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Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial.

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Title: Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial.
Authors: Sitnikova, V., Kämppi, A., Kämppi, L., Alvesalo, E., Burakova, M., Kemppainen, P., Teronen, O.
Source: Pain Practice. Nov2024, Vol. 24 Issue 8, p1014-1023. 10p.
Subjects: Temporomandibular disorders, Pain measurement, Placebos, Physiologic salines, Statistical sampling, Randomized controlled trials, Treatment effectiveness, Mann Whitney U Test, Descriptive statistics, Crossover trials, Injections, Electromyography, Masticatory muscles, Dental occlusion, Botulinum toxin, Drug efficacy, Comparative studies, Sociodemographic factors, Data analysis software, Algorithms
Abstract: Background: Injections of botulinum toxin type A (BoNT‐A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)‐related myofascial pain (MFP). BoNT‐A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo‐controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT‐A. Methods: Sixty‐six subjects were randomized into two groups, one which received BoNT‐A first and a second which received a saline solution (SS) first. Follow‐ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain‐related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. Results: The within‐group analysis showed a significant improvement in pain intensity and pain‐related disability after BoNT‐A (p < 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between‐group analysis of pain‐related variables revealed no differences between groups at any time. Nonetheless, BoNT‐A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16‐week follow‐ups favoring BoNT‐A. Conclusions: Injections of 50 U of BoNT‐A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Clinical benefit of botulinum toxin for treatment of persistent TMD‐related myofascial pain: A randomized, placebo‐controlled, cross‐over trial.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Pain+Practice%22&quot;&gt;Pain Practice&lt;/searchLink&gt;. Nov2024, Vol. 24 Issue 8, p1014-1023. 10p.
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– Name: Abstract
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  Data: Background: Injections of botulinum toxin type A (BoNT‐A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)‐related myofascial pain (MFP). BoNT‐A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo‐controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT‐A. Methods: Sixty‐six subjects were randomized into two groups, one which received BoNT‐A first and a second which received a saline solution (SS) first. Follow‐ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain‐related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. Results: The within‐group analysis showed a significant improvement in pain intensity and pain‐related disability after BoNT‐A (p &lt; 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between‐group analysis of pain‐related variables revealed no differences between groups at any time. Nonetheless, BoNT‐A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16‐week follow‐ups favoring BoNT‐A. Conclusions: Injections of 50 U of BoNT‐A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/papr.13396
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 1014
    Subjects:
      – SubjectFull: Temporomandibular disorders
        Type: general
      – SubjectFull: Pain measurement
        Type: general
      – SubjectFull: Placebos
        Type: general
      – SubjectFull: Physiologic salines
        Type: general
      – SubjectFull: Statistical sampling
        Type: general
      – SubjectFull: Randomized controlled trials
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      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Mann Whitney U Test
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Crossover trials
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      – SubjectFull: Injections
        Type: general
      – SubjectFull: Electromyography
        Type: general
      – SubjectFull: Masticatory muscles
        Type: general
      – SubjectFull: Dental occlusion
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      – SubjectFull: Botulinum toxin
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      – SubjectFull: Drug efficacy
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      – SubjectFull: Algorithms
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              M: 11
              Text: Nov2024
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