Clinical investigation of botulinum toxin (prabotulinumtoxin A) for bruxism related to masseter muscle hypertrophy: A prospective study.

Abstract

This study aims to confirm the effectiveness and safety of a prabotulinumtoxin type A (praBTX-A) injection in patients with bruxism and masseter hypertrophy. The study included patients who ground or clenched their teeth while sleeping and had computed tomography (CT) scans that showed a maximum thickness of the masseter muscle of 15 mm or more. The praBTX-A was administered bilaterally into the masseter muscles; 15 U/side for group 1, 25 U/side for group 2, and 35 U/side for group 3. CT scans and bruxism questionnaires were conducted before and eight weeks after the injection. Thirty-seven patients were enrolled, but three dropped out due to loss of follow-up. After injection, masseter thickness decreased to 15.1 ± 2.0 mm for group 1, 14.3 ± 2.9 mm for group 2, and 13.4 ± 1.8 mm for group 3 (p = 0.043). Group 3 showed a statistically significant lower masseter thickness compared to group 1 (p = 0.039). Both subjective and objective frequencies of bruxism decreased for all groups, but there were no significant differences in either subjective (p = 0.396) or objective frequencies (p = 0.87) between the groups after the injection. The results of this study suggest that praBTX-A injection is a safe and effective treatment for bruxism and masseter hypertrophy. A dosage of 35 IU/side can effectively decrease masseter thickness and relieve bruxism symptoms. Even the minimum dosage of 15 IU/side can contribute to improvements in bruxism symptoms. This investigation provides valuable information for managing bruxism that is associated with hypertrophic masseter muscles.

• Authors: Bok Ki Jung, Hojin Park, Young Woo Cheon, In Sik Yun, Jong-Woo Choi, Han Jo Kim, Mu Young Lee, Byeong Su Kang, Tae Jo Kang
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 51 Issue 5 Pg. 332-337 (May 2023) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 37353404 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• prabotulinumtoxin A
• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Humans
• Masseter Muscle (diagnostic imaging)
• Neuromuscular Agents (therapeutic use)
• Bruxism (complications, drug therapy)
• Prospective Studies
• Injections, Intramuscular
• Botulinum Toxins, Type A (therapeutic use)
• Hypertrophy (drug therapy)