Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial

Abstract BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey’s post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P<.001). BoNT-A was not better than AC in pain reduction (P=0.05), but both therapies were more effective in reducing pain than SS (P<0.05). BoNT-A was the only treatment able to improve PPT values (P<0.05); however, a severe decrease of EMG activity was also found in this group, which is considered an adverse effect. Conclusion after one month of follow-up, all therapies reduced the self-perceived pain in myofascial TMD patients, but only BoNT-A enhanced PPT yet decreased EMG.

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Main Authors: DE LA TORRE CANALES,Giancarlo, CÂMARA-SOUZA,Mariana Barbosa, POLUHA,Rodrigo Lorenzi, GRILLO,Cassia Maria, CONTI,Paulo César Rodrigues, SOUSA,Maria da Luz Rosário de, RODRIGUES GARCIA,Renata Cunha Matheus, RIZZATTI-BARBOSA,Célia Marisa
Format: Digital revista
Language:English
Published: Faculdade De Odontologia De Bauru - USP 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572021000100427
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spelling oai:scielo:S1678-775720210001004272021-06-02Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trialDE LA TORRE CANALES,GiancarloCÂMARA-SOUZA,Mariana BarbosaPOLUHA,Rodrigo LorenziGRILLO,Cassia MariaCONTI,Paulo César RodriguesSOUSA,Maria da Luz Rosário deRODRIGUES GARCIA,Renata Cunha MatheusRIZZATTI-BARBOSA,Célia Marisa Botulinum toxin Acupuncture Myofascial pain Temporomandibular disorders Chronic pain Abstract BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey’s post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P<.001). BoNT-A was not better than AC in pain reduction (P=0.05), but both therapies were more effective in reducing pain than SS (P<0.05). BoNT-A was the only treatment able to improve PPT values (P<0.05); however, a severe decrease of EMG activity was also found in this group, which is considered an adverse effect. Conclusion after one month of follow-up, all therapies reduced the self-perceived pain in myofascial TMD patients, but only BoNT-A enhanced PPT yet decreased EMG.info:eu-repo/semantics/openAccessFaculdade De Odontologia De Bauru - USPJournal of Applied Oral Science v.29 20212021-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572021000100427en10.1590/1678-7757-2020-1035
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language English
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author DE LA TORRE CANALES,Giancarlo
CÂMARA-SOUZA,Mariana Barbosa
POLUHA,Rodrigo Lorenzi
GRILLO,Cassia Maria
CONTI,Paulo César Rodrigues
SOUSA,Maria da Luz Rosário de
RODRIGUES GARCIA,Renata Cunha Matheus
RIZZATTI-BARBOSA,Célia Marisa
spellingShingle DE LA TORRE CANALES,Giancarlo
CÂMARA-SOUZA,Mariana Barbosa
POLUHA,Rodrigo Lorenzi
GRILLO,Cassia Maria
CONTI,Paulo César Rodrigues
SOUSA,Maria da Luz Rosário de
RODRIGUES GARCIA,Renata Cunha Matheus
RIZZATTI-BARBOSA,Célia Marisa
Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
author_facet DE LA TORRE CANALES,Giancarlo
CÂMARA-SOUZA,Mariana Barbosa
POLUHA,Rodrigo Lorenzi
GRILLO,Cassia Maria
CONTI,Paulo César Rodrigues
SOUSA,Maria da Luz Rosário de
RODRIGUES GARCIA,Renata Cunha Matheus
RIZZATTI-BARBOSA,Célia Marisa
author_sort DE LA TORRE CANALES,Giancarlo
title Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
title_short Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
title_full Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
title_fullStr Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
title_full_unstemmed Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial
title_sort botulinum toxin type a and acupuncture for masticatory myofascial pain: a randomized clinical trial
description Abstract BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey’s post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P<.001). BoNT-A was not better than AC in pain reduction (P=0.05), but both therapies were more effective in reducing pain than SS (P<0.05). BoNT-A was the only treatment able to improve PPT values (P<0.05); however, a severe decrease of EMG activity was also found in this group, which is considered an adverse effect. Conclusion after one month of follow-up, all therapies reduced the self-perceived pain in myofascial TMD patients, but only BoNT-A enhanced PPT yet decreased EMG.
publisher Faculdade De Odontologia De Bauru - USP
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572021000100427
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