Factors Influencing the Effectiveness of Botulinum Toxin Therapy in Bruxism Management
2025
Azusa Furuhata | Kazuya Yoshida | Shiroh Isono
A total of 304 patients with bruxism (206 women, 98 men: mean age: 52.5 years) received 25 units of botulinum toxin injected into the bilateral masseter muscles: the changes in various clinical symptoms and their contributing factors were analyzed 2 months after treatment. The mean masseter muscle electromyographic amplitude (189 &mu:V) and maximal bite force (618.4 N) significantly decreased after botulinum toxin therapy compared to that at baseline (55.4 &mu:V, 527.3 N, respectively: p <: 0.001). Maximal mouth opening (44 mm), sleep quality (visual analog scale: 5.3), shoulder and neck stiffness (6.7), and headache (5.4) significantly improved after the injection (47.3 mm, 6.6, 4.7, and 2.6, respectively: p <: 0.001). Multivariate analysis revealed that the mean masseter electromyographic amplitude reduction rate was significantly affected by age, sex, and baseline amplitude (all p <: 0.001): the maximal bite force reduction rate was influenced by age (p <: 0.001), sex (p = 0.007), and baseline bite force (p = 0.008). Age, sex, and muscle activity may affect the therapeutic effects. A more effective outcome for bruxism can be achieved using a tailored approach involving dose adjustment, thereby preventing the side effects attributed to excessive dosage.
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