Botulinum Toxin for the Treatment of Temporomandibular Disorders

2018 • Volume 12 • Issue 2

Natalia Alvarez-Pinzon; Eder Alberto Sigua-Rodriguez; Douglas Rangel Goulart; Sergio Olate; Gustavo Jacobucci Farah & Liogi Iwaki Filho



Temporomandibular Disorders (TMD) is a term that was used to describe a set of pathological conditions that affect temporomandibular joint (TMJ), muscles of mastication and associated structures. Epidemiological studies estimates that 40 % to 75 % of the adult population has at least one sign of TMD, such as joint noise and 33 % presented some symptom such as facial or joint pain. Botulinum toxin is a neurotoxin produced by the anaerobic bacterium Clostridium botulinum. There are two types of toxin (A and B) used in clinical practice that were approved by Food and Drug Administration in 1989 and 2000. These medications are in use to treat various diseases including muscle spasticity, dystonia, headache and myofascial pain. The mechanisms of action were suggested in the mid-1950s, this neurotoxin seems to have an action at cholinergic synapses, causing a block in the release of acetylcholine from the nerve terminals without altering the neural conduction of the electrical signals. The synthesis and storage of acetylcholine were preserved. Intramuscular injection in appropriate doses and location causes partial chemical denervation and decreased contracture, without causing complete paralysis of muscles. Due to this features, it has been considered an innovative and effective method to treat chronic pain associated with hyperactivity of masticatory muscles. The botulinum toxin type A appears to be an alternative method for pain control present in TMDs that have myogenic etiology. The authors recommend a correct diagnosis, since the indication of this type of treatment associated with an incorrect diagnosis leads to uncertain outcomes, creating false conclusions.

KEY WORDS: botulinum toxins, temporomandibular disorder, chronic pain.


How to cite this article

ALVAREZ-PINZON, N.; SIGUA-RODRIGUEZ, E. A.; GOULART, D. R.; OLATE, S.; FARAH, G. J.; IWAKI FILHO, L. Botulinum Toxin for the Treatment of Temporomandibular Disorders. Int. J. Odontostomatol.,12(2):103-109, 2018.


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