Use of Botulinum Toxin In The Treatment of Temporomandibular Disorders

Abstract

Temporomandibular disorder (TMD) is a term used to describe disorders that involve the temporomandibular joint, the masticatory muscles and associated structures. Patients with TMD have symptoms such as tenderness and pain in the joints and masticatory muscles, limitation in mouth opening, and joint sounds. TMD treatment usually requires a multidisciplinary approach and reversible conservative treatment options should be the first choice. Botulinum toxin (BoNT) injection, which is one of these treatment options, is used in many areas of dentistry, as well as in various TMD treatments. BoNT is a neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction and inhibits contraction of the target muscle. In the treatment of TMD, BoNT is applied to reduce muscle tension that causes various temporomandibular diseases and symptoms. In this review, the place of BoNT injection in TMD treatment, its application technique and its effect on symptoms are evaluated in the light of literature.

Keywords

• Temporomandibular disorder
• Botulinum toxin
• Bruxism
• Orofacial pain
• Anterior disc dislocation

Temporomandibular Rahatsızlıkların Tedavisinde Botulinum Toksin Kullanımı

Abstract

Temporomandibular rahatsızlıklar (TMR), temporomandibular eklemler, çiğneme kasları ve tüm ilişkili dokuları kapsayan bir grup rahatsızlık olarak tanımlanmıştır. TMR’si olan hastalarda eklem ve çiğneme kaslarında hassasiyet ve ağrı, ağız açmada kısıtlılık, eklem sesleri gibi semptomlar görülür. TMR tedavisi genellikle multidisipliner yaklaşım gerektirir. Tedavide öncelik geri dönüşümsüz etkileri olmayan konservatif tedavi seçenekleri olmalıdır. Günümüzde bu tedavi seçeneklerinden biri olan Botulinum toksin (BoNT) uygulanması diş hekimliğinin birçok alanıyla birlikte çeşitli TMR'lerin tedavisinde de kullanılmaktadır. BoNT, nöromusküler kavşakta asetilkolin salınımını inhibe eden ve hedef kasta kontraksiyonu engelleyen bir nörotoksindir. TMR tedavisinde BoNT, çeşitli temporomandibular hastalık ve semptomlara yol açan kas gerginliğini azaltmak amacıyla uygulanmaktadır. Bu derlemede, BoNT’in TMR tedavisindeki yeri, uygulama tekniği ve semptomlar üzerindeki etkisi literatürdeki çalışmalar ışığında değerlendirilmektedir.

Keywords

• temporomandibular rahatsızlıklar
• Botulinum Toksin
• Bruksizm
• Orofasiyal ağrı
• Anterior disk dislokasyonu

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