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

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 6­month 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.

Assessing change in functional outcomes and quality of life in myogenic temporomandibular disorders undergoing botulinum toxin injection: A before and after comparison.

PURPOSE: This prospective study aimed to evaluate the changes in functional outcomes and quality of life after the injection of botulinum toxin (BTX) into the masticatory muscles for the management of myogenic temporomandibular disorders (TMDs). MATERIALS AND METHODS: This study was conducted with 45 individuals who presented with clinically myogenic TMDs according to the Diagnostic Criteria for Temporomandibular Disorders. All patients received BTX injections in the temporalis and masseter muscles. The Oral Health Impact Profile-Temporomandibular Dysfunction (OHIP-TMD) questionnaire was used to evaluate the effects of treatment on quality of life. The OHIP-TMD, visual analogue scale (VAS), and maximum mouth opening (MMO) scores before and 3 months after BTX injection were evaluated. RESULTS: The preoperative and postoperative assessments revealed a statistically significant reduction (p ≤ 0.001) in the average overall OHIP-TMD scores. A significant increase in the MMO scores and a significant decrease in the VAS scores were observed (p < 0.001). CONCLUSIONS: The injection of BTX into the masticatory muscles is beneficial for improving the clinical and quality of life parameters in the management of myogenic TMD.

Peripheral Dentinogenic Ghost Cell Tumor of the Maxilla.

ABSTRACT: Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic tumor, representing 1.9% to 2.1% of all odontogenic tumors. The main microscopic features of DGCT are an ameloblastoma-like odontogenic epithelial proliferation with sheets of ghost cells and dentinoid material formation. The peripheral variant of this clinical rarity, which represents a less aggressive behavior than central lesions, mostly affects the anterior region of both jaws. In this case report, the authors present a DGCT that was observed in the maxillary posterior region in a 59-year-old female patient. The patient presented with pain and nodular swelling in the right maxillary molar region, which extended from the buccal vestibule to the edentulous area. Additionally, there was a destruction of the underlying bone, as seen radiographically. This case report includes the clinical, radiological, and histopathological features of the lesion, which was diagnosed as a peripheral DGCT without any evidence of recurrence in the 2 years after excision.

Excision of Rare Intraosseous Traumatic Neuroma of the Mandible.

Traumatic neuroma is a non-neoplastic proliferative disorder of the nerve sheath in response to injury or surgery. Traumatic neuroma most frequently occurs in soft tissues and intraosseous involvement is uncommon. In this paper, we present a rare case of intraosseous traumatic neuroma of the inferior alveolar nerve leading to pain and paresthesia of the lower lip on the left side.

Efficacy of botulinum toxin in the management of temporomandibular myofascial pain and sleep bruxism.

OBJECTIVES: : This study sought to evaluate the efficacy of injecting botulinum toxin into the masseter and temporal muscles in patients with temporomandibular myofascial pain and sleep bruxism. MATERIALS AND METHODS: The study was conducted based on a clinical record review of 44 patients (36 females and eight males; mean age, 35.70±12.66 years). Patients who underwent the injection of botulinum toxin into the masseter and temporal muscles for the management of temporomandibular myofascial pain and sleep bruxism were included in the study. Patients were diagnosed based on the Diagnostic Criteria for Temporomandibular Disorders. Sleep bruxism was diagnosed according to the criteria defined by the American Academy of Sleep Medicine. The values of the visual analogue scale (VAS) and range of jaw motion, including unassisted maximum mouth opening (MMO), protrusion, and right and left laterotrusion, were observed preoperatively and postoperatively at one-, three-, and six-month follow-up visits. RESULTS: MMO, movements of the right and the left laterotrusion, and protrusion increased significantly (P<0.05), while VAS ratings decreased significantly at the three follow-up points relative to baseline values (P<0.05). CONCLUSION: Botulinum toxin is an effective treatment for patients with temporomandibular myofascial pain and sleep bruxism.