RESUMO
Introduction Botulinum toxin (Botox®) is considered an effective treatment for nocturnal bruxism when injected into the masseter muscle. Several studies have used different dosages of Botox for this purpose. The objective was to determine whether 10 MU of botulinum toxin type A (BTXA) injections into the masseter muscle could lessen nocturnal bruxism. Material and methods The sample consisted of 22 patients who suffered from pain in the masseter muscle and sensitivity of the teeth as a result of its wear due to nocturnal bruxism. The sample was randomly divided into two groups. The Botox (BO) group included 11 patients injected with 10 MU of BTXA, and the placebo (PL) group included 11 patients who received a sham intervention. Pain perception was assessed on visual analogue scales, whereas muscle activity was recorded by electromyography (EMG) to evaluate the effectiveness of this treatment protocol on nocturnal bruxism. Results A total of 20 patients entered data analysis with one dropout from each group. The differences in the perceived pain values between the BO and the PL groups before and after the injection were statistically significant (p<0.05). In the BO group, the changes in the perceived pain values over time were statistically significant (p<0.05). The pain levels significantly decreased at two weeks, one month, and three months following the injection. However, the levels increased again at the fourth- and sixth-month assessment times with statistically significant differences (p>0.05). The differences in the EMG recorded values were statistically significant between the two groups (p<0.05). Conclusions Within the current study's limitations, injecting 10 MU of BTXA into the masseter muscle reduced muscular activity in this muscle, resulting in decreased muscle spasms and pain symptoms associated with nocturnal bruxism for about three months before symptoms gradually relapsed.
RESUMO
Introduction Cystic lesions of the jaws and the impacted teeth are two of the most common cases that require surgical intervention in oral and maxillofacial surgery; however, surgeons also frequently use a traditional technique that involves the removal of the buccal bone plate. This study was conducted to compare the clinical and radiologic outcomes of the bone lid technique and the traditional technique. Methods This randomized controlled trial included 20 patients who were randomly divided into two groups (n = 10 each): the T group, in which the lesions were accessed using the traditional technique with classical rotating instruments, and the BL group, in which the lesions were accessed with the bone lid technique performed using a piezoelectric device, with repositioning of the buccal bone plate. Operative time, pain, edema, inferior alveolar nerve injury, and bone defect healing were measured during clinical and radiological follow-ups at 24 h, 72 h, one week, one month, and six months after the surgery. Results Normal soft tissue and bone healing were observed in all cases except one case in the BL group. The T group had a shorter mean operative time than the BL group. In terms of pain, edema, and inferior alveolar nerve injury, the groups did not differ statistically significantly. The percentage of bone defect healing was significantly greater in the BL group than in the T group after six months of follow-up. Conclusion The bone lid technique performed using a piezoelectric device was effective and safe for managing lesions in the posterior mandibular region and was not associated with increased postoperative complications. The disadvantages of this technique include a longer operative time and the need for fixation tools in some cases. In contrast, this technique outperforms the traditional technique in terms of reducing bone loss and improving the healing of bone defects.
