title: Botulinum toxin injection for management of temporomandibular joint clicking.
abstract: The aim of the present study was to investigate the effect of botulinum toxin type A (BTX-A) injection in the lateral pterygoid (LP) muscle on temporomandibular joint (TMJ) clicking. The study enrolled seven patients with a total of 11 joints; all patients were stage I or II of Wilke's staging for internal derangement. BTX-A was injected in the ipsilateral LP muscle with electromyogram (EMG) guidance and the subjects were assessed for 4 months. Maximum inter-incisal opening, range of lateral movement, and the presence of a click were recorded throughout the follow-up period, and magnetic resonance imaging (MRI) was ordered at the end of the 4 months. The results showed that the decrease in inter-incisal opening and side to side movement immediately postoperative was statistically significant, while the difference by the end of the follow-up period was insignificant. MRI showed a marked improvement in disc position postoperatively. It may be concluded that BTX injection in the LP muscle leads to the disappearance of joint clicking clinically and a significant improvement in disc position as shown on MRI.
authors.affiliation: Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt. masa2502@gmail.com
authors.forename: A S
authors.initials: AS
authors.lastname: Emara
authors.forename: M I
authors.initials: MI
authors.lastname: Faramawey
authors.forename: M A
authors.initials: MA
authors.lastname: Hassaan
authors.forename: M M
authors.initials: MM
authors.lastname: Hakam
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004576:Electromyography; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D004204:Joint Dislocations / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D011626:Pterygoid Muscles; D016059:Range of Motion, Articular / Q000187:drug effects; D013016:Sound; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D018726:Anti-Dyskinesia Agents; D019274:Botulinum Toxins, Type A