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Review
. 2023 Jul 10;12(14):4586.
doi: 10.3390/jcm12144586.

Bruxism and Botulinum Injection: Challenges and Insights

Giuseppina Malcangi  1 , Assunta Patano  1 , Carmela Pezzolla  1 , Lilla Riccaldo  1 , Antonio Mancini  1 , Chiara Di Pede  1 , Alessio Danilo Inchingolo  1 , Francesco Inchingolo  1 , Ioana Roxana Bordea  2 , Gianna Dipalma  1 , Angelo Michele Inchingolo  1
Affiliations
Review

Bruxism and Botulinum Injection: Challenges and Insights

Giuseppina Malcangi et al. J Clin Med. .

Abstract

Botulinum toxin (BTA) is a bacterial-derived extract that can inhibit muscle contraction, acting directly on the absorption of acetylcholine. Thanks to this property, botulinum has been used in aesthetic and general medicine for several years. Nowadays, the use of botulinum toxin is being deepened to address the problem of bruxism. In this scoping review, the results of the studies in the literature of the last 10 years were analyzed. Indeed, 12 reports (found on PubMed, Web of Science, and Scopus, entering the keywords "BRUXISM" and "BOTULINUM TOXIN") were deemed eligible for inclusion in this review. In the studies reviewed, BTA was injected into different muscle groups: masseters, masseter and temporalis or masseter, temporalis, and medial pterygoid. Botulinum toxin injection is a viable therapeutic solution, especially in patients with poor compliance or without improvement in conventional treatment.

Keywords: botulinum toxin; bruxism; dentistry; injection; masseters; medial pterygoids; review; temporalis; type A.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 3
Figure 3
Two cases treated with masseter injections of Botox: (A,C), patient before the injection; (B,D), 40 days after the injection. It is evident how the masseters have normalized.
Figure 1
Figure 1
(A) The toxin binds via the heavy chain to presynaptic receptors. The light chain (the active chain) penetrates the cell through the disulfide bridges of the molecule. (B) ZN++-dependent peptidases; once the BTA molecule (light and heavy chains) is in the cytoplasm, break the disulfide bridges of the BTA. The light chains translocate inward to the cytosol and prevent the fusion of acetylcholine vesicles with the cytoplasmic membrane.
Figure 2
Figure 2
Botulinum toxin type A.
Figure 4
Figure 4
Markings for a single botulinum toxin injection point for masseter reduction in this 28-year-old female representative patient. Line B″ is drawn along the anterior border of the masseter with teeth clenched and the most prominent bulge of the muscle. Line B or B′, depending on individual anatomy, is then drawn towards the oral commissure to capture most of the masseter bulk.
Figure 5
Figure 5
Literature search according to PRISMA Extension for Scoping Reviews (PRISMA-ScR) flow diagram.
See this image and copyright information in PMC

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