1
|
Sökmen K, Talo Yıldırım T, Dündar S. Effect of botulinum toxin-A injection applied to the mentalis muscle on free gingival graft operation: A retrospective study. J ESTHET RESTOR DENT 2024; 36:335-345. [PMID: 37477237 DOI: 10.1111/jerd.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The purpose of this retrospective study was to investigate the effects of Botulinum Toxin-A (BTX-A) injection into the mentalis muscle on the free gingival graft (FGG). MATERIALS AND METHODS Forty patients with keratinized gingiva insufficiency and Cairo's RT 2 gingival recession (formerly classified as Miller class III) in their mandibular central incisors were randomly divided into two groups: FGG and FGG + BTX. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), keratinized gingiva width (KGW), attached gingiva width (AGW), clinical attachment level (CAL), gingival thickness (GT), gingival recession amount (GRA), gingival recession width (GRW), and root closure percentage (RCP%) parameters were measured at baseline and at first, third, and sixth months after the operation. RESULTS There was no difference in PI, GI, and PPD levels in both groups (p > 0.05). While the change in GT and RCP% levels were found to be statistically significantly higher at FGG + BTX group than FGG group, the change in GRW and CAL levels were statistically significantly lower (p < 0.05). CONCLUSION The findings of this study indicate that BTX-A injection applied to the mentalis muscle after FGG operation may have positive effects in terms of KGW, AGW, GT, RCP%, GRW, and CAL parameters. CLINICAL SIGNIFICANCE As a result of the fact that BTX-A injection into the mentalis muscle contributed to the nutrition and immobility of FGG, positive developments were obtained in terms of clinical periodontal parameters. BTX-A injection into the mentalis muscle may be an alternative method that increases the success rate of Cairo's RT 2 gingival recession.
Collapse
Affiliation(s)
- Kevser Sökmen
- Faculty of Dentistry, Department of Periodontology, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Tuba Talo Yıldırım
- Faculty of Dentistry, Department of Periodontology, Fırat University, Elazığ, Turkey
| | - Serkan Dündar
- Faculty of Dentistry, Department of Periodontology, Fırat University, Elazığ, Turkey
| |
Collapse
|
2
|
Sarkarat F, Bagheri D, Kahali R, Fateh A, Rakhshan V. Effects of lidocaine incorporation (without epinephrine) on pain and 2-week complications of botulinum toxin: a double-blind randomized placebo-controlled clinical trial. Sci Rep 2023; 13:7812. [PMID: 37183235 PMCID: PMC10183458 DOI: 10.1038/s41598-023-34973-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/10/2023] [Indexed: 05/16/2023] Open
Abstract
No study has assessed the effects of the incorporation of isolated lidocaine into botulinum toxin for reducing its pain or complications. Studies on the dilution of botulinum toxin with other materials are as well extremely few, small, and limited methodologically. Therefore, we aimed to evaluate, for the first time, the effects of the incorporation of lidocaine alone into botulinum toxin type A on post-injection pain and complications. In this 2-week prospective, multicenter, double-blind randomized placebo-controlled clinical trial, 729 participants (667 females) were enrolled. They were randomized into placebo and lidocaine dilutions (about 2:1), and then into two brands of toxins (Dysport versus Xeomin). Hence, there were 4 subgroups. In the 2 experimental subgroups, botulinum toxin was diluted with 2% lidocaine without adrenaline; in the 2 control subgroups, botulinum toxin was diluted with normal saline as a placebo. After injection, the pain level was recorded (as an 11-scale numerical rating scale from 0 to 10). After 2 weeks, post-injection complications were assessed based on the participants' reports and the surgeon's observations. Data were analyzed using 3-way ANCOVA, multiple binary logistic regression, and bivariable analyses (α = 0.05, β ≤ 0.1). The mean ± SD pain levels in the lidocaine group (n = 263) and the placebo group (n = 466) were 3.51 ± 2.04 and 4.15 ± 2.35, respectively. The mean ± SD pain levels in the subgroups 'Xeomin-Lidocaine (n = 61), Dysport-Lidocaine (n = 202), Xeomin-Placebo (n = 133), and Dysport-Placebo (n = 333)' were respectively 3.39 ± 1.86, 3.55 ± 2.09, 4.61 ± 2.49, and 3.97 ± 2.24. Lidocaine incorporation (P = 0.001), Dysport brand (P = 0.030), and younger age (P = 0.032) [but not sex (P = 0.406)] reduced pain. The only significant findings for 2-week complications were for the associations observed between aging with increased asymmetry (P = 0.022, OR = 1.032) and a need for a retouch (P = 0.039, OR = 1.021). Botulinum toxin dilution with lidocaine alone (without adrenaline or other ingredients) can reduce pain without affecting postinjection complications. Toxin brands may cause different extents of pain. Aging, but not sex, may increase pain. Two-week complications were not affected by any factors, except aging in the case of asymmetry and the need for a botulinum toxin retouch.
Collapse
Affiliation(s)
- Farzin Sarkarat
- Department of Oral and Maxillofacial surgery, Gulf Medical University, Ajman, UAE
- Department of Oral and Maxillofacial Surgery, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Roozbeh Kahali
- Department of Oral and Maxillofacial Surgery, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Ali Fateh
- Department of Oral and Maxillofacial Surgery, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Vahid Rakhshan
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies, Tehran, Iran.
| |
Collapse
|
3
|
An JM, Shahriar SMS, Lee DY, Hwang SR, Lee YK. Pore Size-Dependent Stereoscopic Hydrogels Enhance the Therapeutic Efficiency of Botulinum Toxin for the Treatment of Nerve-Related Diseases. ACS APPLIED MATERIALS & INTERFACES 2022; 14:19139-19153. [PMID: 35452222 DOI: 10.1021/acsami.2c01738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Botulinum toxin (BoNT) is a major neurotherapeutic protein that has been used at low doses for diverse pharmacological applications. However, the pleiotropic effect of BoNT depends on multiple periodic injections owing to its rapid elimination profile, short-term therapeutic effect, and high mortality rate when administered at high doses. In addition to low patient compliance, these drawbacks represent the significant challenges that limit the further clinical use of BoNT. This study developed a new hydrogel-based single dosage form of BoNT by employing a one-step cross-linking chemistry. Its controlled porous structures and composition facilitated uniform drug distribution inside the hydrogel and controllable release of BoNT mediated by slow diffusion. A single dose remained stable for at least 2.5 months and showed sustained effect for at least 20 weeks, meeting the requirements for a single-dose form of BoNT. Additionally, this dosage form was evaluated as safe from all aspects of toxicology. This delivery system resulted in a 100% survival rate after administering a BoNT dose of 30 units, while a dose of more than 5 units of naked BoNT caused a 100% mortality rate within a few days. Overall, this strategy could provide patients with the first single-dose treatment option of BoNT and improve their quality of life.
Collapse
Affiliation(s)
- Jeong Man An
- Department of Bioengineering, College of Engineering, Hanyang University, Seoul 04763, Republic of Korea
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 27469, Republic of Korea
- KB Biomed Inc., Chungju 27469, Republic of Korea
| | - S M Shatil Shahriar
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 27469, Republic of Korea
- KB Biomed Inc., Chungju 27469, Republic of Korea
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198-5940, United States
| | - Dong Yun Lee
- Department of Bioengineering, College of Engineering, and BK FOUR Biopharmaceutical Innovation Leader for Education and Research Group, Hanyang University, Seoul 04763, Republic of Korea
- Institute of Nano Science and Technology (INST), Hanyang University, Seoul 04763, Republic of Korea
| | - Seung Rim Hwang
- College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea
| | - Yong-Kyu Lee
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 27469, Republic of Korea
- KB Biomed Inc., Chungju 27469, Republic of Korea
| |
Collapse
|
4
|
Albuquerque MCP, Guerra JM, Aguiar MT, Caetano CFF, Borges MMF, Cetira Filho EL, Silva PGDB, Sousa FB. Analysis of a Brazilian cross-cultural adaptation of the FACE-Q SFAOS in facial harmonization in dentistry. Braz Oral Res 2022; 36:e050. [DOI: 10.1590/1807-3107bor-2022.vol36.0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022] Open
|
5
|
Andre A, Kang J, Dym H. Pharmacologic Treatment for Temporomandibular and Temporomandibular Joint Disorders. Oral Maxillofac Surg Clin North Am 2021; 34:49-59. [PMID: 34598856 DOI: 10.1016/j.coms.2021.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Temporomandibular joint disorder is defined by pain and/or loss of function of the temporomandibular joint and its associated muscles and structures. Treatments include noninvasive pharmacologic therapies, minimally invasive muscular and articular injections, and surgery. Conservative therapies include nonsteroidal anti-inflammatory drugs, muscle relaxants, benzodiazepines, antidepressants, and anticonvulsants. Minimally invasive injections include botulinum toxin, corticosteroids, platelet-rich plasma, hyaluronic acid, and prolotherapy with hypertonic glucose. With many pharmacologic treatment options and modalities available to the oral and maxillofacial surgeon, mild to moderate temporomandibular joint disorder can be managed safely and effectively to improve symptoms of pain and function of the temporomandibular joint.
Collapse
Affiliation(s)
- Amanda Andre
- The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
| | - Joseph Kang
- The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| |
Collapse
|
6
|
Comparison of the Efficacy of Botulinum Toxin, Local Anesthesia, and Platelet-Rich Plasma Injections in Patients With Myofascial Trigger Points in the Masseter Muscle. J Oral Maxillofac Surg 2020; 79:88.e1-88.e9. [PMID: 33045182 DOI: 10.1016/j.joms.2020.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Masticatory myofascial trigger points (TrP) are one of the major causes of nondental pain in the orofacial region. Intramuscular injections are considered the first-line treatment for myofascial TrPs. The objectives of this study were to evaluate and compare the effectiveness of local anesthesia (LA), botulinum toxin (BTX), and platelet-rich plasma (PRP) injections for the treatment of myofascial TrPs in the masseter muscle. METHODS In this retrospective study, the sample was composed of patients with myofascial TrPs in masseter muscle who were treated between 2016 and 2019. Patients were divided into 3 groups according to treatment methods: group I (LA injection), group II (BTX injection), and group III (PRP injection). Primary outcome variable was the average pain level at rest and while chewing, and pressure pain intensity (PPI), Jaw Functional Limitation Scale (JFLS) value, and quality-of-life (measured using Oral Health Impact Profile-14 (OHIP-14)) were secondary outcomes. The outcome variables were assessed at diagnosis, and 1, 3, and 6 months post-treatment. RESULTS The study consisted of 82 patients (group I, 27; group II, 26; group III, 29). At 1 and 3 months, improvement in all parameters was recorded in all groups. Groups I and II showed superior improvement in all parameters compared with group III at 3 months. Improvements in VAS pain, JFLS, and OHIP-14 values were significantly better in group II than group I at 3 months (P = .009; P = .004; P = .002). At 6 months, significant improvement in VAS pain, JFLS, and OHIP-14 (P = .008; P < .001; P < .01) values was recorded only in group II. CONCLUSIONS All procedures successfully improved the symptoms of TrPs in the masseter muscle at 1 and 3 months. However, BTX injection seemed superior at the 3-month follow-up and remained effective up to 6 months.
Collapse
|
7
|
Park EJ, In SK, Yi HS, Kim HI, Kim HS, Kim HY. Treatment of post-traumatic chin deformities using bilateral botulinum toxin injections. Arch Craniofac Surg 2019; 20:310-313. [PMID: 31658795 PMCID: PMC6822072 DOI: 10.7181/acfs.2019.00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/25/2019] [Indexed: 11/20/2022] Open
Abstract
Post-traumatic hematoma formation is a common complication of contusion. If the hematoma is large enough to aspirate or drain, it can be treated quickly and appropriately. However, if the hematoma is small or concealed by local swelling, it may be overlooked and left untreated. In most cases, a hematoma will resolve following conservative treatment; however, associated infection or muscle fibrosis can occur. Herein, we present the case of a patient with a chin deformity caused by a post-traumatic hematoma. The deformity was treated using botulinum toxin and triamcinolone acetonide injections as minimally invasive treatments. The course of treatment was good.
Collapse
Affiliation(s)
- Eon Ju Park
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| | - Seok Kyung In
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| | - Hyung Suk Yi
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| | - Hong Il Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| | - Ho Sung Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| | - Hyo Young Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
| |
Collapse
|
8
|
The use of botulinum toxin-a in the treatment of muscular temporomandibular joint disorders. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:322-325. [PMID: 30807862 DOI: 10.1016/j.jormas.2019.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/05/2019] [Accepted: 02/04/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Botulinum toxin has been used mainly in the treatment of muscular temporomandibular joint disorders (TMD) and hyperactivity of the masticatory muscles. It is used also as a therapeutic option to relieve pain and help in functional recovery from dental, oral and maxillofacial surgery. The aim of our study was to investigate the efficacy of botulinum toxin injection in the treatment of muscular TMD. MATERIALS AND METHODS Of the 200 temporomandibular joint patients who applied for treatment, 25 patients with muscular dysfunction of the origin were included in the study. This patient group received drug, drug - physical therapy, occlusal splint therapy and botulinum toxin. These treatments were performed step by step. Botulinum toxin was applied, in accordance with reflex measurement in electromyography guidelines to nine patients whose results were not success from the other treatments had not been successful. Measurements were taken of bite force, pain and mouth openness. RESULTS Sixteen patients were treated with drug-physical therapy-occlusal splint therapy, and botulinum toxin treatment was found to be successful in the case of nine patients. No side effects were observed at six months follow-up. CONCLUSION Botulinum toxin injection for the treatment of muscular temporomandibular joint disorder is a viable treatment option in the case of patients who do not respond to conservative treatment methods.
Collapse
|
9
|
Rokaya D, Suttagul K, Joshi S, Bhattarai BP, Shah PK, Dixit S. An epidemiological study on the prevalence of temporomandibular disorder and associated history and problems in Nepalese subjects. J Dent Anesth Pain Med 2018; 18:27-33. [PMID: 29556556 PMCID: PMC5858007 DOI: 10.17245/jdapm.2018.18.1.27] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 12/16/2017] [Accepted: 12/21/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time. METHODS A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD. RESULTS The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate. CONCLUSIONS The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.
Collapse
Affiliation(s)
- Dinesh Rokaya
- Department of Prosthodontics, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Kanokwan Suttagul
- Department of Community Dentistry, Faculty of Dentistry, Western University, Pathum Thani, Thailand
| | - Shraddha Joshi
- Department of Oral Medicine and Radiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Bishwa Prakash Bhattarai
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Shantanu Dixit
- Department of Oral Medicine and Radiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| |
Collapse
|