Treatment of chronic myofascial pain syndrome associated with parafunctions by use of botulinum toxin type A

Abstract

Myofascial pain dysfunction syndrome (MPDS) of the temporomandibular joint (TMJ) as a psychophysiological disorder has been developed due to the hyperactivity of mastication muscles. Stress has probably induced parafunction such as bruxism and clenching. The term generally applied for muscle pain and occurred with palpation is “myofascial pain.” Diagnosing and explaining the pathology in terms of muscle pain is under research. Few treatment methods have been attained including education, self-care, physical therapy, intraoral appliance therapy, short-term pharmacotherapy, behavioral therapy, and relaxation techniques such as Botox injections on the masseter and temporalis muscles. The purpose of the study is to define the efficacy of the botulinum toxin type A in the chronic masticatory muscle-spasm treatment of elevators muscles to relief the orofacial pain by Helkimo index criteria (a clinical dysfunction index type) usage. The current study has been conducted in a clinical examination with 18 patients including 17 females and one male in with age range of 17-48 with MPDS by using of Helkimo index criteria. The local injection of botulinum toxin type A has constituted an in- novative and efficient treatment for chronic facial pain related to hyperactivity of the masticatory muscles. The painful symptoms might be improved in all samples with no reaction to conservative treatment methods and physical therapy. Also, Botox therapy has seemed beneficial in nocturnal bruxism treatment. Another study with more samples is recommended to confirm the outcome of this study.