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Botulinum Toxin Therapy for Diseases in the Oral and Maxillofacial...
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Botulinum Toxin Therapy for Diseases in the Oral and Maxillofacial Regions

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 3249

Special Issue Editor

Dr. Kazuya Yoshida

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Guest Editor
Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto 612-8555, Japan
Interests: movement disorders; oromandibular dystonia; botulinum toxin therapy; orofacial pain; temporomandibular disorders; oral dyskinesia; neurophysiology; sleep apnea syndrome; oral appliance therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Botulinum toxin therapy can be indicated for various diseases of the oral and maxillofacial regions, including oromandibular dystonia, orolingual dyskinesia, trigeminal neuralgia, orofacial pain, temporomandibular joint dislocation, tremors, tics, functional involuntary movements, temporomandibular joint disorders, bruxism, sialorrhea, and Frey’s syndrome. If injections are performed carefully with an understanding of the local anatomy, botulinum toxin therapy has been shown to be effective with minimal severe side effects. Cooperation between medical and dental professionals is crucial for the diagnosis and treatment of these diseases. However, the number of diseases for which botulinum has been officially approved is limited in some countries. Although there are large differences depending on the disease, most of the results are based on open studies, and there are limited studies with high-quality evidence. In the future, it will be necessary to conduct research with a high level of evidence, either at multiple facilities or between medical and dental professionals and clinical trials, to obtain official approval for the use of botulinum toxin for the aforementioned diseases. Thus, the purpose of this Special Issue is to discuss the current achievements in botulinum toxin therapy for diseases of the oral and maxillofacial regions as well as future prospects from the perspective of experts in each field. I am pleased to request that you contribute original research or reviews concerning botulinum toxin therapy for oral and maxillofacial diseases. The research areas we will consider include neurology, otorhinolaryngology, neurosurgery, psychiatry, dermatology, oral and maxillofacial surgery, dentistry, and prosthodontics. I eagerly anticipate your contributions.

Dr. Kazuya Yoshida
Guest Editor

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Keywords

  • botulinum toxin therapy
  • movement disorders
  • oromandibular dystonia
  • trigeminal neuralgia
  • orofacial pain
  • temporomandibular disorders
  • sialorrhea
  • bruxism
  • tremor
  • tic

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Published Papers (3 papers)

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Research

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18 pages, 4890 KiB  
Article
Is There a Correlation Between Masticatory Muscle Thickness and Pain After Botulinum Toxin Injections in Myogenic TMD Patients?: A Pilot Study
by Hye-Ji Park, Hee-Jin Kim and Sung Ok Hong
Toxins 2025, 17(5), 220; https://doi.org/10.3390/toxins17050220 - 28 Apr 2025
Viewed by 148
Abstract
Botulinum toxin type A (BoNT-A), a potent neurotoxin, is increasingly used to treat myogenic temporomandibular disorders (TMDs); however, the interplay between muscle atrophy and pain relief remains incompletely understood. This pilot study investigated how masseter and temporalis muscle thickness and pain intensity change [...] Read more.
Botulinum toxin type A (BoNT-A), a potent neurotoxin, is increasingly used to treat myogenic temporomandibular disorders (TMDs); however, the interplay between muscle atrophy and pain relief remains incompletely understood. This pilot study investigated how masseter and temporalis muscle thickness and pain intensity change over 12 weeks following BoNT-A injections in 15 patients (mean age 51.42 years) with myogenic TMD. Muscle thickness was measured via ultrasonography across multiple anatomical positions under both clenching and resting conditions at baseline and at 2, 4, 8, and 12 weeks post-injection. Significant thinning of both muscles occurred within 2 weeks, lasting until 12 weeks, but became less pronounced after the first month. Pain intensity showed parallel decreases, most notably early on, but these reductions were not consistently statistically significant. Correlation analyses revealed no strong persistent association between muscle thickness and pain except for a moderately positive correlation in the anterior temporalis at two weeks (r = 0.61, p = 0.04). BoNT-A induces rapid masticatory muscle atrophy and modest pain relief; however, these outcomes do not coincide. Pain relief was observed earlier than the full development of muscle atrophy and should be considered during TMD pain management. Full article
(This article belongs to the Special Issue Botulinum Toxin Therapy for Diseases in the Oral and Maxillofacial Regions)
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Review

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19 pages, 362 KiB  
Review
The Role of Botulinum Toxin for Masseter Muscle Hypertrophy: A Comprehensive Review
by Martina Ferrillo, Eleonora Sommadossi, Loredana Raciti, Dario Calafiore, Kamal Mezian, Valeria Tarantino, Michele Vecchio, Umile Giuseppe Longo, Luigi Losco and Alessandro de Sire
Toxins 2025, 17(2), 91; https://doi.org/10.3390/toxins17020091 - 14 Feb 2025
Viewed by 1807
Abstract
Masticatory muscle hypertrophy (MMH) is a rare clinical phenomenon of uncertain etiology, characterized by a soft swelling near the angle of the jaw. This abnormal enlargement of the masseter muscle can alter the facial profile, leading to aesthetic concerns. Moreover, MMH may also [...] Read more.
Masticatory muscle hypertrophy (MMH) is a rare clinical phenomenon of uncertain etiology, characterized by a soft swelling near the angle of the jaw. This abnormal enlargement of the masseter muscle can alter the facial profile, leading to aesthetic concerns. Moreover, MMH may also have significant functional repercussions, including pain in the masseter region, often associated with temporomandibular disorders, fatigue, and discomfort during mastication. Non-conservative approaches offer an effective and minimally invasive solution by inducing localized muscle relaxation and reducing hypertrophy. Botulinum neurotoxin type A (BoNT/A) represents a therapeutic option for managing MMH, considering that injections can effectively reduce the masseter muscle volume, improving both facial aesthetics and related symptoms. Currently, the standard non-surgical management of MMH is BoNT/A injections, although consensus on the average dosage has not been definitely reached; on the other hand, there are data available in the literature about the injection technique of BoNT/A for lower face contouring. Therefore, the present comprehensive review aimed at exploring in detail the role of BoNT/A in the treatment of masseter muscle hypertrophy, describing its mechanism of action, the administration protocols, the clinical effects, and any side effects. Full article
(This article belongs to the Special Issue Botulinum Toxin Therapy for Diseases in the Oral and Maxillofacial Regions)

Other

Jump to: Research, Review

14 pages, 2413 KiB  
Systematic Review
Treatment with OnabotulinumtoxinA for Oromandibular Dystonia: A Systematic Review and Meta-Analysis
by Kazuya Yoshida and Ryuji Kaji
Toxins 2024, 16(12), 546; https://doi.org/10.3390/toxins16120546 - 16 Dec 2024
Viewed by 1328
Abstract
Oromandibular dystonia (OMD) is a focal dystonia characterized by contractions of the masticatory, lingual, and other muscles of the stomatognathic system. We conducted a systematic review and meta-analysis to elucidate the impact and safety of botulinum toxin in OMD. The eligibility criteria were [...] Read more.
Oromandibular dystonia (OMD) is a focal dystonia characterized by contractions of the masticatory, lingual, and other muscles of the stomatognathic system. We conducted a systematic review and meta-analysis to elucidate the impact and safety of botulinum toxin in OMD. The eligibility criteria were full-length original articles that provided data evaluating the efficacy and adverse effects of onabotulinumtoxinA injections in patients with OMD. PubMed and Embase were searched for articles published before 31 May 2023. We analyzed cases that showed a favorable response (>0% improvement), moderate or greater response (>50% improvement), and adverse effects. A fixed-model meta-analysis of 26 studies involving 1103 patients revealed that an overall favorable effect of onabotulinumtoxinA injection was observed in 96.2% (95% confidence interval [CI], 95–97.5%, p < 0.00001) of patients, with significant heterogeneity (p < 0.00001, I2 = 85%). A moderate response (>50% improvement) was observed in 88.9% of patients (95% CI, 87–90.8%, p < 0.00001) with significant heterogeneity (p < 0.00001, I2 = 85%). Adverse effects were detected in 17.8% of patients, and the most common event was dysphagia (10.1%). Our systematic review found that onabotulinumtoxinA injection was effective, with a low rate of side effects. Further randomized controlled trials are required to clarify the evidence-based efficacy and adverse effects. Full article
(This article belongs to the Special Issue Botulinum Toxin Therapy for Diseases in the Oral and Maxillofacial Regions)
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