Effects of Botulinum Toxin Type A Injection in Patients with Bruxism and Masseter Muscle Hypertrophy

ABSTRACT Objective: The aim of this study was to evaluate the efficacy of botulinum toxin type A injection on the severity and incidents of bruxism and joint noise and for pain in patients during the manage- ment of bruxism and masseter muscle hypertrophy. Methods: Sixteen adults who had bruxism and bilateral masseter muscle hypertrophy were included in this study. One-session 30 U botulinum toxin type A injection was performed. Maximum interincisal mouth opening, visual analog scale evaluations, and severity and incident of bruxism were recorded at 3 times: baseline and 1 month and 8 months after the injection. Patient satisfaction was assessed only at 8 months after the injection. Results: Significant decreases were observed in pain complaints, restriction in mouth opening, and severity of bruxism at 1 month and 8 months. Bite force decreased significantly at 1 month, but it returned to baseline levels at 8 months. Self-perceived pathologic sound decreased significantly at 8 months. No significant change was observed in painless maximum interincisal mouth opening and mastication efficiency at 1 month and 8 months. Patient satisfaction was good at 8 months. Conclusion: Botulinum toxin type A injection lessened severity and incidents of bruxism and reduced joint noise and pain in patients with bruxism and masseter muscle hypertrophy, and botulinum toxin type A injection produced greater patient satisfaction. Keywords: Botulinum toxin Type A, bruxism, masseter muscle hypertrophy ÖZ Amaç: Bu çalışmanın amacı; bruksizm ve masseter kas hipertrofisi tedavisi gören hastalarda Botulinum Toksin Tip A enjeksiyonunun bruksizm şiddeti ve sıklığı ile eklem ağrısı ve sesi üzerin- deki etkinliğinin incelenmesidir. Yöntemler: Bu çalışma bruksizm ve çift taraflı masseter kas hipertrofisi olan 16 erişkin hastayı içermektedir. Hastalara 30 U Botulinum Toksin Tip A enjeksiyonu yapılmıştır. Maksimum ağız açıklığı miktarı, görsel analog skala incelemeleri ile bruksizm şiddeti ve sıklığı 3 farklı zamanda kayıt edilmiştir: Tedavi başında, enjeksiyondan 1 ay sonra ve enjeksiyondan 8 ay sonra. Hasta memnuniyeti ise sadece enjeksiyondan 8 ay sonra değerlendirilmiştir. Bulgular: Ağrı şikâyetleri, ağız açmadaki kısıtlılık ve bruksizmin şiddetinde tedavinin 1. ve 8. aylarında önemli azalmalar gözlemlenmiştir. Isırma kuvveti tedavinin 1. ayında önemli şekilde azalmış fakat tedavinin 8 ayında tedavi başlangıcındaki seviyelere geri dönmüştür. Bireysel olarak algılanan patolojik eklem sesi tedavinin 8. ayında önemli şekilde azalmıştır. Ağrısız maksimum ağız açıklığı ve çiğneme etkinliğinde tedavinin 1. ve 8. aylarında önemli değişimler gözlemlenmemiştir. Tedavinin 8. ayındaki hasta memnuniyet seviyesinin iyi olduğu görülmüştür. Sonuç: Bruksizm ve masseter kas hipertrofisi olan hastalarda; Botulinum Toksin Tip A enjeksiyonu bruksizm şiddeti ve sıklığı ile eklem ağrısı ve sesini azalmıştır ve Botulinum Toksin Tip A enjeksi- yonu yüksek oranda hasta memnuniyeti oluşturmuştur. Anahtar Kelimeler: Botulinum toksin tip A, bruksizm, masseter kas hipertrofisi

Keywords:

Botulinum toxin Type A, bruxism masseter muscle hypertrophy,

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