DOI:

10.37988/1811-153X_2019_4_93

Application of botulinic toxin in treatment of an immovable displacement of a joint disk of a temp-jain jaw

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Authors

  • A.A. Ilyin 1, PhD in Medical Sciences, professor
  • T.A. Fazylova 1, orthodontist
  • V.N. Olesova 1, PhD in Medical Sciences, professor
  • E.E. Olesov 1, PhD in Medical Sciences, associate professor
  • E.A. Demchinsky 1, PhD in Medical Sciences, dentist
  • N.A. Uzunyan 1, PhD in Medical Sciences, associate professor
  • 1 Academy of Postgraduate Education at the Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia, 125371, Moscow, Russia

Abstract

Among the pathology of the temporomandibular joint (TMJ), non-guided articular displacement of the articular disc (NSSD) is particularly complex clinical manifestations, the severity of the course and always accompanied by myofascial pain disorders. Objective: to improve treatment outcomes for patients with TMJ and myofascial pain syndromes. Materials and methods. 38 patients were examined and treated with non-guided articular displacement of the TMJ and myofascial pain disorders. Of the additional research methods, CBCT, MRI, EMG were used. Phased treatment was carried out, including drug therapy, injections of botulinum toxin type A (BTA) in the actual chewing, temporal, lateral pterygoid muscles (LMW) bilaterally; reposition splint therapy; arthrocentesis with lavage of both joint spaces. Results. overall treatment efficacy was 97.4%. Of the 38 patients in 34 (89.5%), the treatment was carried out without arthrocentesis with full restoration of the range of motion of the lower jaw and the elimination of pain. Conclusions. An effective system has been developed for a phased integrated treatment of non-guided articular displacement of the articular disc of the TMJ; A new method of periarticular injection access to the coatings has been developed, which allows the administration of drugs into its upper and lower heads. The high efficiency of the use of BTA injections in the treatment of NSPD is due to the mandatory introduction of the drug into 3 muscles: the chewing, temporal and lateral pterygoids. In the treatment of NSPD, arthrocentesis is effective with lavage of the lower and upper articular spaces.

Key words:

non-guided displacement of the articular disc, temporomandibular joint, myofascial pain syndrome, botulinum toxin, arthrocentesis

For Citation

[1]
Ilyin A.A., Fazylova T.A., Olesova V.N., Olesov E.E., Demchinsky E.A., Uzunyan N.A. Application of botulinic toxin in treatment of an immovable displacement of a joint disk of a temp-jain jaw. Clinical Dentistry (Russia).  2019; 4 (92): 93—96. DOI: 10.37988/1811-153X_2019_4_93

References

  1. Сысолятин П.Г., Ильин А.А., Дергилев А.П. Классификация заболеваний и повреждений височно-нижнечелюстного сустава. - М.: Медицинская книга; Н. Новгород: НГМА, 2001. - 79 с.
  2. Schiffman E., Ohrbach R., Truelove E., Look J., Anderson G., Goulet J.P., List T., Svensson P., Gonzalez Y., Lobbezoo F., Michelotti A., Brooks S.L., Ceusters W., Drangsholt M., Ettlin D., Gaul C., Goldberg L.J., Haythornthwaite J.A., Hollender L., Jensen R., John M.T., De Laat A., de Leeuw R., Maixner W., van der Meulen M., Murray G.M., Nixdorf D.R., Palla S., Petersson A., Pionchon P., Smith B., Visscher C.M., Zakrzewska J., Dworkin S.F. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. - J Oral Facial Pain Headache. - 2014; 28 (1): 6-27.
  3. Доусон П.Е. Функциональная окклюзия: от височно-нижнечелюстного сустава до планирования улыбки. - М.: Практическая медицина, 2016. - 592 с.
  4. Жулев Е.Н., Вельмакина И.В. Изучение особенностей психоэмоционального статуса у лиц молодого возраста, имеющих ранние признаки синдрома мышечно-суставной дисфункции височно-нижнечелюстного сустава. - Фундаментальные исследования. - 2015; 1-7: 1354-7.
  5. Dimitroulis G. Management of temporomandibular joint disorders: A surgeon’s perspective. - Aust Dent J. - 2018; 63 Suppl 1: S79-S90.
  6. Орлова О.Р., Алексеева А.Ю., Мингазова Л.Р., Коновалава З.Н. Бруксизм как неврологическая проблема (обзор литературы). - Нервно-мышечные болезни. - 2018; 1: 20-7.
  7. Орлова О.Р., Коновалова З.Н., Алексеева А.Ю., Мингазова Л.Р., Сойхер М.И. Взаимосвязь бруксизма и болевой дисфункции височно-нижнечелюстного сустава. - Российский медицинский журнал. - 2017; 24: 1760-3.
  8. Pihut M., Ferendiuk E., Szewczyk M., Kasprzyk K., Wieckiewicz M. The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. - J Headache Pain. - 2016; 17: 29.
  9. Sunil Dutt C., Ramnani P., Thakur D., Pandit M. Botulinum toxin in the treatment of muscle specific oro-facial pain: a literature review. - J Maxillofac Oral Surg. - 2015; 14 (2): 171-5.
  10. Dym H., Bowler D., Zeidan J. Pharmacologic treatment for temporomandibular disorders. - Dent Clin North Am. - 2016; 60 (2): 367-79.DOI: 10.1016/j.cden.2015.11.012
  11. Ян Ч., Чжэн Ц., Лю С. Артроскопическая репозиция диска височно-нижнечелюстного сустава: часть III - подробное описание методики. - Альманах клинической медицины. - 2017; 5:460-5.
  12. Бекреев В.В. Диагностика и комплексное лечение заболеваний височно-нижнечелюстного сустава: дис. … д.м.н. - М., 2019. - 333 с.
  13. Епифанов С.А., Балин В.Н., Скуредин В.Д., Игнатьева А.Н. Хирургическое лечение больных с дислокацией суставного диска височно-нижнечелюстного сустава. - Вестник национального медико-хирургического центра им. Н.И. Пирогова. - 2015; 2: 47-9.
  14. Семкин В.А., Волков С.И. Заболевания височно-нижнечелюстного сустава. - М. : ГОЭТАР-Медиа, 2016. - 288 с.
  15. Адоньева А.В., Ильин А.А., Щелкунов К.С. Репозиционная сплинт-терапия в комплексном лечении вправляемого смещения суставного диска височно-нижнечелюстного сустава. - Медицина и образование в Сибири. - 2015; 2: 22.
  16. Ильин А.А., Адоньева А.В. Артроцентез височно-нижнечелюстного сустава. Обзор литературы. - Медицина и образование в Сибири. - 2014; 6: 36-7.
  17. Armijo-Olivo S., Pitance L., Singh V., Neto F., Thie N., Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. - Phys Ther. - 2016; 96 (1): 9-25.
  18. Sivri M.B., Ozkan Y., Pekiner F.N., Gocmen G. Comparison of ultrasound-guided and conventional arthrocentesis of the temporomandibular joint. - Br J Oral Maxillofac Surg. - 2016; 54 (6): 677-81.
  19. Connelly S.T., Myung J., Gupta R., Tartaglia G.M., Gizdulich A., Yang J., Silva R. Clinical outcomes of Botox injections for chronic temporomandibular disorders: do we understand how Botox works on muscle, pain, and the brain? - Int J Oral Maxillofac Surg. - 2017; 46 (3): 322-7.
  20. Chen Y.W., Chiu Y.W., Chen C.Y., Chuang S.K. Botulinum toxin therapy for temporomandibular joint disorders: a systematic review of randomized controlled trials. - Int J Oral Maxillofac Surg. - 2015; 44 (8): 1018-26.
  21. Mor N., Tang C., Blitzer A. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection. - Toxins (Basel). - 2015; 7 (8): 2791-800.
  22. Kumar S. The emerging role of botulinum toxin in the treatment of orofacial disorders: literature update. - Asian Journal of Pharmaceutical and Clinical Research. - 2017; 10 (9): 21-9.DOI: 10.22159/ajpcr.2017.v10i9.16914
  23. Синицина Т.М. Диагностика и лечение мышечно-суставных дисфункций височно-нижнечелюстных суставов и жевательных мышц: дис. … к.м.н. - СПб., 2016. - 106 с.
  24. Bogucki Z.A., Kownacka M. Clinical aspects of the use of botulinum toxin type A in the treatment of dysfunction of the masticatory system. - Adv Clin Exp Med. - 2016; 25 (3): 569-73.
  25. Pons M., Meyer C., Euvrard E., Weber E., Sigaux N., Louvrier A. MR-guided navigation for botulinum toxin injection in the lateral pterygoid muscle. First results in the treatment of temporomandibular joint disorders. - J Stomatol Oral Maxillofac Surg. - 2019; 120 (3): 188-195.

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Published on

December 1, 2019