BOTULINUM TOXIN TYPE-A…AN EVOLVING TREATMENT MODALITY IN THE MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISC DISPLACEMENT | ||||
| Alexandria Dental Journal | ||||
| Article 10, Volume 43, Issue 2, August 2018, Page 57-61 PDF (643.38 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2018.57625 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mariam M. Bahgat* 1; Nadia R. El-Helw2; Ahmed M. Abdelhamid2; Mohamed H. Emam3 | ||||
| 1Demonstrator of Prosthodontics, Faculty of Dentistry, Alexandria University | ||||
| 2Professor of Prosthodontics, Faculty of Dentistry, Alexandria University | ||||
| 3Professor of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University. | ||||
| Abstract | ||||
| INTRODUCTION: Temporomandibular disorders (TMD) is an umbrella term embracing a set of conditions that affect the masticatory muscles and the temporomandibular joint (TMJ) .Internal derangements, specifically disc displacement with reduction (DDr), are one of the major findings in TMD . For the treatment of DDr, occlusal appliances and some pharmacological agents were suggested. Several studies were done evaluating the therapeutic use of Botulinum Toxin Type A (BTX-A) in TMD of myogenic origin. But only few studies investigated its effect in the management of TMD of arthrogenic origin. OBJECTIVES: This study was done to evaluate the effect of Botulinum Toxin Type A (BTX-A) injection in the lateral pterygoid muscle (LPM) with and without anterior repositioning appliance (ARA) as a treatment modality for DDr. MATERIALS AND METHODS: Eighteen patients with anterior disc displacement with reduction (DDr) as diagnosed clinically using Research Diagnostic Criteria (RDC/TMD) and confirmed by MRI were enrolled in this study. Patients were randomly assigned into three groups each comprising 6 patients. Group I received ARA, group II received BTX-A while group III received both treatment modalities. After 3 months, evaluation was done subjectively through Helkimo Anamnestic index (Ai) and objectively through electromyography (EMG) as well as MRI. RESULTS: Clinically, there was significant improvement in TMD symptoms in the three studied groups, while disc position was significantly improved in groups II and III as proved by MRI. CONCLUSIONS: Anterior repositioning appliance is effective in treating patients with disc displacement with reduction; however, BTX-A with and without ARA proved to be a more valuable treatment modality in the management of disc displacement with reduction. | ||||
| Keywords | ||||
| Botulinum toxin; disc displacement; lateral pterygoid; electromyography | ||||
| References | ||||
|
1. Manfredini D, Piccotti F, Ferronato G,Guarda-Nardini L. Age peaks of different RDC/TMD diagnoses in a patient population. Journal of dentistry. 2010;38:392-9.
2. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet J P et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications. Journal of oral & facial pain and headache. 2014;28:6-27.
3. De Leeuw R. Internal derangements of the temporomandibular joint. Oral and maxillofacial surgery clinics of North America. 2008;20:159-68.
4. Ogütcen-Toller M. Sound analysis of temporomandibular joint internal derangements with phonographic recordings. Journal of Prosthetic Dentistry. 2003;89:311-8.
5. Dworkin S F,Leresche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examination, critique. . J Craniomandib Disord 1992;6:301- 55.
6. Naeije M, Te Veldhuis A, Te Veldhuis E, Visscher C,Lobbezoo F. Disc displacement within the human temporomandibular joint: a systematic review of a 'noisy annoyance'. Journal of oral rehabilitation. 2012;40:139-58.
7. Haggman-Henrikson B, Rezvani M,List T. Prevalence of whiplash trauma in TMD patients: a systematic review. Journal of oral rehabilitation. 2014;41:59-68.
8. Liu F,Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dental clinics of North America. 2013;57:465-79.
9. Manfredini D. Etiopathogenesis of disk displacement of the temporomandibular joint: A review of the mechanisms. Indian J Dent Res 2009;20:212-21.
10. S.Fujita, T.Iizuka,W.Dauber. Variation of Heads of Lateral Pterygoid Muscle and Morphology of Articular Disc of Human Temporomandibular Joint-Anatomical and Histological Analysis. Journal of oral rehabilitation. 2001;28:560-71.
11. Kilic C, Dergin G, Yazar F, Kurt B, Kutoglu T, Ozan H et al. Insertions of the lateral pterygoid muscle to the disc-capsule complex of the temporomandibular joint and condyle. Turk J Med Sci. 2010;40:435-41.
12. Murray G, Bhutada M, Peck C, Phanachet I, Sae-Lee D,Whittle T. The human lateral pterygoid muscle. Arch Oral Biol. 2007;52:377-80
13. Bakke M, Møller E, Werdelin L M, Dalager T, Kitai N,Kreiborg S. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2005;100:693-700.
14. Kamble V R,Mitra K R. Lateral pterygoid muscle attachment type is related to the pathogenesis ofanterior disc displacement, Disc degeneration and articular surface degeneration- A Magnetic Resonance Imaging assessment. International Journal of Biomedical Research. 2016;7: 423-9.
15. Hiraba, Katsunari, Hibino K, Hiranuma K,Negoro. T. EMG Activities of Two Heads of the Human Lateral Pterygoid Muscle in Relation to Mandibular Condyle Movement and Biting Force. J Neurophysiol. 2000;83:2120–37.
16. Herranz-Aparicio J, Vazquez-Delgado E, ArnabatDominguez J, Espana-Tost A,Gay-Escoda C. The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature. Medicina Oral Patología Oral y Cirugia Bucal. 2013;18:e603-e12.
17. Conti P C R, Da Mota Correa A S, Lauris J R P,Stuginskibarbosa J. Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study. Journal of applied oral science : revista FOB. 2015;23:529-35.
18. List T,Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. Journal of oral rehabilitation. 2010;37:430-51.
19. Yadav S,Karani J T. The Essentials of Occlusal Splint Therapy. International Journal of Prosthetic Dentistry. 2011;2:12-21.
20. Madani A S,Mirmortazavi A. Comparison of three treatment options for painful temporomandibular joint clicking. Journal of Oral Science. 2011;53: 349-54.
21. Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P,Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. JRSM short reports. 2013;4:10.
22. Rady N A, Abdelhamid A M,El-Razik M K A. The Effect of Low Level Laser with Repositioning Appliance in the Management of Temporomandibular Joint Disc Displacement with Reduction. International Journal of Science and Research. 2016;5:1628-32.
23. Mor N, Tang C,Blitzer A. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection. Toxins. 2015;7:2791-800.
24. Rossetto O, Pirazzini M,Montecucco C. Botulinum neurotoxins: genetic, structural and mechanistic insights. Nature reviews Microbiology. 2014;12:535-49.
25. Pirazzini M, Rossetto O, Eleopra R,Montecucco C. Botulinum Neurotoxins: Biology, Pharmacology, and Toxicology. Pharmacological reviews. 2017;69:200-35.
26. Rosales R L, Bigalke H,Dressler D. Pharmacology of botulinum toxin: differences between type A preparations. European Journal of Neurology 2006;13:2-10.
27. Guarda-Nardini L, Manfredini D, Salamone M, Salmaso L, Tonello S,Ferronato G. Efficacy of Botulinum Toxin in Treating Myofascial Pain in Bruxers: A Controlled Placebo Pilot Study. Journal of craniomandibular practice. 2008;26:126-35.
28. Baker J S,Nolan P J. Effectiveness of Botulinum Toxin Type a for the Treatment of Chronic Masticatory Myofascial Pain: A Case Series. J Am Dent Assoc 2016;148:33-9.
29. Hassan M A, Emara A S, Hakam M M,Elfarmawy M I. MRI Monitoring of Disc Position Changes Following Botulinum Toxin Injection for Management of TMJ Clicking. Med J Cairo Univ. 2013;81:11-20.
30. Okeson J P. Management of Temporomandibular Disorders and Occlusion. 6th ed. St. Louis, Missouri, USA: Elsevier Mosby Co.; 2008.
31. Helkimo M. Studies of function and dysfunction of the masticatory system. Index of Anamnestic and clinical dysfunction and occlusal state. Swed Dent J 1974;67:101- 9.
32. Alonso M B C C, Gamba T O, Lopes S L P C, Cruz A D, Freitas D Q,Haiter-Neto F. Magnetic resonance imaging of the temporomandibular joint acquired using different parameters. Journal of Morphological Sciences. 2014;31:103-9.
33. Kurita H, Oshtsuka A, Kurashina K,Kopp S. A study of factors for successful splint capture of anteriorly displaced temporomandibular joint disc with disc repositioning appliance. Journal of oral rehabilitation. 2001;28:651-7.
34. Mills K R. The basics of electromyography. Journal of neurology, neurosurgery, and psychiatry. 2005;76 Suppl 2:ii32-5.
35. Kotz S, Balakrishnan N, Read C B,Vidakovic B. Encyclopedia of statistical sciences. 2nd ed. Hoboken, New Jersey, USA: John Wiley & Sons, Inc; 2006.
36. Gray R,Al-Ani Z. Risk management in clinical practice. Part 8: Temporomandibular disorders. British Dental Journal. 2010;209:433-49.
37. Murray G, Bhutada M, Peck C, Phanachet I, Sae-Lee D,Whittle T. Threshold properties of single motor units in superior head of human lateral pterygoid muscle. Aust Dent J 2004;49:2-8. | ||||
|
Statistics Article View: 220 PDF Download: 481 |
||||
