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Botulinum Toxin Paves the Way for the Treatment of Functional Lower Urinary Tract Dysfunction
Open AccessArticle

Efficacy and Safety of Botulinum Toxin Type A on Persistent Myofascial Pain: A Randomized Clinical Trial

1
Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil
2
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil
3
Department of Dentistry, State University of Ponta Grossa, Paraná 84030-900, Brazil
4
Department of Dentistry, University of Siena, 53100 Siena, Italy
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(6), 395; https://doi.org/10.3390/toxins12060395
Received: 18 May 2020 / Revised: 4 June 2020 / Accepted: 7 June 2020 / Published: 15 June 2020
(This article belongs to the Section Bacterial Toxins)
This study assessed the safety and efficacy of three different doses of BoNT-A for persistent myofascial pain (MFP). One hundred female subjects were randomly assigned into five groups (n = 20): oral appliance (OA), saline solution (SS) and three BoNT-A groups with different doses. Pain intensity and pressure pain threshold were evaluated up to 24 weeks after treatment. Adverse effects related to muscle contraction, masticatory performance, muscle thickness and mandibular bone volume were also assessed. Changes over time were compared within and between groups. The “nparLD” package and Wilcoxon signed-rank test were used to analyze the data. BoNT-A reduced pain intensity (p < 0.0001) and increased pressure pain threshold (p < 0.0001) for up to 24 weeks compared to the placebo. No differences were found between BoNT-A and OA at the last follow-up. A transient decline in masticatory performance (p < 0.05) and muscle contraction (p < 0.0001), and a decrease in muscle thickness (p < 0.05) and coronoid and condylar process bone volume (p < 0.05) were found as dose-related adverse effects of BoNT-A. Regardless of the dose, BoNT-A was as effective as OA on MFP. Notwithstanding, due to BoNT-A dose-related adverse effects, we suggest the use of low doses of BoNT-A in MFP patients that do not benefit from conservative treatments. View Full-Text
Keywords: temporomandibular disorders; myofascial pain; botulinum toxin type A; bone loss; chronic pain temporomandibular disorders; myofascial pain; botulinum toxin type A; bone loss; chronic pain
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De la Torre Canales, G.; Alvarez-Pinzon, N.; Muñoz-Lora, V.R.M.; Vieira Peroni, L.; Farias Gomes, A.; Sánchez-Ayala, A.; Haiter-Neto, F.; Manfredini, D.; Rizzatti-Barbosa, C.M. Efficacy and Safety of Botulinum Toxin Type A on Persistent Myofascial Pain: A Randomized Clinical Trial. Toxins 2020, 12, 395.

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