Comparison of the efficacy of occlusal splint and botulinum toxin therapies in patients with temporomandibular disorders with sleep bruxism

• Published in: Journal of orofacial orthopedics Vol. 85; no. Suppl 1; pp. 102 - 108
• Main Authors: Hosgor, Hatice, Altindis, Sezen, Sen, Esengul
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer Medizin 01.05.2024
• Subjects: Adult; Botulinum Toxins - therapeutic use; Botulinum Toxins, Type A - therapeutic use; Cohort Studies; Dentistry; Female; Humans; Male; Medicine; Middle Aged; Neuromuscular Agents - therapeutic use; Occlusal Splints; Oral and Maxillofacial Surgery; Original Article; Pain Measurement; Retrospective Studies; Sleep Bruxism - drug therapy; Sleep Bruxism - therapy; Temporomandibular Joint Disorders - drug therapy; Temporomandibular Joint Disorders - therapy; Treatment Outcome; Pain score; Maximale ununterstützte Mundöffnung; Craniomandibular disorders; Kiefergelenkstörungen; Schmerz-Score; Maximum unassisted mouth opening; Temporomandibular joint disorders; Orthotic devices; Kraniomandibuläre Dysfunktion; Orthetische Apparaturen
• DOI: 10.1007/s00056-023-00498-8
• ISSN: 1434-5293

Purpose This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB). Materials and methods A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes. Results A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values ( P  = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group ( P  = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment ( P  > 0.05). Conclusions Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain.