title: The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.
abstract: BACKGROUND
  Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.
  
  
  METHODS
  This prospective outcome study consisted of 42 subjects of both genders aged 19-48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test (p ≤ 0,005).
  
  
  RESULTS
  The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections (p = 0,000).
  
  
  CONCLUSIONS
  The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.
authors.affiliation: Department of Dental Prosthetics, Jagiellonian University in Krakow, College of Medicine, Institute of Dentistry, 4 Montelupich St., 31-155, Krakow, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Pihut
authors.affiliation: Department of Dental Prosthetics, Jagiellonian University in Krakow, College of Medicine, Institute of Dentistry, 4 Montelupich St., 31-155, Krakow, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Ferendiuk
authors.affiliation: Department of Dental Prosthetics, Jagiellonian University in Krakow, College of Medicine, Institute of Dentistry, 4 Montelupich St., 31-155, Krakow, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Szewczyk
authors.affiliation: Department of Neurology, Jagiellonian University in Krakow, College of Medicine, 3 Botaniczna St., 31-503, Krakow, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kasprzyk
authors.affiliation: Department of Prosthetic Dentistry, Faculty of Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425, Wroclaw, Poland. m.wieckiewicz@onet.pl.
authors.forename: Mieszko
authors.initials: M
authors.lastname: Wieckiewicz
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008406:Masseter Muscle / Q000187:drug effects; D008875:Middle Aged; D063806:Myalgia / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D010147:Pain Measurement; D011446:Prospective Studies; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000188:drug therapy*; D018781:Tension-Type Headache / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; Masseter muscle pain; Temporomandibular joint dysfunction; Tension-type headache