Biomaterial Database

Effectiveness of botulinum toxin type A for the treatment of chronic masticatory myofascial pain: A case series. 2017

Jason S Baker, and Patrick J Nolan

The aim of this study is to evaluate the effectiveness of botulinum toxin type A (BTX-A) for the treatment of chronic masticatory myofascial pain (MMP) over 12 months and to test a standardized protocol. This is a prospective case series of consecutive adult patients with chronic MMP treated with injection of BTX-A into the bilateral temporalis and masseter muscles. The authors used the same anatomic landmarks and dosage and followed each patient for 12 months. The primary outcome variables were reduction in pain measured with visual analog scale (VAS) and Physician Global Assessment (PGA). Secondary outcome variables were change in maximum pain-free opening, change in palpatory pain points in the face and oral cavity, and change in results from a questionnaire measuring disability, dysfunction, and psychosocial effects of the disease. The authors included 15 women and 4 men (mean [standard deviation] age, 32.7 [6.9] years) in the study. Pain decreased significantly as measured with the VAS (P < .0001) and PGA (P < .0001). Maximum pain-free opening increased significantly (P = .010), but maximum voluntary opening did not change significantly (P = .837). The number of palpatory pain points (P < .0001) and the symptom questionnaire score decreased over time (P < .0001). The results of this case series suggest that injecting BTX-A into the bilateral temporalis and masseter muscles may be a safe and effective treatment for chronic MMP. Controlled clinical trials are needed to confirm whether administration of BTX-A is effective in treating facial pain.

UI	MeSH Term	Description	Entries
D007273	Injections, Intramuscular	Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.	Intramuscular Injections,Injection, Intramuscular,Intramuscular Injection
D008297	Male		Males
D008406	Masseter Muscle	A masticatory muscle whose action is closing the jaws.	Masseter Muscles,Muscle, Masseter,Muscles, Masseter
D008409	Mastication	The act and process of chewing and grinding food in the mouth.	Chewing
D009209	Myofascial Pain Syndromes	Muscular pain in numerous body regions that can be reproduced by pressure on TRIGGER POINTS, localized hardenings in skeletal muscle tissue. Pain is referred to a location distant from the trigger points. A prime example is the TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME.	Myofascial Trigger Point Pain,Trigger Point Pain, Myofascial,Myofascial Pain Syndrome,Pain Syndrome, Myofascial,Pain Syndromes, Myofascial,Syndrome, Myofascial Pain,Syndromes, Myofascial Pain
D009465	Neuromuscular Agents	Drugs used for their actions on skeletal muscle. Included are agents that act directly on skeletal muscle, those that alter neuromuscular transmission (NEUROMUSCULAR BLOCKING AGENTS), and drugs that act centrally as skeletal muscle relaxants (MUSCLE RELAXANTS, CENTRAL). Drugs used in the treatment of movement disorders are ANTI-DYSKINESIA AGENTS.	Skeletal Muscle Relaxants,Neuromuscular Effect,Neuromuscular Effects,Agents, Neuromuscular,Effect, Neuromuscular,Effects, Neuromuscular,Muscle Relaxants, Skeletal,Relaxants, Skeletal Muscle
D010147	Pain Measurement	Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.	Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260	Female		Females