Clinical use of botulinum toxins in oral and maxillofacial surgery

Abstract

Botulinum toxin (BTX), widely recognized as Botox, is generated by the gram-positive anaerobic bacterium Clostridium botulinum. The administration of BTX toxin has become one of the most prevalent cosmetic procedures worldwide. Over the past three decades, the clinical applications of BTX have expanded markedly, with numerous novel indications emerging. Primarily, botulinum toxin A (BTX-A) has been employed in the management of temporomandibular joint disorders (TMD) and in addressing the hypertrophy and hyperactivity of masticatory muscles, thereby facilitating pain relief and functional recovery following dental and oral-maxillofacial surgical interventions. Moreover, BTA is extensively utilized for cosmetic purposes, including the reduction of facial wrinkles and asymmetries. Although the therapeutic effects of BTA are temporary and generally considered safe, a comprehensive understanding of the relevant anatomical structures, as well as the potential systemic and local adverse effects associated with its facial applications, is essential. This article presents a thorough literature review detailing the historical development of BTX, its structural characteristics and mechanisms of action, available market formulations, guidelines for dilution and storage, toxicity considerations, indications and contraindications, the potential for resistance development, and its applications in dentistry and oral-maxillofacial surgery, accompanied by a discussion of associated side effects.

Keywords

• botulinum toxin
• dentistry
• oral and maxillofacial surgery

Oral ve Maksillofasiyal Cerrahide Botulinum Toksinlerin Kullanımı

Abstract

Botulinum toksini (BTX), yaygın olarak Botox olarak bilinir, gram-pozitif anaerobik bakteri Clostridium botulinum’dan üretilir. Botulinum toksini enjeksiyonları, dünya genelinde en yaygın uygulanan kozmetik prosedürlerden biridir. Son otuz yılda, Botulinum toksininin klinik uygulamaları önemli ölçüde genişlemiş ve birçok yeni alan bildirilmiştir. Öncelikle, botulinum toksini A, temporomandibular eklem bozukluklarının (TME) yönetiminde ve çiğneme kaslarının hipertrofisi ve hiperaktivitesinin tedavisinde kullanılmış, dental ve oral-maxillofasiyal cerrahi sonrası ağrı hafifletme ve fonksiyonel iyileşme sağlamak için terapötik bir müdahale olarak hizmet etmiştir. Ayrıca yüz kırışıklıklarının ve asimetrilerin azaltılması gibi kozmetik amaçlarla yaygın bir şekilde kullanılmaktadır. Botulinum toksinin terapötik etkileri geçici ve genel olarak güvenli olarak kabul edilse de, bu ajanın yüz uygulamaları ile ilişkili potansiyel sistemik ve lokal yan etkilerinin bilinmesi, ilgili anatomik yapılar hakkında kapsamlı bir bilgiye sahip olunması önemlidir. Bu makale, botulinum toksininin tarihi gelişimi, yapısal özellikleri ve etki mekanizması, mevcut formülasyonları, seyreltme ve depolama yöntemleri, toksisitesi, endikasyon ve kontraendikasyonları ile diş hekimliği ve oral-maxillofasiyal cerrahide uygulama alanları ve yan etkileri hakkında kapsamlı bir literatür incelemesi sunmaktadır.

Keywords

• botulinum toksini
• diş hekimliği
• ağız diş ve çene cerrahisi

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