Robert Delcanho, Matteo Val, Luca Guarda Nardini, Daniele Manfredini
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引用次数: 14
Abstract
Aims: To systematically review the scientific literature for evidence concerning the clinical use of botulinum toxin (BTX) for the management of various temporomandibular disorders (TMDs).
Methods: A comprehensive literature search was conducted in the Medline, Web of Science, and Cochrane Library databases to find randomized clinical trials (RCT) published between 2000 and the end of April 2021 investigating the use of BTX to treat TMDs. The selected articles were reviewed and tabulated according to the PICO (patients/problem/population, intervention, comparison, outcome) format.
Results: A total of 24 RCTs were selected. Nine articles used BTX injections to treat myofascial pain, 4 to treat temporomandibular joint (TMJ) articular TMDs, 8 for the management of bruxism, and 3 to treat masseter hypertrophy. A total of 411 patients were treated by injection of BTX. Wide variability was found in the methods of injection and in the doses injected. Many trials concluded superiority of BTX injections over placebo for reducing TMD pain levels and improving maximum mouth opening; however, this was not universal.
Conclusion: There is good scientific evidence to support the use of BTX injections for treatment of masseter hypertrophy and equivocal evidence for myogenous TMDs, but very little for TMJ articular disorders. Studies with improved methodologic design are needed to gain better insight into the utility and effectiveness of BTX injections for treating both myogenous and TMJ articular TMDs and to establish suitable protocols for treating different TMDs.
目的:系统地回顾有关肉毒毒素(BTX)治疗各种颞下颌疾病(TMDs)的临床应用的科学文献。方法:在Medline、Web of Science和Cochrane Library数据库中进行全面的文献检索，查找2000年至2021年4月底发表的调查使用BTX治疗tmd的随机临床试验(RCT)。根据PICO(患者/问题/人群，干预，比较，结果)格式对选定的文章进行审查和制表。结果:共入选24项rct。9篇文章使用BTX注射治疗肌筋膜疼痛，4篇文章用于治疗颞下颌关节(TMJ)关节TMDs, 8篇用于治疗磨牙症，3篇用于治疗咬肌肥大。共411例患者接受BTX注射治疗。在注射方法和注射剂量方面存在很大的差异。许多试验得出BTX注射优于安慰剂在减少TMD疼痛水平和提高最大张嘴;然而，这并不是普遍现象。结论:有很好的科学证据支持BTX注射剂治疗咬肌肥大，对肌源性TMDs的证据模棱两可，但对TMJ关节疾病的证据很少。需要改进方法学设计的研究，以更好地了解BTX注射治疗肌源性和TMJ关节TMDs的效用和有效性，并建立治疗不同TMDs的合适方案。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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