Is Botulinum Toxin More Effective than Occlusal Device for the Treatment of Temporomandibular Dysfunction? A Systematic Review
DOI:
https://doi.org/10.17921/2447-8938.2024v26n4p182-188Resumo
Abstract
Temporomandibular disorders (TMDs) can cause muscular, skeletal, or mixed changes, and their treatment includes the use of occlusal devices (ODs). However, the literature shows that the use of botulinum toxin (BTX) can be effective for this purpose. Therefore, the aim of this study was to perform a systematic review to answer the following question: "Is botulinum toxin (BTX) more effective than occlusal devices (OD) for the treatment of temporomandibular disorders (TMD)?”. The methodology was started following the PRISMA guidelines, and this project was registered with PROSPERO (CRD42022330701). A search of the Embase, PubMed, Scopus, Science Direct, and Lilacs databases was conducted on April 28th, 2022. Eligibility criteria included randomized and non-randomized in vivo experimental clinical trials comparing the effects of BTX and DO on TMD patients. Of the 447 results found, 10 studies were selected for full-text reading, and 6 were included in this review. Both treatments were effective in relieving the painful symptoms of TMD and orofacial pain. BTX had advantages such as increased mouth opening and range of motion; however, it had time-dependent efficacy and could cause side effects. In conclusion, BTX has advantages and is an effective therapy for TMD; however, due to its short-term effects and side effects, both treatments are considered to have similar efficacy.
Keywords: Temporomandibular Disorders. Occlusal Devices. Botox. Botulinum Toxin. Myofascial Pain.
Resumo
As disfunções temporomandibulares (DTM) podem ocasionar alterações musculatórias, esqueléticas ou mistas e seu tratamento inclui o uso de dispositivos oclusais (DO). No entanto, a literatura aponta que o uso da toxina botulínica (BTX) pode ser eficaz para esta finalidade. Assim, o objetivo desse estudo foi realizar uma revisão sistemática para responder a seguinte pergunta: "A toxina botulínica (BTX) é mais eficaz do que dispositivo oclusal (DO) para o tratamento das DTMs?". Iniciou-se a metodologia, seguindo-se as diretrizes PRISMA e registrou-se este projeto no PROSPERO (CRD42022330701). Foi realizada uma busca nas bases de dados Embase, PubMed, Scopus, Science Direct e Lilacs em 28 de abril de 2022. Os critérios de elegibilidade incluíram ensaios clínicos experimentais in vivo randomizados e não randomizados que compararam os efeitos da BTX e dos DO em pacientes com DTM. Dos 447 resultados encontrados, 10 estudos foram selecionados para leitura do texto completo e 6 foram incluídos nesta revisão. Ambos os tratamentos foram eficazes no alívio dos sintomas dolorosos da DTM e da dor orofacial. A BTX apresentou vantagens como o aumento da abertura bucal e da amplitude de movimento, entretanto, apresentou eficáciatempo-dose-dependente e pode causar efeitos colaterais. Em conclusão, a BTX apresenta vantagens e é uma terapia eficiente para a DTM, entretanto, devido ao seu efeito de curto prazo e aos efeitos colaterais, considera-se que ambos os tratamentos apresentam eficácia semelhante.
Palavras-chave: Desordens Temporomandibulares. Dispositivos Oclusais. Botox. Toxina Botulínica. Dor Miofascial.
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