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      Change of Distribution and Timing of Bite Force after Botulinum Toxin Type A Injection Evaluated by a Computerized Occlusion Analysis System

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          Abstract

          Purpose

          The aim of this study was to determine the force distribution and pattern of mastication after injection of botulinum toxin type A (BTX-A) into both masseter muscles. The hypothesis to be tested was that the difference between right and left balance of occlusal force diminishes over time following BTX-A injection.

          Materials and Methods

          Fifteen patients were submitted to BTX-A injection therapy for subjective masseter hypertrophy. A total of 25 U of BTX-A (50 U in total) was injected into two points located 1 cm apart at the center of the lower one-third of both masseter muscles. All patients were examined using the T-Scan occlusion analysis system before and 4, 8, 12, and 24 weeks after BTX-A injection.

          Results

          A significant change in force balance was found between the right and left sides over time and the difference between the two sides decreased with the time post-injection, reaching a minimum at 12 weeks. Comparison of the force balance between the anterior and posterior occlusions revealed no significant difference at any of the time points. The occlusion and disclusion times (right and left sides) did not differ significantly with time since BTX-A injection.

          Conclusion

          A decline in the difference in the clenching force between the left and right sides was found with increasing time up to 12 weeks following BTX-A injection.

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          Most cited references24

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          Management of Temporomandibular Disorders and Occlusion

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            The origin, structure, and pharmacological activity of botulinum toxin.

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              Botulinum A toxin effects on rat jaw muscle spindles.

              Botulinum A toxin (Botox) is used for the treatment of many muscular dystonias. However, the relief of the sustained and abnormal postures induced by Botox administration is not fully explained. In this work the possibility was considered that Botox can produce a block not only at the alpha motor endings, but also at the gamma motor endings, consequently reducing the spindle inflow to the alpha motoneurons, which have a great role in maintaining the tonic myotatic reflex. Jaw muscle spindle discharge was recorded before and after Botox injection in the deep masseter muscle. The drug consistently reduced the spindle afferent discharge. Such an effect is suggested to be direct on gamma endings as: i) muscle tension was not modified by Botox during the recording time; ii) saline administration never changed the spindle discharge. The Botox effect on muscle spindles suggests that the relief from dystonias could be due not only to a partial motor paralysis, but also to a decrease of the reflex muscular tone.
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                Author and article information

                Journal
                Yonsei Med J
                Yonsei Med. J
                YMJ
                Yonsei Medical Journal
                Yonsei University College of Medicine
                0513-5796
                1976-2437
                01 July 2014
                13 June 2014
                : 55
                : 4
                : 1123-1129
                Affiliations
                Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University, Seoul, Korea.
                Author notes
                Corresponding author: Dr. Hyung Joon Ahn, Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3112, Fax: 82-2-393-5673, hjahn@ 123456yuhs.ac
                Article
                10.3349/ymj.2014.55.4.1123
                4075376
                24954346
                df57f5cd-5892-4574-833d-838117d9fa63
                © Copyright: Yonsei University College of Medicine 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 September 2013
                : 22 November 2013
                : 22 November 2013
                Categories
                Original Article
                Rehabilitation

                Medicine
                botulinum toxin type a,bite force,dental occlusion,masseter muscle,mastication,time factors
                Medicine
                botulinum toxin type a, bite force, dental occlusion, masseter muscle, mastication, time factors

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