Bibliometric Analysis of Botulinum Toxin and Bruxism: Impact, Visualization, and Collaborative Networks.

AIM: To analyze the scientific production related to the use of botulinum toxin (BTX-A) in the management of bruxism and evaluate its scope, impact, networks, and new research trends. MATERIALS AND METHODS: A descriptive and retrospective study of publications indexed in Scopus from January 2018 to May 2024 was conducted. The bibliometric indicators evaluated were a number of publications, citations, h-index, SCImago Journal Rank 2022, CiteScore 2022, Lotka's Law, Bradford's Law, and keyword co-occurrence analysis. Data were processed using SciVal and VOSviewer. RESULTS: We obtained 98 publications, including original articles, reviews, and other types of documents. Among the most productive authors, most were from South Korea and Turkey. Wonkwang University (South Korea) had the highest number of publications, while Baylor College of Medicine (USA) had the highest impact with 66.5 citations per publication. Toxins had the highest number of publications and the best Cite Score in 2022. Six main topics related to BTX-A in bruxism were identified, highlighting "reviews," "electromyography" and "controlled clinical trials". CONCLUSIONS: The use of BTX-A for the treatment of bruxism has generated increasing interest and scientific output in recent years, especially in South Korea and Brazil. However, there is a disparity in the productivity of authors, with most authors presenting only one publication. CLINICAL SIGNIFICANCE: This study highlights the need for further research and collaborations to optimize clinical practice and better understand the efficacy and management of BTX-A for treating bruxism. How to cite this article: Villanueva-García M, Ruck-Sanchez N, Tinedo-López PL, et al. Bibliometric Analysis of Botulinum Toxin and Bruxism: Impact, Visualization, and Collaborative Networks. J Contemp Dent Pract 2024;25(6):599-604.

Botulinum toxin for bruxism treatment: a nationwide study among oral and maxillofacial surgeons in Germany.

INTRODUCTION: This study aimed to evaluate the use of botulinum toxin (BTX) for the treatment of bruxism in oral and maxillofacial surgery in Germany. MATERIAL AND METHODS: A dynamic online questionnaire comprising 7 to 25 questions was formulated to gather general and specific information regarding using BTX to treat bruxism. The questionnaire underwent internal and external assessments for validation. Subsequently, it was distributed to 906 oral and maxillofacial surgeons (OMFS) affiliated with the German Association for Oral and Maxillofacial Surgery (DGMKG). Weekly reminders were dispatched over four weeks to enhance response rates. Participation in the study was voluntary and anonymized. Descriptive methods were employed for data analysis. RESULTS: 107 OMFS participated in the study, yielding a response rate of 11.81%. On average, 17 patients with bruxism were per month, with 4 of these patients receiving BTX therapy. BTX administration was frequently accompanied by splints and physiotherapy (35.51% of participants). Botox® (Allergan) was the preferred BTX preparation, utilized by 40.79% and reconstituted with saline by 92.11% of participants. The masseter muscles were primarily targeted for BTX treatment (67.57% of participants), averaging 29 BTX (Allergan-) units per side. Injection points for each masseter muscle typically amounted to six per side, preferred by 30.67% of participants. Follow-up assessments post-BTX treatment were conducted regularly, predominantly after four weeks, by 36% of participants. In 8% of cases, additional BTX injections were necessary due to inadequate outcomes. Side effects were reported in 4% of cases, commonly manifesting as a non-disturbing reduction in bite force. Most participating OMFS (61.84%) using BTX for bruxism therapy regarded bruxism treatment with BTX as evidence-based. Notably, 97.37% of respondents expressed their willingness to recommend BTX-based bruxism treatment to their colleagues. Overall, the efficacy of BTX therapy for bruxism was rated as good (53.95%) and very good (40.79%). CONCLUSION: The use of BTX for the management of bruxism among OMFS in Germany has demonstrated efficacy. Substantial variances in certain facets of bruxism treatment employing BTX have been observed. CLINICAL RELEVANCE: Additional research endeavors are warranted to comprehensively investigate distinct elements of BTX therapy for bruxism, including the optimal dosage of BTX units and the precise localization of injection sites across various muscles.

[Treatment of bruxism with botulinum toxin: think twice!] / Behandeling van bruxisme met botulinetoxine: bezint eer ge begint!

A recent publication in the Nederlands Tijdschrift Voor Tandheelkunde (Dutch Journal of Dentistry) suggests botulinum toxin as a primary treatment for bruxism, especially for severe complaints of teeth grinding or jaw clenching. However, in the opinion of Lobbezoo et al., some outdated views on bruxism are used, and botulinum toxin is incorrectly classified as safe, according to them. In this Vision article, the authors describe the current insights into bruxism; they indicate how the presence of bruxism can be assessed in the clinic; when and how bruxism is treated; and finally, what the role of botulinum toxin is: an ultimum refugium. Therefore, regarding the use of botulinum toxin within the discipline of orofacial pain and dysfunction Lobbezoo et al. recommend: think twice!

Evaluation of the quality of Internet information on masseter botox injection for bruxism.

BACKGROUND: Botulinum toxin, commonly referred to as botox, is frequently used in facial aesthetics, but also has therapeutic applications in various medical and surgical conditions such as bruxism treatment. OBJECTIVE: The aim of this research is to evaluate the information quality of only English resources available on the Internet regarding the use of botulinum toxin in the treatment of bruxism. METHODS: The terms "Botox + Tooth Grinding" selected for this study were searched on the Internet using the Google Search Engine, and the URLs of the top 150 websites containing only English pages were recorded and examined. The websites were assessed using DISCERN tools, the Journal of the American Medical Association (JAMA) benchmark, and HONcode tools. The website readability evaluation involved utilizing the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL). RESULTS: A total of 130 websites met the inclusion criteria. The total mean DISCERN score (section 1 + section 2) for all websites was 39.75/75 (range: 15-67). The average FRES of all websites was 52.79, and the average FKGL score of all websites was 10.72. Internet blog websites had significantly higher DISCERN (Section 1) scores than other websites (p= 0.007). Only one website had the HON code. Internet blog websites showed better compliance with JAMA (authorship and currency) benchmarks. No statistically significant difference was determined related to FRES and FKGL scores between groups (p> 0.05). CONCLUSIONS: There is moderate and difficult-to-read information on the Internet about masseter botox injection for bruxism. Relevant guidelines are needed to improve the quality of websites about botulinum toxin for the treatment of bruxism.

Fractal analysis of the effects on mandibular bone of botulinum toxin therapy of the masseter muscle in patients with bruxism.

OBJECTIVE: We examined changes in the mandibular angle, ramus, and condylar neck of patients with bruxism after botulinum toxin-A (BTX-A) injection into the masseter muscle as calculated with fractal analysis (FA) on panoramic radiographs (PRs). METHODS: We examined the PRs of 3 groups of 22 patients each (n = 66) obtained upon presentation and 6 months later. One group included healthy controls without bruxism, one group included patients with untreated bruxism, and one group included patients with bruxism who had undergone BTX-A injection into the masseter muscle. We performed FA of the bilateral angle, ramus, and condylar neck of the PRs to calculate fractal dimension (FD). RESULTS: The FD values of the angle on the second PRs of the untreated bruxism group were significantly higher than those of the other groups (P = .026), specifically when compared to the BTX-A injection group (P = .017). The FD values in the angle and ramus of the bruxism group were significantly higher on the second PRs (P ≤..005)) Conversely, the FD values in the angle of the BTX-A injection group were significantly lower on the second PR (P = .039). CONCLUSIONS: Masseter muscle hyperactivity due to bruxism increases bone density in masseter muscle attachment regions. BTX-A injection restricts muscle activity, thereby chnging bone structure and decreasing FD.

[Treatment with botulinum toxin of masseter hypertrophy, myalgia of the tendons and attrition induced by bruxism]. / Behandeling van bruxismegeïnduceerde masseterhypertrofie, tendomyalgie en attritie met botulinetoxine.

Bruxism is a disabling condition in which unconscious contractions of the masticulatory muscles lead to teeth grinding and jaw clenching. Symptoms include toothache, temporomandibular dysfunction, headache and attrition. Treatment options range from conservative approaches to invasive interventions. Education, stress reduction, avoidance of stimulants, and relaxation techniques can help in mild cases. Wearing an occlusal splint can reduce attrition. Botulinum neurotoxin type A (BoNT-A) injections are a treatment option temporarily causing partial paralysis of the masticulatory muscles. BoNT-A is a treatment for reducing symptoms and improving the quality of life of patients with bruxism that has been proven safe and effective. The effects usually last several months. To achieve the best results and minimize side effects, BoNT-A injections should be applied by an experienced practitioner.

Evaluation of biochemical changes and treatment efficacy in patients with bruxism following botulinum toxin or splint therapy: a randomized clinical trial.

OBJECTIVES: This clinical study aims to analyze the levels of cortisol, dehydroepiandrosterone (DHEA), and tumor necrosis factor alpha (TNF-α) in the gingival crevicular fluid (GCF) of persons with bruxism and to compare the efficacy of botulinum toxin (botox) and occlusal splint treatments through biomarkers. MATERIALS AND METHODS: A total of 40 patients with bruxism were selected according to the clinical examination and anamnesis of which 20 received occlusal splint treatment and 20 botox treatment. GCF samples were taken from the patients before and after treatment. Cortisol, DHEA, and TNF-α levels were measured by enzyme-linked immunosorbent assay test. The change in measurements between time and groups and the time-group interaction were tested by repeated measures ANOVA. RESULTS: There was a statistically significant difference between the cortisol levels before and after treatment in both groups (p = 0.001). In individuals with bruxism, a statistically significant decrease in cortisol levels was observed after both treatments (p < 0.05), while DHEA levels increased after treatment but were not statistically significant (p > 0.05). There was no statistically significant difference between TNF-α intra-group measurements (p > 0.05). CONCLUSIONS: Stress and inflammatory biomarkers were found to be associated with bruxism. Cortisol levels decreased in people with bruxism after treatment with both occlusal splint and botox. CLINICAL RELEVANCE: Both splint and botox treatments were effective for bruxism by reducing the stress levels.

Clinical investigation of botulinum toxin (prabotulinumtoxin A) for bruxism related to masseter muscle hypertrophy: A prospective study.

This study aims to confirm the effectiveness and safety of a prabotulinumtoxin type A (praBTX-A) injection in patients with bruxism and masseter hypertrophy. The study included patients who ground or clenched their teeth while sleeping and had computed tomography (CT) scans that showed a maximum thickness of the masseter muscle of 15 mm or more. The praBTX-A was administered bilaterally into the masseter muscles; 15 U/side for group 1, 25 U/side for group 2, and 35 U/side for group 3. CT scans and bruxism questionnaires were conducted before and eight weeks after the injection. Thirty-seven patients were enrolled, but three dropped out due to loss of follow-up. After injection, masseter thickness decreased to 15.1 ± 2.0 mm for group 1, 14.3 ± 2.9 mm for group 2, and 13.4 ± 1.8 mm for group 3 (p = 0.043). Group 3 showed a statistically significant lower masseter thickness compared to group 1 (p = 0.039). Both subjective and objective frequencies of bruxism decreased for all groups, but there were no significant differences in either subjective (p = 0.396) or objective frequencies (p = 0.87) between the groups after the injection. The results of this study suggest that praBTX-A injection is a safe and effective treatment for bruxism and masseter hypertrophy. A dosage of 35 IU/side can effectively decrease masseter thickness and relieve bruxism symptoms. Even the minimum dosage of 15 IU/side can contribute to improvements in bruxism symptoms. This investigation provides valuable information for managing bruxism that is associated with hypertrophic masseter muscles.

Effectiveness of Botulinum Toxin Injection on Bruxism: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: The present study compiled evidence on the efficacy of botulinum toxin A (BTX) for management of bruxism. METHODS: A literature review that included randomized control, cohort, as well as observational studies published between January 2000 and November 2022 was conducted. All studies related to BTX injections administered into the masseters of patients with bruxism were included. Primary outcomes were measured by performing a meta-analysis of changes in maximal biting forces and pain severity and meta-regression of the effects of the BTX dose. RESULTS: Ten studies were included for quantitative analysis. The analysis of the maximal biting force after BTX injections demonstrated a significant reduction at 1 month or less compared with both oral splints (P < 0.000001) and saline injections (P = 0.01). BTX continued to outperform oral splinting (P = 0.001) and saline placebos (P = 0.03) at 3 months. Between 3 and 6 months, a significantly higher maximal biting strength was observed in the BTX group than the oral splinting group (P < 0.00001). No significant differences in the maximal biting force were observed between the BTX and saline placebo groups (P = 0.50). A similar trend was observed in the analysis of pain reduction after botulinum treatment. Additionally, for every unit increase in the BTX dose, pain severity decreased by 0.0831 points (P = 0.0011). CONCLUSION: BTX is effective in reducing biting strength and pain severity. BTX effects are evident at less than 4 weeks, peak between 5 and 8 weeks, and last for up to 24 weeks. Higher BTX doses result in greater improvement in pain. Although BTX benefits manifest earlier, they gradually diminish, and oral splinting exerts a more enduring effect, especially after 9-12 weeks. BTX injections into masseters are recommended as management options for bruxers, especially for those having difficulties complying with wearing oral splints or those seeking earlier symptom relief. However, future studies should determine BTX effects beyond 24 weeks and after repetitive injections and how bruxers of different ages or genders respond to treatment. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Quality of information on Instagram about masseter botox injection for bruxism.

STATEMENT OF PROBLEM: Nowadays, masseter botulinum toxin injections are frequently used to treat bruxism. People first search for social media resources for their health-related problems. However, the quality of the information on Instagram about masseter botox injection for bruxism is unknown. PURPOSE: The aim of this study was to evaluate the quality ant content of the Instagram posts shared publicly about masseter botox. The hashtag #masseterbotox was searched on Instagram. MATERIALS AND METHODS: A total of 1000 posts were scanned. Unrelated posts were excluded from the study. The video posts were evaluated by using Global Quality Scale (GQS) and reliability of information toolkits. RESULTS: One-hundred seventy-nine photograph and 65 video posts that met the criteria were analyzed. Most of the posts were posted by doctors and healthcare professionals (151 posts), followed by clinics (87 posts) and patients (6 posts). The information reliability scores of Instagram video posts about #masseterbotox were found to be very low (1.34±1.28). Number of views, reliability of information and GQS scores were not statistically significant between groups according to the source of the video posts (p>.05). GQS scores were higher in experience videos than information and advertisement videos (p<.05). CONCLUSIONS: Clinicians should warn their patients about the reliability of information on Instagram and should guide them to the right social media resources. CLINICAL IMPLICATIONS: Dental professionals should direct their patients about masseter botox injections to the right resources on social media platforms.

Assessment of Electromyographic Changes in a Patient with Masseter Hypertrophy and Muscle Pain after Botulinum Injections: A Case Report and 5 Months Follow-up.

AIM: To determine if botulinum injections in masseters could be an option to avoid surgery and prolonged treatment with occlusal splints and/or drugs to care for both painful bruxism and cosmetic improvement in a patient with a square jaw, bruxism, and orofacial pain. BACKGROUND: Masseter muscle hypertrophy (MMH) is a benign, unilateral, or bilateral, painless enlargement in the lower face. It presents as a symmetrical or asymmetrical increase in the masseter muscle. Masseter muscle hypertrophy (MMH) sometimes can be related to bruxism symptoms like muscle and/or temporomandibular joint (TMJ) pain. CASE DESCRIPTION: A 38-year-old woman complained of bilateral pain at palpation in the masseter body. She also complained about esthetics because of the prominent masseter muscle in the face and square face shape. A diagnosis of bruxism-related myalgia was performed, and treatment with botulinum injections into the masseter muscles was opted for. An oral electromyography was performed to detect the electrical muscular activity of masseter muscles over time. CONCLUSION: After a drastic reduction in the mean electrical activity immediately after the botulinum injections, a progressive increase in strength over time was noted, testifying about the decrease in the effect of botulinum over time. The pain disappeared for 5 months after the injections of botulinum. The reduction of the masseter muscle mass led to a softening of the face shape. CLINICAL SIGNIFICANCE: This case report shows that treatment with botulinum can lead, in the short term, to a reduction in orofacial pain due to a decrease in muscle electrical activity.

Valoración del tratamiento del bruxismo mediante toxina botulínica / Assessment of the treatment of bruxism by botulinum toxin

El bruxismo se caracteriza por ser una actividad relacionada la activación de los músculos masticatorios de forma repetitiva y habitualmente durante el sueño. La relevancia de esta entidad reside en su asociación con erosiones y movilidad dentarias, fracturas dentales, mialgia e hipertrofia del músculo masetero y o artralgia característica. Si bien de etiología no clara se relaciona con multitud de factores fisiopatológicos. En la actualidad existen multitud de líneas de tratamiento para este problema de salud, tales como: terapia cognitivo-conductual, férulas de oclusión o de descarga, opciones farmacológicas como benzodiacepinas, y dopamina. Estas medidas habitualmente sirven como manejo de los signos y síntomas derivados del bruxismo, pero la eficacia de todas ella no es total. Actualmente, ante la necesidad de búsqueda de otras opciones terapéuticas al problema del bruxismo, múltiples ensayos han centrado su atención en la utilización de la toxina botulínica como alternativa, teniendo en cuenta su eficacia para una amplia variedad de patologías médicas y estéticas.El objetivo de esta puesta al día es actualizar el conocimiento a fecha actual de la evidencia existente acerca de la utilización de la toxina botulínica en el tratamiento del bruxismo. Para ello se seleccionan las revisiones sistemáticas existentes que incluyen los principales ensayos clínicos aleatorizados disponibles.Método: Revisión bibliográfica en las principales bases de datos utilizando las palabras “bruxismo” y/o “toxina botulínica” Resultados: Tras el análisis de las diferentes revisiones podemos decir que todos los resultados apuntan en la misma dirección: que las inyecciones de toxina botulínica en el masetero y / o los músculos temporales pueden ser una opción de tratamiento válida en pacientes con bruxismo, ya que pueden mejorar la calidad de vida.(AU)

Bruxism is characterized by being an activity related to the activation of the chewing muscles repeatedly and usually during sleep. The relevance of this entity resides in its association with tooth erosions and mobility, dental fractures, myalgia and hypertrophy of the masseter muscle and or characteristic arthralgia. Although its etiology is not clear, it is related to a multitude of pathophysiological factors. Currently there are many lines of treatment for this health problem, such as: cognitive-behavioral therapy, occlusion or discharge splints, pharmacological options such as benzodiazepines, and dopamine. These measures usually serve to manage the signs and symptoms derived from bruxism, but the effectiveness of all of them is not total. Currently, faced with the need to search for other therapeutic options for the problem of bruxism, multiple trials have focused their attention on the use of botulinum toxin as an alternative, taking into account its efficacy for a wide variety of medical and aesthetic pathologies. The objective of this update is to update the knowledge to date of the existing evidence about the use of botulinum toxin in the treatment of bruxism. For this, the existing systematic reviews that include the main available randomized clinical trials are selected. Method: Bibliographic review in the main databases using the words "bruxism" and / or "botulinum toxin" Results: After the analysis of the different reviews we can say that all the results point in the same direction: that botulinum toxin injections in the masseter and / or temporal muscles can be a valid treatment option in patients with bruxism, since they can improve the quality of life. With the exception of the systematic review by Ågren et al, 28 who do not see evidence through the tests that record electromyographic activity and bite force to recommend the use of botulinum toxin as a treatment for bruxism at the present time.(AU)

Botulinum toxin type A for controlling bruxism assessed with computerized occlusal analysis: A pilot study.

Objective: To assess botulinum toxin-A (BTX-A) on mandibular movements and bite force (BF%) in bruxism.Methods: Ten bruxers were divided into 2 groups based on BF% imbalance (G1: >10%, G2: <10%). BTX-A 140U was total injected into the masseter and temporalis muscles. A T-Scan® recorded BF%, occlusion time (OT), right, left, and protrusive disclusion time (DT) before administering BTX-A, as well as 15, 45, 90, and 120 days after injection.Results: The Friedman and Wilcoxon tests found significant differences in BF% in G1 subjects at 15 days (p = 0.028 s), OT at 90 (p = 0.043 s), and 120 (p = 0.027 s) days, DTR at 90 (p = 0.046 s) and 120 (p = 0.028 s) days, DTL at 15 (p = 0.043 s) and 90 (p = 0.027 s) days, and DTP 45-90 days (p = 0.043 s).Conclusion: BTX-A induced BF% starting at 15 days post-injection and influenced lateralities later.

Efficacy of botulinum-A for nocturnal bruxism pain and the occurrence of bruxism events: a meta-analysis and systematic review.

The purpose of this study was to explore the treatment efficacy of botulinum-A (BTX-A) in nocturnal bruxism. Five electronic databases (PubMed, Web of Science, Cochrane, Embase and Clinical Trials) were searched to identify related randomised controlled trials up to September 1, 2020. Five evaluation indices were extracted, namely, the pain at rest and at chewing (PR and PC), the number of bruxism events (NBE) and the self-assessment by patients (SA), to assess the treatment efficacy of BTX-A in bruxism. All data analyses were conducted using Review Manager (Version 5.3; The Cochrane Collaboration, London, United Kingdom). Six studies were included in this review. The sample was composed of 148 participants. Compared with the placebo group, the BTX-A group showed the significantly improved the PR index scores (MD, 1.16 cm; 95%CI, 0.65 to 1.67 cm; p < 0.00001), slightly improved the PC index scores (SMD, 0.25; 95%CI -0.14 to 0.64; p = 0.21), and the NBEs were significantly decreased in the before-injection group compared with that in the after-injection group (MD, 1.72; 95%CI, 0.60 to 2.85; p = 0.003). The results of this study suggest that BTX-A possesses significant therapeutic efficiency for the relief of pain and events of bruxism. However, whether the events of bruxism would recur or rebound after botulinum toxin injection needs more follow-up clinical evidence.

Cannabis. Usos y aplicaciones en la práctica odontológica diaria: revisión de la literatura / Cannabis. Uses and applications in daily dental practice: a review of the literature

La evidencia científica presente en la literatura indica que el cannabis puede ser utilizado con fines terapéuticos para tratar distintas afecciones odontológicas. Dado el acceso sencillo a la cavidad bucal, las distintas formulaciones de cannabis pueden aplicarse de forma tópica. La aplicación local de dosis bajas de cannabis ha demostrado alta efectividad para tratar distintas afecciones bucales, constituyendo un tratamiento seguro con baja probabilidad de generar repercusiones sistémicas indeseadas. En la actualidad, está siendo incorporado a materiales convencionales de uso e higiene odontológica con la finalidad de aprovechar sus efectos terapéuticos. El cannabis tiene múltiples usos en odontología: como componen-te de enjuagues bucales y soluciones para la desinfección de conductos radiculares, en tratamientos de trastornos de ansiedad bucal, como complemento en terapias oncológicas, como analgésico para atenuar el dolor inflamatorio y el neuropático, como miorrelajante y condroprotector para tratar trastornos de articulación témporomandibular (ATM) y bruxismo, como osteomodulador para el tratamiento de patologías que comprometen la integridad ósea, como la enfermedad periodontal y la osteoporosis, y para la cicatrización ósea asociada a fracturas, extracciones dentarias e implantes, y como inmunomodulador con potencial terapéutico para tratar patologías autoinmunes como las enfermedades reumáticas. El trata-miento local con cannabis es efectivo, bien tolerado por el paciente y con pocos efectos adversos. Por lo tanto, se puede concluir que el cannabis aporta un enorme abanico de posibilidades terapéuticas para tratar distintas afecciones odontológicas, aunque aún se requiere mayor cantidad de estudios científicos que avalen su utilización en cada situación fisiopatológica particular (AU)

The scientific evidence present in the literature indicates that cannabis can be used for therapeutic purposes to treat different dental conditions. Given the easy access to the oral cavity, the different cannabis formulations can be applied topically. The local application of low doses of cannabis has shown high effectiveness in treating different oral conditions, constituting a safe treatment with a low probability of generating unwanted systemic repercussions. It is currently being incorporated into conventional materials for dental use and hygiene in order to take advantage of its therapeutic effects. Cannabis has multiple uses in dentistry: as a component of mouthwashes and solutions for disinfecting root canals, in the treatment of oral anxiety disorders, as a complement in oncological therapies, as an analgesic to reduce inflammatory and neuropathic pain, as a muscle relaxant and chondroprotective to treat temporomandibular joint disorders and bruxism, as an osteomodulator for the treatment of pathologies that compromise bone integrity, such as periodontal disease and osteoporosis, and or bone healing associated with fractures, dental extractions and implants, and as immunomodulator with therapeutic potential to treat autoimmune pathologies such as rheumatic diseases. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Therefore, it can be concluded that cannabis provides an enormous range of therapeutic possibilities to treat different dental conditions, although more scientific studies are still required to support its use in each particular pathophysiological situation (AU)

Cannabidiol in the management of bruxism in behavioral variant of frontotemporal degeneration.

Awake bruxism is an understudied feature of behavioral variant of frontotemporal dementia (bvFTD). We present the case of aman who presented with psychiatric, behavioral, cognitive changes, and teeth clenching that resulted in significant changes in his teeth alignment including an underbite. He received multiple treatments with partial response. He then started using acannabidiol (CBD) capsule, and the grinding was almost completely relieved after this intervention. There is still no standardized pharmacology treatment for bruxism in patients with bvFTD. As aconsequence, acase-by-case approach is suggested. CBD can be helpful as an adjunct therapeutic agent for awake bruxism.Not StartedCompletedRejected.

Botulinum toxin treatment of temporomandibular joint pain in patients with bruxism: A prospective and randomized clinical study.

BACKGROUND: Bruxism is a parafunctional habit, usually performed in sleep, by rhythmic and involuntary teeth being squeezed or squeaked. The most common methods of treatment are the use of occlusal splints. AIMS: The aim of this study was to compare the efficacy of occlusal splinting with botulinum toxin administration in the treatment of TMJ pain. SUBJECTS AND METHODS: For this purpose, 40 patients with bruxism were divided into two groups and one group was treated with occlusal splint and the other group received masseter muscle botulinum toxin injection. Then, the participants in both groups were evaluated in terms of pain, functional movement, and maximum bite force change at 2 weeks, 6 weeks, 3 months, and 6 months. Mann-Whitney U test was used to examine the differences between two independent groups. While Friedman test was used for differences between dependent groups, the Wilcoxon test was used for the differences between two repetitive measurements. Chi-square test was used to examine the relationship between categorical variables. Results: When pain was evaluated, both methods were effective in pain reduction, botulinum toxin injection was found to be less effective in reducing pain but no difference was found between the two methods. The maximum bite force decreased in the 2nd and 6th weeks and increased in the 3rd and 6th months in patients receiving botulinum toxin. In patients using occlusal splints, there was no change until the 3rd month and an increase was seen in the 6th month. In this study, it was observed that low dose BTX-A and occlusal splint use were effective in eliminating bruxism-related pain but not superior to each other. CONCLUSIONS: According to these results, low dose botulinum toxin can be considered as an alternative treatment in patients who cannot use occlusal splint for various reasons.

Medications and addictive substances potentially inducing or attenuating sleep bruxism and/or awake bruxism.

Bruxism is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. It can occur during sleep, indicated as sleep bruxism, or during wakefulness, indicated as awake bruxism. Exogenous risk indicators of sleep bruxism and/or awake bruxism are, among others, medications and addictive substances, whereas also several medications seem to have the potential to attenuate sleep bruxism and/or awake bruxism. The objective of this study was to present a narrative literature on medications and addictive substances potentially inducing or aggravating sleep bruxism and/or awake bruxism and on medications potentially attenuating sleep bruxism and/or awake bruxism. Literature reviews reporting evidence or indications for sleep bruxism and/or awake bruxism as an adverse effect of several (classes of) medications as well as some addictive substances and literature reviews on medications potentially attenuating sleep bruxism and/or awake bruxism were used as starting point and guidelines to describe the topics mentioned. Additionally, two literature searches were established on PubMed. Three types of bruxism were distinguished: sleep bruxism, awake bruxism and non-specified bruxism. Generally, there are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism. There are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism.

Awake Bruxism Treated with Pregabaline in a Patient with Generalized Anxiety Disorder.

BACKGROUND: Bruxism is excessive teeth grinding or jaw clenching. Several symptoms are commonly associated with bruxism, including hypersensitive teeth, aching jaw muscles, headaches, tooth wear, and damage to dental restorations. There are two types of bruxism, awake bruxism and sleep bruxism. Awake bruxism is generally treated by dentists and maxilla-facial surgeons through several treatment modalities such as, counselling about triggers, relaxation, occlusal splints and botulinum toxin type A injections. METHODS: We will present the case of a 21-year-old woman presenting mood swings with a high level of anxiety and concentration difficulties since childhood. She also complained of awake bruxism. Intelligence was evaluated using The Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). Attention-deficit hyperactivity disorder (ADHD) was investigated through a neuropsychology test. RESULTS: Intelligence evaluation showed normal intellectual function. Neuropsychology test showed a profile corresponding to ADHD. Bupropion XR 300 mg was initiated for ADHD. Pregabalin was prescribed for general anxiety syndrome. The patient reported a complete disappearance of awake bruxism at a daily dose of 375 mg, with no occlusal appliances. Following the improvement of the anxiety symptoms, the attempt to reduce the dose twice leading to the recurrence of bruxism. CONCLUSIONS: A 21 years old female treated with 375 mg daily doses of pregabalin for generalized anxiety disorder experienced a significant reduction of daytime bruxism. More studies are needed to determine whether pregabalin has a long term effect against awake bruxism.

The approach and management of bruxism in Alzheimer's disease: An under-recognized habit that concerns caregivers (innovative practice).

Bruxism (teeth grinding) is an under-recognized cause of caregiver concern in patients with Alzheimer's disease. We report two cases of Alzheimer's disease with bruxism that caused significant distress to the caregivers. Patient data were collected from the case records of our hospital. One patient presented with early Alzheimer's disease and another with advanced Alzheimer's disease had bruxism causing significant caregiver distress. One patient was treated with botulinum toxin type A with complete relief of the symptom. Bruxism in Alzheimer's disease patients can be a cause of caregiver distress. It can be successfully treated with botulinum toxin. Whether bruxism is rare in Alzheimer's disease or is under-reported is to be evaluated in future studies.