Efficacy and Safety of Botulinum Toxin Type A on Persistent Myofascial Pain: A Randomized Clinical Trial

Autor(es)

Canales, Giancarlo De la Torre ^[1] ; Alvarez-Pinzon, Natalia ^[1] ; Manuel Munoz-Lora, Victor Ricardo ^[1] ; Peroni, Leonardo Vieira ^[2] ; Gomes, Amanda Farias ^[2] ; Sanchez-Ayala, Alfonso ^[3] ; Haiter-Neto, Francisco ^[2] ; Manfredini, Daniele ^[4] ; Rizzatti-Barbosa, Celia Marisa ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Piracicaba Dent Sch, Dept Prosthodont & Periodontol, BR-13414903 Sao Paulo - Brazil

^[2] Univ Estadual Campinas, Piracicaba Dent Sch, Dept Oral Diag, BR-13414903 Sao Paulo - Brazil

^[3] Univ Estadual Ponta Grossa, Dept Dent, BR-84030900 Ponta Grossa, Parana - Brazil

^[4] Univ Siena, Dept Dent, I-53100 Siena - Italy

• Tipo de documento: Artigo Científico
• Fonte: TOXINS; v. 12, n. 6 JUN 2020.
• Citações Web of Science: 0

Resumo

This study assessed the safety and efficacy of three different doses of BoNT-A for persistent myofascial pain (MFP). One hundred female subjects were randomly assigned into five groups (n= 20): oral appliance (OA), saline solution (SS) and three BoNT-A groups with different doses. Pain intensity and pressure pain threshold were evaluated up to 24 weeks after treatment. Adverse effects related to muscle contraction, masticatory performance, muscle thickness and mandibular bone volume were also assessed. Changes over time were compared within and between groups. The ``nparLD{''} package and Wilcoxon signed-rank test were used to analyze the data. BoNT-A reduced pain intensity (p< 0.0001) and increased pressure pain threshold (p< 0.0001) for up to 24 weeks compared to the placebo. No differences were found between BoNT-A and OA at the last follow-up. A transient decline in masticatory performance (p< 0.05) and muscle contraction (p< 0.0001), and a decrease in muscle thickness (p< 0.05) and coronoid and condylar process bone volume (p< 0.05) were found as dose-related adverse effects of BoNT-A. Regardless of the dose, BoNT-A was as effective as OA on MFP. Notwithstanding, due to BoNT-A dose-related adverse effects, we suggest the use of low doses of BoNT-A in MFP patients that do not benefit from conservative treatments. (AU)

• Processo FAPESP: 14/15863-7 - Comparação do grau de eficiência do tratamento convencional e do tratamento com TXB-A em portadores de disfunção temporomandibular miogênica e dor crônica
• Beneficiário: Celia Marisa Rizzatti Barbosa
• Modalidade de apoio: Auxílio à Pesquisa - Regular