corticosteroids, antiemetics, hemostatic agents, local anesthetics, herbal medicine, and botulinum toxin. Pain and edema control involved specific medications, while local anesthesia utilized ropivacaine and bupivacaine. The guide also discusses mineral and vitamin supplementation. The effectiveness of hemostatic agents and antiemetics was highlighted. CONCLUSION Pain management, reduced swelling, enhanced wound healing, and faster recovery are among the advantages. In addition to the standard drugs and medications, the inclusion of vitamin and mineral supplements, tranexamic acid, postoperative anesthetic blocks, and preemptive antiemetics is anticipated to offer various benefits in orthognathic surgery, despite the limited available evidence.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília-DF, Brazil.
| | | | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil
| | - Andreia Aparecida Traina
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil
| | - Fernando Melhem-Elias
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil; Private Practice in São Paulo-SP, Brazil
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Liaw JJL, Park JH. Orthodontic considerations in hypodivergent craniofacial patterns. J World Fed Orthod 2024; 13:18-24. [PMID: 38171974 DOI: 10.1016/j.ejwf.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/10/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024]
Abstract
This article examines the characteristics of hypodivergent craniofacial patterns and explores treatment modalities in response to these features. It discusses the impact of robust masticatory muscles, which produce heavy occlusal forces. In addition, it examines the use of Botox or splints to reduce gonial angles in individuals with a square face. A nonextraction treatment approach supported by temporary skeletal anchorage devices is recommended; however, if anatomical limitations persist, extraction may be necessary when arch expansion, molar distalization, incisor proclination, or interproximal reduction cannot create the necessary space. In hypodivergent cases where a nonextraction approach is impractical, a single-arch extraction strategy may be considered to prevent a reduction in the vertical dimension. Emphasizing esthetics, particularly maxillary incisor display, a protocol of total arch extrusion of the maxillary dentition assisted with temporary skeletal anchorage device, bite raisers, and interarch elastics is suggested.
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Affiliation(s)
- Johnny J L Liaw
- Adjunct clinical instructor, Department of Orthodontics, National Taiwan University Hospital, Taipei, Taiwan; Director, Beauty Forever Dental Clinic, Taipei, Taiwan
| | - Jae Hyun Park
- Professor and chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona; International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea.
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Ban A, Roman R, Bran S, Băciuț M, Dinu C, Crasnean E, Almășan O, Hedeșiu M. Botulinum Toxin Injection into the Digastric Muscle: Current Clinical Use and a Report of Five Cases. Biomedicines 2023; 11:2767. [PMID: 37893140 PMCID: PMC10604337 DOI: 10.3390/biomedicines11102767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
The present research aimed to review the clinical applications of botulinum toxin-A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM) and to highlight the potential role of the BTX-A injection into ABDM in preventing postsurgical relapse. Five Class II malocclusion patients who underwent orthognathic surgery received BTX-A injections into both ABDM for the prevention of postoperative relapse. The relapse was evaluated using lateral cephalometric radiographs by comparing the postoperative cephalometric analyses at two different time points, postoperatively at 2 weeks (T1), and long-term, at 9 months after the surgical intervention (T2). The results demonstrated no significant differences between T2 and T1 for the Selle-Nasion-point A (SNA) angle, Selle-Nasion-point B (SNB) angle, point A-Nasion-point B (ANB) angle, mandibular length, and sagittal mandibular position. The patients exhibited stable occlusion without any signs of relapse after the surgery. A single BTX-A injection into the ABDM can effectively prevent postoperative relapse in Class II malocclusion patients, following orthognathic surgery. From a clinical perspective, in case of optimal dosage and procedure, BTX-A injection could be considered as the primary option for the prevention of postsurgical relapse for Class II malocclusion patients.
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Affiliation(s)
- Alina Ban
- Department of Maxillofacial Surgery and Radiology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Raluca Roman
- Department of Maxillofacial Surgery and Radiology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Emil Crasnean
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Radiology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
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Pereira IN, Hassan H. Botulinum toxin A in dentistry and orofacial surgery: an evidence-based review - part 1: therapeutic applications. Evid Based Dent 2022:10.1038/s41432-022-0256-9. [PMID: 35624296 DOI: 10.1038/s41432-022-0256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022]
Abstract
Objective An evidence-based review on the safety and efficacy of botulinum toxin type-A (BoNTA) in orofacial conditions, focusing on the therapeutic applications and role of BoNTA as an adjuvant treatment.Data source and selection Data was collected using PubMed (Medline), Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials electronic databases. Having satisfied the search parameters, 32 studies for therapeutic applications and 26 for BoNTA as an adjunctive treatment were included. The quality of relevant studies was assessed using the Best Evidence Topics (BETs) Critical Appraisal Tool.Data extraction The highest level of evidence (LOE) behind BoNTA safety and efficacy was for wound healing and scar management in the orofacial surgery context, where BoNTA was presented as an adjunctive modality. Level-I evidence was controversial for temporomandibular disorders and bruxism. However, it showed promising results for painful temporomandibular disorders of myogenic origin refractory to conservative therapies, and to decrease muscle contraction intensity in sleeping bruxism. There was only one level-II study for persistent recurrent aphthous stomatitis. Data showed limited level-III evidence for orofacial pain conditions (temporomandibular joint recurrent dislocation and pain, burning mouth syndrome or atypical odontalgia), oral cancer complications, or as an adjuvant to maxillofacial and orthognathic surgeries. Benefits of BoNTA in prosthodontics had weak level-IV evidence. No evidence was found among the periodontology field.Conclusion There is growing evidence to support the safety and efficacy of BoNTA in the investigated orofacial pathological conditions, with high levels of satisfaction from the patient and clinician perspective. However, there are some inconsistencies and limited high-quality evidence available. Well-designed controlled clinical trials are necessary to evaluate long-term safety, efficacy and cost-effectiveness before BoNTA is widely adopted with irrefutable evidence-based clinical guidelines.
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Affiliation(s)
- Ines Novo Pereira
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK
| | - Haidar Hassan
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK.
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Grillo R, Borba AM, Lima APC, Pitta MC, Veronesi R, Jodas CR. Use of non-surgical aesthetic refinement after orthognathic surgery: Case studies. J Taibah Univ Med Sci 2022; 17:320-325. [PMID: 35592800 PMCID: PMC9073885 DOI: 10.1016/j.jtumed.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/18/2021] [Accepted: 08/11/2021] [Indexed: 11/02/2022] Open
Abstract
Orthognathic surgery has an undeniable functional effect, but the aesthetic result must not be disregarded, especially since many patients visit the surgeon precisely because of an aesthetic complaint and ignore the practical benefits. The aim of this paper is to discuss about an ideal treatment that combines this functional improvement with facial aesthetics and improves it after the operation. In order to predict which aesthetic deficits may occur, a facial analysis is essential. As precise as the virtual planning may be, there is still no exact predictability of soft tissue behavior. Some non-surgical procedures can help the surgeon achieve a result that better meets the patients' expectations. Imaging exams, photographs, facial analyzes, and patient complaints are essential to assess the possibility of any postoperative refinement. The entire surgical planning is discussed with the patient; the possibility of refinement must be part of the treatment plan. The surgeon's focus is on the functional correction of the dentofacial deformity, but the aesthetic outcome is essential for the patient. The results of this study suggest that refinement should be part of the treatment plan.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Alexandre M. Borba
- Department of Oral and Maxillofacial Surgery, Universidade de Cuiabá, Cuiabá, Brazil
| | - Ana Paula C.B. Lima
- Department of Oral and Maxillofacial Surgery, Universidade de Cuiabá, Cuiabá, Brazil
| | | | | | - Claudio R.P. Jodas
- Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil
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“ Does suprahyoid muscle complex pull cause the relapse following genial advancement by distraction osteogenesis? - An EMG study.”. Br J Oral Maxillofac Surg 2022; 60:956-962. [DOI: 10.1016/j.bjoms.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022]
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Van den Bempt M, Vinayahalingam S, Han MD, Bergé SJ, Xi T. The role of muscular traction in the occurrence of skeletal relapse after advancement bilateral sagittal split osteotomy (BSSO): A systematic review. Orthod Craniofac Res 2021; 25:1-13. [PMID: 33938136 PMCID: PMC9292715 DOI: 10.1111/ocr.12488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/13/2021] [Accepted: 04/25/2021] [Indexed: 11/27/2022]
Abstract
The aim of this systematic review was (i) to determine the role of muscular traction in the occurrence of skeletal relapse after advancement BSSO and (ii) to investigate the effect of advancement BSSO on the perimandibular muscles. This systematic review reports in accordance with the recommendations proposed by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Electronic database searches were performed in the databases MEDLINE, Embase and Cochrane Library. Inclusion criteria were as follows: assessment of relapse after advancement BSSO; assessment of morphological and functional change of the muscles after advancement BSSO; and clinical studies on human subjects. Exclusion criteria were as follows: surgery other than advancement BSSO; studies in which muscle activity/traction was not investigated; and case reports with a sample of five cases or fewer, review articles, meta‐analyses, letters, congress abstracts or commentaries. Of the initial 1006 unique articles, 11 studies were finally included. In four studies, an intervention involving the musculature was performed with subsequent assessment of skeletal relapse. The changes in the morphological and functional properties of the muscles after BSSO were studied in seven studies. The findings of this review demonstrate that the perimandibular musculature plays a role in skeletal relapse after advancement BSSO and may serve as a target for preventive strategies to reduce this complication. However, further research is necessary to (i) develop a better understanding of the role of each muscle group, (ii) to develop new therapeutic strategies and (iii) to define criteria that allow identification of patients at risk.
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Affiliation(s)
- Maxim Van den Bempt
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Michael D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Stefaan J Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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Shandilya S, Mohanty S, Sharma P, Chaudhary Z, Kohli S, Kumar RD. Effect of botulinum toxin-A on pain and mouth opening following surgical intervention in oral submucous fibrosis - A controlled clinical trial. J Craniomaxillofac Surg 2021; 49:675-681. [PMID: 33757688 DOI: 10.1016/j.jcms.2021.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/03/2020] [Accepted: 01/31/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this trial was to study the effect on pain and mouth opening of intramuscular injection of botulinum toxin-A into masticatory muscles following surgical intervention in oral submucous fibrosis (OSMF) cases. Injections of either botulinum toxin A (BTX-A) (study group) or normal saline (control group) were given 2 weeks prior to surgical intervention in OSMF patients, into the bilateral masseter and temporalis muscles. All patients were evaluated for pain and ease of active physiotherapy at 1 week and 1, 3, and 6 months after surgery using a numerical rating scale and appropriate questionnaires, with comparisons made between the study and control group patients. Electromyographic studies of the masticator muscles were also carried out in all patients before injection, and at 1 month and 6 months after injection. 20 OSMF patients were equally divided into study and control groups (n = 10 each). At 1, 3, and 6 months after surgery, the study group patients showed significantly greater decreases in pain (p-values of 0.007, 0.001, and 0.005, respectively) and greater ease in physiotherapy compared with the control group. EMG recordings of masticator muscles showed a transient drop in microvolt value in the study group 1 month after injection, unlike the control group recordings. It was concluded that preoperative BTX-A injection was a good addition to surgical therapy in the patient group.
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Affiliation(s)
- Saatvik Shandilya
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, 226003, India.
| | - Sujata Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
| | - Pankaj Sharma
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
| | - Zainab Chaudhary
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
| | - Sanchaita Kohli
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
| | - Rudra Deo Kumar
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, 110023, India.
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11
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Coclici A, Roman RA, Bran S, Crasnean E, Baciut M, Dinu C, Hedesiu M. Ultrasound dimensional changes of the anterior belly of the digastric muscle induced by orthognathic surgery and botulinum toxin A injection in Class II malocclusion. Oral Radiol 2021; 37:625-630. [PMID: 33420944 DOI: 10.1007/s11282-020-00502-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study is to evaluate the ultrasonographic dimensional changes of the anterior belly of the digastric muscle (ABDM), occurring after intramuscular botulinum toxin A (BTX-A) injection during orthognathic surgery, in a series of five Class II malocclusion patients. METHODS All the patients received 20 units of BTX-A, into both ABDM, intraoperatively. The length, width and cross-sectional area (CSA) of the ABDM were ultrasonographically measured at three different time points: T0 (preoperatively), T1 (postoperatively at 2 weeks after the surgical intervention), and T2 (postoperatively at 6-9 months). RESULTS A statistically significant higher length of the ABDM was noted postoperatively, at T1 and T2 compared to T0. The patients showed an increased length by 12.2% at 2 weeks postoperatively and continued to increase, reaching 24.6% at 6 months. A decreased width of ABDM by 6.5% at T1 compared with T0 was also found. CONCLUSIONS Postoperative ultrasound (US) follow-up measurements in patients with Class II malocclusion, orthognathic surgery and intraoperative BTX-A injection in the ABDM, showed dimensional changes of the muscle, with elongation and thinning. The muscular modifications were more pronounced at 6 months postoperatively, indicating consistency and potential benefit of using BTX-A in reducing the risk of surgical relapse. Further data on longer-term follow-up and larger number of cases are necessary.
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Affiliation(s)
- Alina Coclici
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
| | - Raluca Ancuta Roman
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania.
| | - Simion Bran
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
| | - Emil Crasnean
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
| | - Mihaela Hedesiu
- Department of Maxillofacial Surgery and Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, Cluj Napoca, Romania
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Effect of Botulinum Toxin Type A on Mandibular Fracture Healing: An Experimental Study in Rabbits. J Oral Maxillofac Surg 2020; 78:2281.e1-2281.e8. [PMID: 32652049 DOI: 10.1016/j.joms.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/11/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE The effect of botulinum toxin type A (BTX-A) on fracture healing of the long bones is controversial, and no controlled clinical or experimental study has investigated the effect of BTX-A on mandibular fractures. The purpose of this study was to investigate whether BTX-A injection into the masseter muscles affects bone healing by reducing the displacing forces in an unfavorable mandibular fracture model. MATERIALS AND METHODS Forty-eight male New Zealand white rabbits were used. Ten units of BTX-A was injected into each masseter muscle in the animals in the BTX-A group, whereas saline solution was injected in the animals in the control group. A unilateral osteotomy and fixation with a microplate were performed. Bone healing was evaluated by radiodensitometric, biomechanical, histologic, and histomorphometric methods after 21 days. RESULTS The mean bone mineral density in the fracture area was significantly higher in the BTX-A group (P = .038). The mean failure load and bending modulus values were significantly higher in the BTX-A group than in the control group (P = .032 and P = .005, respectively). The mean histologic bone healing scores, bone volume-total volume values, and trabecular diameter values were significantly higher in the BTX-A group than in the control group (P = .001, P = .001, and P = .026, respectively). CONCLUSIONS BTX-A application into the masseter muscles improves bone healing of a unilateral mandibular fracture in rabbits.
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Diouf JS, Beugre-Kouassi AML, Diop-Ba K, Badiane A, Ngom PI, Ouedraogo Y, Diagne F. [Long-term stability and relapse of deep bite correction: a systematic review]. Orthod Fr 2019; 90:169-187. [PMID: 31241459 DOI: 10.1051/orthodfr/2019016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 03/10/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Deep overbite is one of the most common malocclusions and is the most difficult to treat successfully. The real challenge remains the stability of long-term deep overbite correction. A search through the scientific literature revealed only one systematic review on this subject. Given the recent publications on the stability of deep bite correction and the development of new processes designed to avoid relapse of these treatments, this one existing systematic review needs to be updated. The purpose of the present systematic review is to evaluate the long-term stability of deep overbite correction. MATERIALS AND METHODS Electronic databases were searched and nonelectronic journals were manually explored for papers on long-term stability and relapse of deep overbite correction. Articles deemed appropriate for inclusion in this review were selected and analyzed. Their scientific quality was assessed and the data they contained were extracted and summarized. RESULTS The rate of deep overbite relapse was 47.27%. Patients treated with the straight wire appliance showed a 67.74% relapse rate whereas those treated with the Ricketts biological progressive segmented mechanics appliance displayed a 30.38% rate. Subjects treated towards the end of adolescence presented a 14.3% rate of deep overbite relapse whereas those treated in their early teens or in adulthood had a deep overbite relapse rate of 30% and 30.8%, respectively. Intramuscular injections of botox helped obtain 100% stability in maxillofacial surgery to correct deep bite. CONCLUSION Age at initiation of treatment and treatment technique are two factors impacting the long-term stability of deep overbite correction.
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Affiliation(s)
- Joseph Samba Diouf
- Service d'orthodontie, Département d'odontologie, Faculté de médecine, de pharmacie et d'odontologie, Université Cheikh Anta DIOP Dakar, Sénégal
| | | | - Khady Diop-Ba
- Service d'orthodontie, Département d'odontologie, Faculté de médecine, de pharmacie et d'odontologie, Université Cheikh Anta DIOP Dakar, Sénégal
| | - Alpha Badiane
- Service d'orthodontie, Département d'odontologie, Faculté de médecine, de pharmacie et d'odontologie, Université Cheikh Anta DIOP Dakar, Sénégal
| | - Papa Ibrahima Ngom
- Service d'orthodontie, Département d'odontologie, Faculté de médecine, de pharmacie et d'odontologie, Université Cheikh Anta DIOP Dakar, Sénégal
| | - Youssouf Ouedraogo
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Université Ouaga I, Ouagadougou, Burkina Faso
| | - Falou Diagne
- Service d'orthodontie, Département d'odontologie, Faculté de médecine, de pharmacie et d'odontologie, Université Cheikh Anta DIOP Dakar, Sénégal
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Correction of Malocclusion by Botulinum Neurotoxin Injection into Masticatory Muscles. Toxins (Basel) 2018; 10:toxins10010027. [PMID: 29301317 PMCID: PMC5793114 DOI: 10.3390/toxins10010027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 12/17/2022] Open
Abstract
Botulinum toxin (BTX) is a neurotoxin, and its injection in masticatory muscles induces muscle weakness and paralysis. This paralytic effect of BTX induces growth retardation of the maxillofacial bones, changes in dental eruption and occlusion state, and facial asymmetry. Using masticatory muscle paralysis and its effect via BTX, BTX can be used for the correction of malocclusion after orthognathic surgery and mandible fracture. The paralysis of specific masticatory muscles by BTX injection reduces the tensional force to the mandible and prevents relapse and changes in dental occlusion. BTX injection in the anterior belly of digastric and mylohyoid muscle prevents the open-bite and deep bite of dental occlusion and contributes to mandible stability after orthognathic surgery. The effect of BTX injection in masticatory muscles for maxillofacial bone growth and dental occlusion is reviewed in this article. The clinical application of BTX is also discussed for the correction of dental malocclusion and suppression of post-operative relapse after mandibular surgery.
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