EFFICACY OF BOTULINUM TOXIN IN THE TREATMENT OF MUSCULAR TMD, BRUXISM, AND MYOFASCIAL PAIN
Botulinum toxin has been investigated as a therapeutic option for painful conditions associated with muscle hyperactivity, particularly in muscle-related temporomandibular disorder, bruxism, and orofacial myofascial pain. Although its pharmacological action is related to blocking the release of acetylcholine at the neuromuscular junction, promoting temporary muscle relaxation, its clinical application in these conditions still requires careful analysis, especially given the heterogeneity of the available results. This study aimed to analyze the scientific evidence regarding the efficacy, safety, and therapeutic role of botulinum toxin in the treatment of muscular TMD, bruxism, and myofascial pain. This is an evidence-based critical narrative review, with a selection of randomized clinical trials and systematic reviews indexed in the PubMed, Scopus, and Web of Science databases. The results indicate that botulinum toxin may reduce pain and muscle hyperactivity in specific subgroups, especially in patients refractory to conservative therapies. However, the studies show significant variations regarding dose, treated muscles, diagnostic criteria, follow-up duration, and assessment tools. In some cases, pain relief was not accompanied by complete functional recovery, with reports of reduced masticatory strength, local discomfort, and possible muscular and skeletal effects with repeated applications. It is concluded that botulinum toxin should not be considered a first-line treatment, but rather an adjunctive, individualized resource reserved for selected cases, within a multidisciplinary approach that considers pain, function, safety, and quality of life.
EFFICACY OF BOTULINUM TOXIN IN THE TREATMENT OF MUSCULAR TMD, BRUXISM, AND MYOFASCIAL PAIN
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DOI: https://doi.org/10.22533/at.ed.515721126010612
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Palavras-chave: Botulinum Toxins; Temporomandibular Joint Disorders; Bruxism; Myofascial Pain Syndromes; Chronic Pain.
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Keywords: Botulinum Toxins; Temporomandibular Joint Disorders; Bruxism; Myofascial Pain Syndromes; Chronic Pain.
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Abstract:
Botulinum toxin has been investigated as a therapeutic option for painful conditions associated with muscle hyperactivity, particularly in muscle-related temporomandibular disorder, bruxism, and orofacial myofascial pain. Although its pharmacological action is related to blocking the release of acetylcholine at the neuromuscular junction, promoting temporary muscle relaxation, its clinical application in these conditions still requires careful analysis, especially given the heterogeneity of the available results. This study aimed to analyze the scientific evidence regarding the efficacy, safety, and therapeutic role of botulinum toxin in the treatment of muscular TMD, bruxism, and myofascial pain. This is an evidence-based critical narrative review, with a selection of randomized clinical trials and systematic reviews indexed in the PubMed, Scopus, and Web of Science databases. The results indicate that botulinum toxin may reduce pain and muscle hyperactivity in specific subgroups, especially in patients refractory to conservative therapies. However, the studies show significant variations regarding dose, treated muscles, diagnostic criteria, follow-up duration, and assessment tools. In some cases, pain relief was not accompanied by complete functional recovery, with reports of reduced masticatory strength, local discomfort, and possible muscular and skeletal effects with repeated applications. It is concluded that botulinum toxin should not be considered a first-line treatment, but rather an adjunctive, individualized resource reserved for selected cases, within a multidisciplinary approach that considers pain, function, safety, and quality of life.
- vania sarubo loca
- FLÁVIA TENÓRIO
- VIVIANE RODRIGUES
- GLÓRIA M. PIMENTA CABRAL
