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. 2022 Jun;49(6):644-653.
doi: 10.1111/joor.13326. Epub 2022 Apr 9.

Impact of botulinum toxin injection into the masticatory muscles on mandibular bone: A systematic review

Michael Owen  1 , Benjamin Gray  2 , Nawaz Hack  3 , Leonel Perez  4 , Rhonda J Allard  5 , James M Hawkins  6
Affiliations

Impact of botulinum toxin injection into the masticatory muscles on mandibular bone: A systematic review

Michael Owen et al. J Oral Rehabil. 2022 Jun.

Abstract

Background: Botulinum toxin type A (BoNTA) injection into the masticatory muscles has been widely used to treat a number of painful and nonpainful conditions; however, no systematic reviews have been performed on the long-term effect to the mandibular bone.

Objective: Our systematic review aimed to evaluate the impact of botulinum toxin injection into the masticatory muscles on mandibular bone based.

Methods: PubMed, Embase, Ovid, CINAHL and Web of Science were searched for human studies assessing mandibular bone after injection of BoNTA using computed tomography (CT) and cone beam CT (CBCT).

Results: Seven studies were eligible for review; five reported significant bony changes to one or more areas of the mandible. Most frequently affected were the condylar head, coronoid process and ramus. The most frequent changes were decreased bone volume, cortical thickness and cortical and trabecular density.

Conclusions: This is the first systematic review to examine an association between BoNTA injection into the masticatory muscles and mandibular bone quality. Data were analysed from a limited number of studies with a small sample size, and the quality of the included studies was very low. While the majority of available evidence suggests BoNTA injection results in bony change, further study is required to confirm a dose-dependence effect and the impact of gender and age. High-quality trials should utilise a combination of software analysis and radiologist review, with longer-term follow-up to monitor for persistence of bony effect and clinical significance.

Keywords: botulinum toxin; condyle; cone beam computed tomography; mandible; osteopenia; temporomandibular disorder.

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References

REFERENCES

    1. Dodick DW, Turkel CC, DeGryse RE, et al. Onabotulinumtoxin A for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010;50(6):921-936.
    1. Morra ME, Elgebaly A, Elmaraezy A, et al. Therapeutic efficacy and safety of botulinum toxin A therapy in Trigeminal neuralgia: a systematic review and meta-analysis of randomized controlled trials. J Headache Pain. 2016;17(1):63.
    1. Moreno-Hay I, Mishra P, Okeson JP. Intraoral administration of botulinum toxin for continuous dentoalveolar neuropathic pain: a case series. J Oral Facial Pain Headache. 2019;33(2):160-164.
    1. Connelly ST, Myung J, Gupta R, et al. Clinical outcomes of Botox injections for chronic temporomandibular disorders: do we understand how Botox works on muscle, pain, and the brain? Int J Oral Maxillofac Surg. 2017;46(3):322-327.
    1. Dubyk N, Smith A, Criddle P, Jones B, Hawkins J. First bite syndrome treated with onabotulinumtoxin A injections. J Am Dent Assoc. 2022;153(3):284-289.

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