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

Author(s)

Canales, Giancarlo De la Torre ^[1] ; Camara-Souza, Mariana Barbosa ^[2] ; Poluha, Rodrigo Lorenzi ^[1] ; Grillo, Cassia Maria ^[3] ; Rodrigues Conti, Paulo Cesar ^[1] ; Rosario de Sousa, Maria da Luz ^[3] ; Matheus Rodrigues Garcia, Renata Cunha ^[2] ; Rizzatti-Barbosa, Celia Marisa ^{[2, 4]}

Affiliation

^[1] Univ Sao Paulo, Fac Odontol Bauru, Dept Protese, Al Octavio Pinheiro Brisola 9-75, BR-17012901 Bauru, SP - Brazil

^[2] Univ Estadual Campinas, Fac Odontol Piracicaba, Dept Protese & Periodontia, Piracicaba, SP - Brazil

^[3] Univ Estadual Campinas, Fac Odontol Piracicaba, Dept Saude Colet, Piracicaba, SP - Brazil

^[4] UNINGA, Dept Odontol, Maringa, Parana - Brazil

• Document type: Journal article
• Source: Journal of Applied Oral Science; v. 29, 2021.
• Web of Science Citations: 0

Abstract

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. (AU)

• FAPESP's process: 14/15863-7 - Comparison of conventional and BontA treatments in patients with myogenic temporomandibular disorders and chronic pain
• Grantee: Celia Marisa Rizzatti Barbosa
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/21674-0 - Comparison of the effectiveness of botulinum toxin type A in patients with refractory chronic orofacial pain according to different somatosensory profiles
• Grantee: Giancarlo de La Torre Canales
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 17/23429-3 - Influence of behavioral therapies on awake bruxism, biopsychosocial factors and orofacial pain: randomized controlled clinical trial
• Grantee: Mariana Barbosa Câmara de Souza
• Support Opportunities: Scholarships in Brazil - Doctorate