Abstract：
OBJECTIVE: To investigate the pain perception (PP) and condyle-fossa relationship (CFR) after botulinum toxin A (BoNTA) injection in the masseter muscles of painful muscular temporomandibular dysfunction (TMD) patients.
METHODS: Fourteen women (aged 29.7 ± 5.4 years) diagnosed with myogenic TMD were randomized in the BoNTA-treated group (TG) and control group (CG). TG masseter muscles (n = 7) were bilaterally injected with 30 U. The CG (n = 7) were injected with saline injections. Condyle-fossa relationship (CFR) spaces were measured in sagittal (SP) and frontal planes (FP) of images of cone-beam computed tomography (CBCT) done before (T0) and after 30 days\' interventions (T1). Visual analogue scale (VAS) measured the patients\' TMD pain perception (PP). Data were compared by generalized linear models considering the results over time (α = .05).
RESULTS: There were no statistical differences in CFR in the SP or FP for TG and CG over time (p ˃ .05), except for frontal lateral space CFR (p < .05). In both groups, the condyle was positioned medially after interventions. Frontal lateral space increased in TG for both, left and right sides, over time (p < .05), as well as PP decreased over time (p < .05) for TG and CG.
CONCLUSIONS: The results depicted that there was no significant association with BoNTA injection in TMD masseter muscles in PP and CFR, except considering the frontal lateral space of CFR.
CONCLUSIONS: BoNTA injection in the masseter muscles may not promote clinically significant shifts in the condyle-fossa relationships of muscular TMD patients.
METHODS: Fourteen women (aged 29.7 ± 5.4 years) diagnosed with myogenic TMD were randomized in the BoNTA-treated group (TG) and control group (CG). TG masseter muscles (n = 7) were bilaterally injected with 30 U. The CG (n = 7) were injected with saline injections. Condyle-fossa relationship (CFR) spaces were measured in sagittal (SP) and frontal planes (FP) of images of cone-beam computed tomography (CBCT) done before (T0) and after 30 days\' interventions (T1). Visual analogue scale (VAS) measured the patients\' TMD pain perception (PP). Data were compared by generalized linear models considering the results over time (α = .05).
RESULTS: There were no statistical differences in CFR in the SP or FP for TG and CG over time (p ˃ .05), except for frontal lateral space CFR (p < .05). In both groups, the condyle was positioned medially after interventions. Frontal lateral space increased in TG for both, left and right sides, over time (p < .05), as well as PP decreased over time (p < .05) for TG and CG.
CONCLUSIONS: The results depicted that there was no significant association with BoNTA injection in TMD masseter muscles in PP and CFR, except considering the frontal lateral space of CFR.
CONCLUSIONS: BoNTA injection in the masseter muscles may not promote clinically significant shifts in the condyle-fossa relationships of muscular TMD patients.
摘要：
目的：探讨疼痛性颞下颌关节功能障碍(TMD)患者咬肌注射肉毒毒素A(BoNTA)后的疼痛感觉(PP)及髁窝关系(CFR)。
方法：将诊断为肌源性TMD的14名女性（年龄29.7±5.4岁）随机分为BoNTA治疗组（TG）和对照组（CG）。向TG咬肌(n=7)双侧注射30U。向CG(n=7)注射生理盐水。在30天干预之前（T0）和之后（T1）进行的锥形束计算机断层扫描（CBCT）图像的矢状（SP）和额面（FP）中测量了髁-窝关系（CFR）空间。视觉模拟评分(VAS)测量患者的TMD疼痛感知(PP)。通过考虑随时间变化的结果的广义线性模型比较数据(α=0.05)。
结果：随着时间的推移，TG和CG在SP或FP中的CFR没有统计学差异（p^0.05），除了额侧空间CFR（p<.05）。在这两组中,干预后,髁位于内侧.前侧间隙TG均增加，左侧和右侧，随着时间的推移（p<0.05），对于TG和CG，PP也随着时间的推移而下降（p<0.05）。
结论：结果表明，PP和CFR中TMD咬肌注射与BoNTA没有显着关联，除了考虑CFR的正面横向空间。
结论：咬肌注射BoNTA可能不会促进TMD患者髁-窝关系的临床显著变化。
方法：将诊断为肌源性TMD的14名女性（年龄29.7±5.4岁）随机分为BoNTA治疗组（TG）和对照组（CG）。向TG咬肌(n=7)双侧注射30U。向CG(n=7)注射生理盐水。在30天干预之前（T0）和之后（T1）进行的锥形束计算机断层扫描（CBCT）图像的矢状（SP）和额面（FP）中测量了髁-窝关系（CFR）空间。视觉模拟评分(VAS)测量患者的TMD疼痛感知(PP)。通过考虑随时间变化的结果的广义线性模型比较数据(α=0.05)。
结果：随着时间的推移，TG和CG在SP或FP中的CFR没有统计学差异（p^0.05），除了额侧空间CFR（p<.05）。在这两组中,干预后,髁位于内侧.前侧间隙TG均增加，左侧和右侧，随着时间的推移（p<0.05），对于TG和CG，PP也随着时间的推移而下降（p<0.05）。
结论：结果表明，PP和CFR中TMD咬肌注射与BoNTA没有显着关联，除了考虑CFR的正面横向空间。
结论：咬肌注射BoNTA可能不会促进TMD患者髁-窝关系的临床显著变化。
