Botulinum Toxin Type A as Preoperative Treatment for Immediately Loaded Dental Implants Placed in Fresh Extraction Sockets for Full-Arch Restoration of Patients With Bruxism.
OBJECTIVE
The aim of the present report was to describe the use of Botulinum toxin type A as preoperative treatment for immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration of patients with bruxism.


METHODS
Patients with bruxism who were scheduled to receive immediately loaded full-arch implant supported fixed restorations were included in this retrospective clinical report. To reduce the occlusal forces applied in patients with bruxism, Botulinum toxin type A was introduced prior to the implant placement procedure. Patients were followed and implant survival as well as peri-implant bone level was assessed in each periodic follow-up visit. Adverse effects were also recorded. A control group with no use of Botulinum toxin was evaluated as well.


RESULTS
A total of 26 patients (13 test and 13 control), with bruxism, aged 59.15 ± 11.43 years on average were included in this retrospective report and received immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration. The test group treatment preceded by Botulinum toxin type A injection. Maxillary arches were supported by 8 to 10 implants while the mandibular arch was supported by 6 implants. All surgeries went uneventfully and no adverse effects were observed. The average follow-up time was 32.5 ± 10.4 months (range, 18-51). In the test group, no implant failures were recorded. One patient presented with 1 to 2 mm bone loss around 4 of the implants; the other implants presented with stable bone level. In the control group 1 patient lost 2 implants and another demonstrated 2 mm bone loss around 3 of the implants.


CONCLUSIONS
The preoperative use of Botulinum toxin in patients with bruxism undergoing full-arch rehabilitation using immediately loaded dental implants placed in fresh extraction sockets seems to be a technique that deserves attention. Further long-term, large-scale randomized clinical trials will help to determine the additional benefit of this suggested treatment modality.
*Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel†Department of Health Sciences 'A. Avogadro,' University of Eastern Piedmont, Novara, Italy‡Private Practice, Kfar Haim§Private Practice, Herzliya, Israel||Department of Oral Implantology, Istanbul University Faculty of Dentistry, Capa Istanbul, Turkey¶Division of Periodontology, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada.
Eitan
E
Mijiritsky
Carmen
C
Mortellaro
Omri
O
Rudberg
Miri
M
Fahn
Cansu
C
Basegmez
Liran
L
Levin
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002012:Bruxism / Q000601:surgery*; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D012189:Retrospective Studies; D014081:Tooth Extraction; D020390:Tooth Socket / Q000187:drug effects*
D019274:Botulinum Toxins, Type A