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Coelho MS, Lopes GC, Sichi LGB, Rode SDM, Araújo RMD. Influence of vitamin D on muscle strength and botulinum toxin dosage through surface electromyography. Acta Cir Bras 2024; 39:e396824. [PMID: 39383419 DOI: 10.1590/acb396824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/19/2024] [Indexed: 10/11/2024] Open
Abstract
PURPOSE To evaluate the influence of patients' serum vitamin D levels on muscle strength characteristics and whether it impacts the durability of botulinum toxin (BT) treatment. METHODS The muscle strength of the frontal and corrugator muscles was evaluated before and after the application of TB with pre- and post-application control measurements, and at weeks 2, 5 and 12. The effect of vitamin D on muscle strength and its interaction with BT were investigated in 20 patients. The muscle contraction force was measured by surface electromyography. RESULTS The results revealed statistically significant differences between the frontal measurement groups at weeks 2 and 5, as well as for the corrugator in the same weeks and at week 12. Regarding vitamin D, significant differences were observed only in the initial group with vitamin D > 30 ng/mL compared to < 30 ng/mL for the frontal muscles. Patients with higher levels of vitamin D had higher average muscle strength compared to those with lower levels in all evaluations. CONCLUSIONS It was observed that vitamin D influences muscle strength and the necessary dosage of BT.
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Affiliation(s)
- Marcelle Simões Coelho
- Universidade Estadual Paulista "Júlio de Mesquita Filho" - Dental Materials and Prosthesis Departament - São José dos Campos (SP) - Brazil
| | - Gabriel Cirone Lopes
- Universidade Estadual Paulista "Júlio de Mesquita Filho" - Dental Materials and Prosthesis Departament - São José dos Campos (SP) - Brazil
| | - Luigi Giovanni Bernardo Sichi
- Universidade Estadual Paulista "Júlio de Mesquita Filho" - Dental Materials and Prosthesis Departament - São José dos Campos (SP) - Brazil
| | - Sigmar de Mello Rode
- Universidade Estadual Paulista "Júlio de Mesquita Filho" - Dental Materials and Prosthesis Departament - São José dos Campos (SP) - Brazil
| | - Rodrigo Máximo de Araújo
- Universidade Estadual Paulista "Júlio de Mesquita Filho" - Dental Materials and Prosthesis Departament - São José dos Campos (SP) - Brazil
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Guignardat JF, Raoul G, Ferri J, Sciote JJ, Nicot R. Systematic review of the histological and functional effects of botulinum toxin A on masticatory muscles: Consideration in dentofacial orthopedics and orthognathic surgery. Ann Anat 2024; 256:152302. [PMID: 39038690 DOI: 10.1016/j.aanat.2024.152302] [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: 10/27/2023] [Revised: 05/31/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Botulinum toxin type A causes muscle paralysis and is widely used in the masticatory muscle for stomatognathic diseases, such as temporomandibular disorder, bruxism, or masseteric hypertrophy. Nonetheless, its muscular effect remains unclear. Better understanding could aid improved use and perhaps new indications, particularly in dentofacial orthopaedics and orthognathic surgery. METHODS This systematic review explored the histologic and functional effects of botulinum toxin in animal and human masticatory muscles and was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The MEDLINE, Web of Science, and Cochrane Library electronic databases were searched for relevant articles. The inclusion criteria were human or animal masticatory muscle analysis after botulinum toxin injection(s) AND histological structural/ultrastructural analysis by optical or electronic microscopy OR functional effect analysis by bite force evaluation (occlusal force analyzer) and muscle activity (electromyography). RESULTS Of an initial 1578 articles, 44 studies were eventually included. Botulinum toxin injection in the masticatory muscle altered its histological structure and functional properties. The human and animal studies revealed ultrastructural change, atrophy, and fiber type modifications of the masticatory muscles after one injection. Botulinum toxin decreased bite force and muscle activity, but recovery was uncertain. CONCLUSIONS Muscle forces applied on the skeleton is a key feature of facial growth. Masticatory muscle paralysis changes mechanical stress on bones, which rebalances the force applied on facial bones. This new balance could benefit dental deformity or surgical relapse. Therefore, botulinum toxin could limit the orthognathic effect of the masticatory muscles in such patients. Given the uncertain recovery, multiple injections should be avoided, and usage should not deviate from established consensus.
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Affiliation(s)
| | - Gwénaël Raoul
- Univ. Lille, Inserm, CHU Lille, U1008 - Advanced Drug Delivery Systems, Department of Oral and Maxillofacial Surgery, F-59000 Lille, France
| | - Joël Ferri
- Univ. Lille, Inserm, CHU Lille, U1008 - Advanced Drug Delivery Systems, Department of Oral and Maxillofacial Surgery, F-59000 Lille, France
| | - James J Sciote
- Department of Orthodontics, Temple University, Philadelphia, Pennsylvania, USA
| | - Romain Nicot
- Univ. Lille, Inserm, CHU Lille, U1008 - Advanced Drug Delivery Systems, Department of Oral and Maxillofacial Surgery, F-59000 Lille, France.
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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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Ioannou CI, Hodde-Chriske FL, Altenmüller E. Long-Term Muscular Atrophy and Weakness Following Cessation of Botulinum Toxin Type A Injections in the Flexor Digitorum Muscle of Musicians with Focal Hand Dystonia. Toxins (Basel) 2023; 15:toxins15040296. [PMID: 37104234 PMCID: PMC10144778 DOI: 10.3390/toxins15040296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
The present study assessed muscular atrophy and weakness of the flexor digitorum superficialis (FDS) and profundus (FDP) muscle as possible long-term side effects of botulinum toxin (BoNT) injections in hand dystonia patients after the termination of their treatment. For the assessment of both parameters, a group of 12 musicians diagnosed with focal hand dystonia was compared with a group of 12 healthy matched musicians. The minimum and maximum times since the last injection across patients were 0.5 to 3.5 years, respectively. The thickness and strength of the FDS and FDP were assessed via ultrasonography and a strength measurement device. Group differences were estimated through the calculation of the symmetry index between the dominant and non-dominant hand. The results revealed that compared to the control group, thickness and flexion strength of the injected FDS and FDP were decreased by 10.6% ± 5.3% (95% CI) and 12.5% ± 6.4% (95% CI), respectively, in the patient group. The amount of weakness and atrophy was predicted significantly by the total amount of BoNT injected throughout the entire treatment period. In contrast, the time after the last injection did not predict the amount of strength and muscle mass recovery after the cessation of the treatment. The current study revealed that even up to 3.5 years after the termination of BoNT injections, long-term side effects such as weakness and atrophy can still be observed. We suggest that the total BoNT dose should remain as small as possible to reduce long-lasting side effects to the minimum. Although side effects differ significantly among patients, a potential full recovery of atrophy and weakness after the cessation of BoNT treatment might be observed after periods longer than 3.5 years.
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Affiliation(s)
- Christos I Ioannou
- CYENS-Centre of Excellence, 1016 Nicosia, Cyprus
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, 30175 Hanover, Germany
| | - Franziska L Hodde-Chriske
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, 30175 Hanover, Germany
- Hanover Medical School, 30625 Hanover, Germany
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, 30175 Hanover, Germany
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Odorico SK, Shulzhenko NO, Zeng W, Dingle AM, Francis DO, Poore SO. Effect of Nimodipine and Botulinum Toxin A on Peripheral Nerve Regeneration in Rats: A Pilot Study. J Surg Res 2021; 264:208-221. [PMID: 33838405 DOI: 10.1016/j.jss.2021.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 01/05/2021] [Accepted: 02/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Peripheral nerve damage is a frequent problem, with an estimated 2.8%-5.0% of trauma admissions involving peripheral nerve injury. End-to-end, tension-free microsurgical repair (neurorrhaphy) is the current gold standard treatment for complete transection (neurotmesis). While neurorrhaphy reapproximates the nerve, it does not address the complex molecular regenerative process. Evidence suggests that botulinum toxin A (BTX) and nimodipine (NDP) may improve functional recovery, but mechanisms of action remain unknown. METHODS This research investigates BTX and NDP for their novel capacity to improve neural regeneration in the setting of neurorrhaphy using a Lewis rat tibial nerve neurotmesis model. In a triple-masked, placebo-controlled, randomized study design, we compared functional (rotarod, horizontal ladder walk), electrophysiological (conduction velocity, duration), and stereological (axon count, density) outcomes of rats treated with: NDP+saline injection, BTX+NDP, Saline+placebo, and BTX+placebo. Additional controls included sham surgery +/- BTX. RESULTS NDP+saline outperformed other treatment groups in the ladder walk. This group had the fewest deep slips (15.07% versus 30.77% in BTX+NDP, P = 0.122), and the most correct steps (70.53% versus 55.58% in BTX+NDP, P = 0.149) in functional testing. NDP+saline also had the fastest nerve conduction velocity (0.811m/s versus 0.598m/s in BTX+NDP, P = 0.126) among treatment groups. BTX+NDP had the highest axon count (10,012.36 versus 7,738.18 in NDP+Saline, P = 0.009). CONCLUSION This study is the first to test NDP with BTX in a multimodal assessment of nerve recovery following neurotmesis and neurorrhaphy. NDP outperformed BTX+NDP functionally. Future work will focus on nimodipine in an effort to improve nerve recovery in trauma patients.
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Affiliation(s)
- Scott K Odorico
- University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin
| | - Nikita O Shulzhenko
- University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin
| | - Weifeng Zeng
- University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin
| | - Aaron M Dingle
- University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin
| | - David O Francis
- University of Wisconsin School of Medicine and Public Health, Division of Otolaryngology, Department of Surgery, Madison, Wisconsin; University of Wisconsin School of Medicine and Public Health, Wisconsin Surgical Outcomes Research Program, Department of Surgery, Madison, Wisconsin
| | - Samuel O Poore
- University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin.
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Wang Z, Sa G, Wei Z, Dai X, Wan Q, Yang X. Obvious morphologic changes in the mandible and condylar cartilage after triple botulinum toxin injections into the bilateral masseter. Am J Orthod Dentofacial Orthop 2020; 158:e43-e52. [PMID: 32988574 DOI: 10.1016/j.ajodo.2020.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Nonsurgical treatments that can prevent or reduce the extent of the mandibular excess at an early stage are desirable. A single botulinum toxin (BTX) injection into the unilateral and bilateral masseter can regulate mandibular contour and condylar cartilage. However, BTX injection is frequency dependent when used in facelifts. This study aimed to evaluate the effect of BTX injection into the bilateral masseter at different frequencies on the mandibular contour and condylar cartilage. METHODS In the present study, 24 female Sprague Dawley rats (4 weeks old) were divided into 3 groups: control, single injection, and triple injection. Contour measurement of the mandible was carried out by radiographic imaging. Microcomputerized tomography was performed to determine the change in bone volume in the subchondral bone. Hematoxylin and eosin staining was used to observe the morphologic changes of condylar cartilage. Immunohistochemistry was performed to detect the expression level of biomechanically sensitive factors, including transforming growth factor-β1, parathyroid hormone-related protein, SRY-box 9, and type II collagen. RESULTS Bone volume and/or total volume, trabecular number, and trabecular thickness of the mineralized cartilage and subchondral bone significantly decreased in the triple injection group when compared with the single injection group. Mandibular contour also diminished after increased BTX injection frequencies. Chondrocyte proliferation ability and the expression levels of transforming growth factor-β1, parathyroid hormone-related protein, SRY-box 9, and type II collagen significantly decreased in all BTX injection groups and more in the triple injection group. CONCLUSIONS Morphologic changes of the mandible and condylar cartilage become more obvious after increased BTX injection frequencies, suggesting that multiple BTX injections into the masseter of patients may relieve the severity of mandibular deformity at an early stage.
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Affiliation(s)
- Zhuo Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Guoliang Sa
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zequan Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xing Dai
- Department of Skin Medical Cosmetology, Renmin Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qilong Wan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xuewen Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Botzenhart UU, Gredes T, Gerlach R, Zeidler-Rentzsch I, Gedrange T, Keil C. Histological features of masticatory muscles after botulinum toxin A injection into the right masseter muscle of dystrophin deficient (mdx-) mice. Ann Anat 2020; 229:151464. [PMID: 31978572 DOI: 10.1016/j.aanat.2020.151464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/15/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE/BACKGROUND The most frequently used animal model for human DMD (Duchenne muscular dystrophy) research is the mdx mouse. In both species, characteristic histological changes like inflammation, muscle fiber degeneration and fibrosis are the same, but in contrast to humans, in mdx mice, phases of muscle fiber degeneration are compensated by regeneration processes. AIM Therefore, the interest of this study was to evaluate histological features in masticatory muscles after BTX-A injection into the right masseter muscle of wild type and dystrophic (mdx) mice, illustrating de- and regeneration processes induced by this substance. MATERIAL AND METHODS The right masseter muscle of 100 days old healthy and mdx mice were selectively paralyzed by a single intramuscular BTX-A injection. Masseter as well as temporal muscle of injection and non-injection side were carefully dissected 21 days and 42 days after injection, respectively, and fiber diameter, cell nuclei position, necrosis and collagen content were analyzed histomorphologically in order to evaluate de- and regeneration processes in these muscles. Statistical analysis was performed using SigmaStat Software and Mann Whitney U-test (significance level: p < 0.05). RESULTS At both investigation periods and in both mouse strains fiber diameter was significantly reduced and collagen content was significantly increased in the right injected masseter muscle whereas fiber diameters in mdx mice were much smaller, and these differences were even more apparent at the second investigation period. Necrosis and central located nuclei could generally be found in all mdx mice muscles investigated with an amount of centronucleation exceeding 60%, and a significant increase of necrosis six weeks after injection. In wild type mice central located nuclei could primarily be found in the treated masseter muscle with a portion of 2.7%, and this portion decreased after six weeks, whereas in mdx mice a decrease could also be seen in the non-injected muscles. In contrast, in wild type mice necrosis was not apparent at any time and in all muscles investigated. CONCLUSION From our results it can be concluded that in mdx mice masticatory muscles de- and regeneration processes were extended, triggered by a selective BTX-A injection, or mdx mice at this age, independently of BTX-A treatment, went through another cycle of de- and regeneration as a characteristic of this disease.
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Affiliation(s)
- Ute Ulrike Botzenhart
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany.
| | - Tomasz Gredes
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany
| | - Ricarda Gerlach
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany
| | - Ines Zeidler-Rentzsch
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany
| | - Tomasz Gedrange
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany
| | - Christiane Keil
- Medical Faculty Carl Gustav Carus Campus, Technische Universtität Dresden, Dresden, Germany
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Kang YJ, Cha BK, Choi DS, Jang IS, Kim SG. Botulinum toxin-A injection into the anterior belly of the digastric muscle for the prevention of post-operative open bite in class II malocclusions: a case report and literature review. Maxillofac Plast Reconstr Surg 2019; 41:17. [PMID: 31093487 PMCID: PMC6484054 DOI: 10.1186/s40902-019-0201-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. Case presentation A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. Conclusion In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.
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Affiliation(s)
- Yei-Jin Kang
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Bong Kuen Cha
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Dong Soon Choi
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - In San Jang
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Seong-Gon Kim
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
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Tsai CY, Lee HP, Chang HM, Wu FC. Masticatory hypofunction effects induced by BTXA injection of hippocampal neurons in developing rats. Arch Oral Biol 2018; 96:122-129. [PMID: 30227358 DOI: 10.1016/j.archoralbio.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/07/2018] [Accepted: 09/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE In clinical practice, malocclusion is often encountered during the period of growth and development of individuals. In addition to nutritional imbalance, some studies have found that mastication affects learning and memory ability. Tooth loss and masticatory hypofunction have been suggested as risk factors of Alzheimer disease. However, relatively little research has been done in developing animals. The present study evaluated the relationship between masticatory hypofunction and neuropathological changes of the hippocampus in developing rats. DESIGN Four-week-old Wistar rats were randomly divided into saline-injected and botulinum toxin type A (BTXA)-injected groups. After an experiment period of 4 weeks, the rats were sacrificed for evaluation of neuropathological changes in the hippocampus through Nissl staining and phosphorylated cyclic AMP (cAMP) response element binding protein (CREB) immunohistochemistry. RESULTS Nissl staining revealed a significant reduction in the density of neurons in the BTXA-injected rats. The BTXA-injected rats exhibited a decreased level of CREB phosphorylation. The degree of p-CREB immunoreactivity differed significantly between the two groups. CONCLUSION The BTXA-injected rats exhibited a reduction in neuron density and phosphorylated CREB, indicating that mastication might influence the learning and memory ability during the growth period. Therefore, it is strongly suggested that malocclusion be corrected as soon as possible during growth and development.
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Affiliation(s)
- Chi-Yang Tsai
- Department of Orthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsin-Ping Lee
- Department of Orthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hung-Ming Chang
- Department of Anatomy, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fang-Chun Wu
- Department of Orthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Shin SH, Kang YJ, Kim SG. The effect of botulinum toxin-A injection into the masseter muscles on prevention of plate fracture and post-operative relapse in patients receiving orthognathic surgery. Maxillofac Plast Reconstr Surg 2018; 40:36. [PMID: 30538972 PMCID: PMC6261083 DOI: 10.1186/s40902-018-0174-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/08/2018] [Indexed: 02/06/2023] Open
Abstract
Background Botulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent post-operative complication after orthognathic surgery. The purpose of this study was (1) to evaluate BTX-A injection into the masseter muscle on the prevention of plate fracture and (2) to compare post-operative relapse between the BTX-A injection group and the no injection group. Methods Sixteen patients were included in this study. Eight patients received BTX-A injection bilaterally, and eight patients served as control. All patients received bilateral sagittal split ramus osteotomy for the mandibular setback and additional surgery, such as LeFort I osteotomy or genioplasty. Post-operative plate fracture was recorded. SNB angle, mandibular plane angle, and gonial angle were used for post-operative relapse. Results Total number of fractured plates in patients was 2 out of 16 plates in the BTX-A injection group and that was 8 out of 16 plates in the no treatment group (P = 0.031). However, there were no significant differences in post-operative changes in SNB angle, mandibular plane angle, and gonial angle between groups (P > 0.05). Conclusions BTX-A injection into the masseter muscle could reduce the incidence of plate fracture.
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Affiliation(s)
- Sung-Ho Shin
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Jukheon gil 7, Gangneung, Gangwondo 25457 Republic of Korea
| | - Yei-Jin Kang
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Jukheon gil 7, Gangneung, Gangwondo 25457 Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Jukheon gil 7, Gangneung, Gangwondo 25457 Republic of Korea
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Abouelhuda AM, Khalifa AK, Kim YK, Hegazy SA. Non-invasive different modalities of treatment for temporomandibular disorders: review of literature. J Korean Assoc Oral Maxillofac Surg 2018; 44:43-51. [PMID: 29732308 PMCID: PMC5932270 DOI: 10.5125/jkaoms.2018.44.2.43] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 02/05/2023] Open
Abstract
Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs.
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Affiliation(s)
- Amira Mokhtar Abouelhuda
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Prosthodontics, Mansoura University Hospital, College of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmad Khalifa Khalifa
- Department of Prosthodontics, Mansoura University Hospital, College of Dentistry, Mansoura University, Mansoura, Egypt
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Salah Abdelftah Hegazy
- Department of Prosthodontics, Mansoura University Hospital, College of Dentistry, Mansoura University, Mansoura, Egypt
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Seok H, Kim SG, Kim MK, Jang I, Ahn J. Effect of the masseter muscle injection of botulinum toxin A on the mandibular bone growth of developmental rats. Maxillofac Plast Reconstr Surg 2018; 40:5. [PMID: 29588910 PMCID: PMC5866820 DOI: 10.1186/s40902-018-0146-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/21/2018] [Indexed: 12/11/2022] Open
Abstract
Background The objective of this study was to evaluate the influence of masticatory muscle injection of botulinum toxin type A (BTX-A) on the growth of the mandibular bone in vivo. Methods Eleven Sprague-Dawley rats were used, and BTX-A (n = 6) or saline (n = 5) was injected at 13 days of age. All injections were given to the right masseter muscle, and the BTX-A dose was 0.5 units. All of the rats were euthanized at 60 days of age. The skulls of the rats were separated and fixed with 10% formalin for micro-computed tomography (micro-CT) analysis. Results The anthropometric analysis found that the ramus heights and bigonial widths of the BTX-A-injected group were significantly smaller than those of the saline-injected group (P < 0.05), and the mandibular plane angle of the BTX-A-injected group was significantly greater than in the saline-injected group (P < 0.001). In the BTX-A-injected group, the ramus heights II and III and the mandibular plane angles I and II showed significant differences between the injected and non-injected sides (P < 0.05). The BTX-A-injected side of the mandible in the masseter group showed significantly lower mandibular bone growth compared with the non-injected side. Conclusion BTX-A injection into the masseter muscle influences mandibular bone growth.
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Affiliation(s)
- Hyun Seok
- 1Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju, 28644 South Korea
| | - Seong-Gon Kim
- 2Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 South Korea
| | - Min-Keun Kim
- 2Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 South Korea
| | - Insan Jang
- 3Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457 South Korea
| | - Janghoon Ahn
- 4Department of Dentistry, College of Medicine, Hallym University, Chuncheon, 24252 South Korea
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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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Abstract
PURPOSE The objective of this study was to evaluate whether silk fibroin (SF) incorporated into 4-hexylresorcinol (4HR) could increase botulinum toxin-A (BTX-A) activity. MATERIAL AND METHODS In total, 30 rats were used for this study. The animals were divided into 6 groups according to the injected materials (SA: saline only; SF; 4HR; B2: 2 units of BTX-A; B2 + SF + 4HR: combination of B2, SF, and 4HR; B5: 5 units of BTX-A). Serial sonography was used for the evaluation of muscle thickness after injection. Immunohistochemical staining was used for the evaluation of myosin type II (myo2) and Bcl-2 protein expression. RESULTS The relative thickness of the masseter muscle in B2 group was 66.14% ± 4.55% to the preinjection level; in B2 + SF + 4HR group was 54.59% ± 4.83%, and in B5 group was 56.19% ± 8.28%. Any BTX-injected group showed significantly lower value of the relative muscle thickness compared to SA, SF, or 4HR group (P < 0.001 for all). The difference of relative muscle thickness between B2 group and B2 + SF + 4HR group was statistically significant (P < 0.001). The intensity of myo2 immunostaining in B5, B2, and B2 + SF + 4HR group was significantly higher than those in the other groups (P < 0.05). CONCLUSIONS When 2 units of BTX was incorporated to SF and 4HR, combination formula showed similar activity to those of 5 units of BTX.
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Shehata AS, Al-Ghonemy NM, Ahmed SM, Mohamed SR. Effect of mesenchymal stem cells on induced skeletal muscle chemodenervation atrophy in adult male albino rats. Int J Biochem Cell Biol 2017; 85:135-148. [PMID: 28232107 DOI: 10.1016/j.biocel.2017.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/25/2017] [Accepted: 01/29/2017] [Indexed: 12/11/2022]
Abstract
The present research was conducted to evaluate the effect of bone marrow derived mesenchymal stem cells (BM-MSCs) as a potential therapeutic tool for improvement of skeletal muscle recovery after induced chemodenervation atrophy by repeated local injection of botulinum toxin-A in the right tibialis anterior muscle of adult male albino rats. Forty five adult Wistar male albino rats were classified into control and experimental groups. Experimental group was further subdivided into 3 equal subgroups; induced atrophy, BM-MSCs treated and recovery groups. Biochemical analysis of serum LDH, CK and Real-time PCR for Bcl-2, caspase 3 and caspase 9 was measured. Skeletal muscle sections were stained with H and E, Mallory trichrome, and Immunohistochemical reaction for Bax and CD34. Improvement in the skeletal muscle histological structure was noticed in BM-MSCs treated group, however, in the recovery group, some sections showed apparent transverse striations and others still affected. Immunohistochemical reaction of Bax protein showed strong positive immunoreaction in the cytoplasm of muscle fibers in the induced atrophy group. BM-MSCs treated group showed weak positive reaction while the recovery group showed moderate reaction in the cytoplasm of muscle fibers. Immunohistochemical reaction for CD34 revealed occasional positive CD34 stained cells in the induced atrophy group. In BM-MSCs treated group, multiple positive CD34 stained cells were detected. However, recovery group showed some positive CD34 stained cells at the periphery of the muscle fibers. Marked improvement in the regenerative capacity of skeletal muscles after BM-MSCs therapy. Hence, stem cell therapy provides a new hope for patients suffering from myopathies and severe injuries.
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Affiliation(s)
| | | | - Samah M Ahmed
- Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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Park YW, Kim SG, Jo YY. S100 and p65 expression are increased in the masseter muscle after botulinum toxin-A injection. Maxillofac Plast Reconstr Surg 2016; 38:33. [PMID: 27635391 PMCID: PMC5002051 DOI: 10.1186/s40902-016-0079-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to compare the expression levels of p65 and S100 in the rat masseter muscle after the injection of different concentrations of botulinum toxin-A (BTX-A). Methods We injected either 5 or 10 U of BTX-A into both masseter muscle of rats. As a control group, the same volume of saline was injected. After 14 days, the animals were sacrificed. Subsequently, a biopsy and immunohistochemical staining of the samples were performed using a p65 or S100 antibody. Results The cross-sectional area of each myofibril was significantly reduced by BTX-A injection (P < 0.001). The expression of p65 and S100 increased significantly with increasing concentrations of BTX-A (P < 0.001). Conclusions The injection of BTX-A into the masseter muscle induced muscle atrophy. Subsequently, p65 and S100 expression in myoblasts were increased for the protection of muscle cells.
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Affiliation(s)
- Young-Wook Park
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 South Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 South Korea
| | - You-Young Jo
- Sericultural and Apicultural Materials Division, National Academy of Agricultural Science, Suwon, South Korea
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Moon YM, Kim MK, Kim SG, Kim TW. Apoptotic action of botulinum toxin on masseter muscle in rats: early and late changes in the expression of molecular markers. SPRINGERPLUS 2016; 5:991. [PMID: 27398270 PMCID: PMC4936988 DOI: 10.1186/s40064-016-2680-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/26/2016] [Indexed: 12/24/2022]
Abstract
The purpose of this study was to compare the early or late expression levels of p65, Bcl-2, and type II myosin and the frequency of TUNEL-positive nuclei in the rat masseter muscle after injection of different concentrations of botulinum toxin-A (BTX-A). We injected either 5 U or 10 U of BTX-A into both masseter muscles of the rat. As a control group, the same volume of saline was injected. After 2 or 12 weeks, the animals were sacrificed. Subsequently, a biopsy and immunohistochemical staining of the samples were performed using a p65, Bcl-2, or type II myosin antibody. Additionally, a TUNEL assay and transmission electron microscopic analysis were performed. The expression of p65, Bcl-2, and type II myosin increased significantly with increasing concentrations of BTX-A at 2 weeks after BTX-A injection (P < 0.05). The number of TUNEL-positive nuclei was also significantly increased in the BTX-A-treated groups in comparison to the saline-treated control at 2 weeks after BTX-A injection (P < 0.05). Elevated expression of Bcl-2 was also observed in 10-unit BTX-A-treated group at 12 weeks after injection (P < 0.05). At 12 weeks after injection, the number of enlarged mitochondria was increased, and many mitochondria displayed aberrations in cristae morphology after BTX-A injection. In conclusion, BTX-A injection into the masseter muscle increased the expression level of p65, Bcl-2, and type II myosin at an early stage. The morphological changes of mitochondria were more evident at 12 weeks after injection.
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Affiliation(s)
- Young-Min Moon
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Min-Keun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 Korea
| | - Tae-Woo Kim
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
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Authors' response. Am J Orthod Dentofacial Orthop 2016; 149:443-5. [DOI: 10.1016/j.ajodo.2016.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 01/21/2016] [Accepted: 01/21/2016] [Indexed: 01/09/2023]
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Moon YM, Kim YJ, Kim MK, Kim SG, Kweon H, Kim TW. Early effect of Botox-A injection into the masseter muscle of rats: functional and histological evaluation. Maxillofac Plast Reconstr Surg 2015; 37:46. [PMID: 26753166 PMCID: PMC4695496 DOI: 10.1186/s40902-015-0049-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 12/22/2015] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was to evaluate the change of food intake after different dosages of botulinum toxin A (BTX) injection in the animal model. Additionally, the dimensional and histological change at 14 days after BTX injection was also evaluated. Methods The comparative study was performed using the BTX injection model in rats (n = 5 for each group). Group 1 was the saline-injected group. Group 2 was the 5-unit BTX-injection group to each masseter muscle. Group 3 was the 10-unit BTX-injection group to each masseter muscle. Food intake rates and body weight were checked daily before and after BTX injection until 10 days. All animals were sacrificed at 14 days after BTX injection, and the specimens underwent hematoxylin and eosin stain and immunohistochemical staining for myosin type II (MYH2). Results The recovery of food intake in groups 2 and 3 decreased significantly compared with group 1 from day 2 to day 7 and day 9 after injection (p < 0.05). The BTX-treated masseter muscles were significantly smaller than those in group 1 (p = 0.015). The immunohistochemical findings demonstrated that the expression of MYH2 was significantly higher in group 3 compared to groups 1 and 2 (p < 0.001). Conclusions BTX injection to the masseter muscle in rats demonstrated short food-intake-rate reduction with recovery until 10 days after injection. The thickness of the masseter muscle and MYH2 expression were significantly changed according to the injected dose of BTX.
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Affiliation(s)
- Young-Min Moon
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Young-Jun Kim
- Department of Oral Medicine and Diagnosis, College of Dentistry, Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, South Korea
| | - Min-Keun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 South Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 210-702 South Korea
| | - HaeYong Kweon
- Sericultural and Apicultural Materials Division, National Academy of Agricultural Science, Suwon, South Korea
| | - Tae-Woo Kim
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
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