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Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation

 Young Joo Shim  ;  Moon Kyu Lee  ;  Takafumi Kato  ;  Hyung Uk Park  ;  Kyoung Heo  ;  Seong Taek Kim 
 JOURNAL OF CLINICAL SLEEP MEDICINE, Vol.10(3) : 291-298, 2014 
Journal Title
Issue Date
Adult ; Botulinum Toxins, Type A/administration & dosage ; Botulinum Toxins, Type A/therapeutic use* ; Electromyography ; Female ; Humans ; Injections, Intramuscular ; Male ; Masseter Muscle/drug effects ; Masseter Muscle/physiology ; Masticatory Muscles/drug effects ; Masticatory Muscles/physiology* ; Movement/drug effects ; Movement/physiology ; Polysomnography ; Sleep Bruxism/drug therapy* ; Temporal Muscle/drug effects ; Temporal Muscle/physiology ; Video Recording ; Young Adult
Sleep bruxism ; botulinum toxin ; jaw motor activity ; masticatory muscle pain ; polysomnography ; rhythmic masticatory muscle activity
STUDY OBJECTIVES: To investigate the effects of botulinum toxin type A (BoNT-A) injection on jaw motor episodes during sleep in patients with or without orofacial pain who did not respond to oral splint treatment. METHODS: Twenty subjects with a clinical diagnosis of SB completed this study. Ten subjects received bilateral BoNT-A injections (25 U per muscle) into the masseter muscles only (group A), and the other 10 received the injections into both the masseter and temporalis muscles (group B). Video-polysomnographic (vPSG) recordings were made before and at 4 weeks after injection. Rhythmic masticatory muscle activity (RMMA) and orofacial activity (OFA) were scored and analyzed for several parameters (e.g., frequency of episodes, bursts per episode, episode duration). The peak amplitude of electromyographic (EMG) activity in the two muscles was also measured. RESULTS: BoNT-A injection did not reduce the frequency, number of bursts, or duration for RMMA episodes in the two groups. The injection decreased the peak amplitude of EMG burst of RMMA episodes in the injected muscles (p < 0.001, repeated measure ANOVA) in both groups. At 4 weeks after injection, 9 subjects self-reported reduction of tooth grinding and 18 subjects self-reported reduction of morning jaw stiffness. CONCLUSIONS: A single BoNT-A injection is an effective strategy for controlling SB for at least a month. It reduces the intensity rather than the generation of the contraction in jaw-closing muscles. Future investigations on the efficacy and safety in larger samples over a longer follow-up period are needed before establishing management strategies for SB with BoNT-A.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seong Taek(김성택)
Heo, Kyoung(허경)
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