title: Botulinum toxin as a therapeutic agent to prevent relapse in deep bite patients.
abstract: BACKGROUND
  The etiology of deep bite is multifactorial. One of the causes is increased muscular activity. This makes the treatment of deep bite malocclusions difficult and often results in relapse in many cases. In this work we compared patients with surgical orthognathic treatment only and surgical orthognathic treatment with additional injections of botulinum toxin after mandibular advancement for class II division 2 malocclusion.
  
  
  METHODS
  This is a prospective study. Adult patients were assessed pretreatment (T1), posttreatment (T2), and long-term after 1 year (T3). In total, 32 patients (mean age, 30.7 years; 23 women and 9 men) reached the study end point (T3); 24 patients were treated without botulinum toxin and 8 patients received preoperative injections of botulinum toxin.
  
  
  RESULTS
  Significant differences between both groups were observed, with a more stable result for the experimental group treated with botulinum toxin.
  
  
  CONCLUSIONS
  In a selective group of adult patients with a class II division II incisor relationship and with a class II skeletal base, botulinum toxin injections can effectively prevent relapse. This may present an alternative to a conventional myotomy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany. Electronic address: th.mucke@gmx.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Löffel
authors.affiliation: Leeds Teaching Hospitals and St James Institute of Oncology, Leeds General Infirmary, LS1 3EX, UK.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Kanatas
authors.affiliation: Leeds Teaching Hospitals and St James Institute of Oncology, Leeds General Infirmary, LS1 3EX, UK.
authors.forename: Sandy
authors.initials: S
authors.lastname: Karnezi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medizinische Hochschule Hannover, Germany.
authors.forename: Majeed
authors.initials: M
authors.lastname: Rana
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fichter
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Haarmann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany.
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Germany.
authors.forename: Denys John
authors.initials: DJ
authors.lastname: Loeffelbein
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D019186:Mandibular Advancement; D009498:Neurotoxins / Q000627:therapeutic use*; D010027:Osteotomy; D057887:Overbite / Q000628:therapy*; D011446:Prospective Studies; D055502:Secondary Prevention
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins
keywords: Botulinum toxin; Cephalometry; Class II division 2 malocclusion; Deep bite; Muscular paralysis; Relapse; Stability