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Publication
A eficácia da toxina botulínica no tratamento da hipertrofia do masséter
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Advisor(s)
Abstract(s)
A revisão proposta pretende avaliar os efeitos da Toxina Botulínica tipo A, em doentes com Hipertrofia do Músculo Masséter bilateral ou unilateral, com o intuito de obter recomendações clínicas fundamentadas para futuros casos clínicos equiparáveis.
A pesquisa bibliográfica foi realizada por dois investigadores de forma independente, entre dezembro de 2021 e fevereiro de 2022, nas bases de dados Cochrane, LILACS, Pubmed, Scopus, Web of Science e B-on. Após uma seleção criteriosa, foram obtidos 34 artigos em inglês, entre 1994 e 2021. Os dados de cada um dos estudos foram compilados em tabelas. Para a análise do risco de viés de cada um dos artigos, utilizou-se a ferramenta Critical Appraisal Skills Programme checklist (CASP) e, posteriormente, a ferramenta Robvis tool para resumir a informação em Summary e Traffic Light Plots. Posteriormente foram realizadas meta-regressões e meta-análises, para avaliar a percentagem de redução de espessura do músculo masséter ao 3º mês.
Foram realizados tratamentos bilateralmente e unilateralmente, com injeções de Toxina Botulínica tipo A em 1354 indivíduos. Observaram-se diferenças significativas após o tratamento na maior parte dos doentes, com taxas de satisfação elevadas, entre os 70-100%. Obteve-se uma percentagem de redução de espessura do músculo masséter de 8.1% ao 3º mês, com um intervalo de confiança de 95% e um desvio padrão de (5.5; 10.7). Verificou-se que as covariáveis “Idade Média” e “Região” não interferiram no valor médio da percentagem de redução de espessura do músculo masséter (p>0.05).
Conclui-se que a Toxina Botulínica tipo A constitui um meio seguro, previsível e eficaz no tratamento da Hipertrofia do Músculo do Masséter, dado que apresenta poucos efeitos adversos e bons resultados, com taxas de satisfação elevadas. Futuramente, recomenda-se a padronização dos ensaios clínicos. São necessários mais estudos em indivíduos caucasianos, dado que a maior parte dos estudos são realizados em indivíduos asiáticos.
Aim: The proposed review aims to evaluate the effects of Botulinum Toxin type A in patients with bilateral or unilateral Masseter Muscle Hypertrophy, in order to obtain clinical recommendations based on comparable clinical cases. Materials and methods: The literature search was conducted by two investigators independently, between December 2021 and February 2022, in the Cochrane, LILACS, Pubmed, Scopus, Web of Science and B-on databases. After a careful selection, 34 articles were obtained in English, between 1994 and 2021. The most data from each of the studies were compiled in tables. The Critical Appraisal Skills Program (CASP) checklist was used to analyze the risk of bias in each article. Later the Robvis tool was used to summarize the information in Summary and Traffic Light Plots. Subsequently, meta-analyses and meta-regressions were performed to assess the percentage of reduction of masseter muscle thickness in the 3rd month. Results: Treatments were performed bilaterally and unilaterally, with injections of Botulinum Toxin type A in 1354 individuals. Significant post-treatment differences were observed in most patients, with high satisfaction rates ranging from 70-100%. A percentage of masseter muscle thickness reduction of 8.1% was obtained in the 3rd month, with a confidence interval of 95%, with a standard deviation of (5.5; 10.7). It was found that the covariates “Middle Age” and “Region” did not interfere in the mean value of the percentage of masseter muscle thickness reduction (p>0.05). Conclusion: It is concluded that Botulinum Toxin type A is a safe, predictable and effective way to treat Masseter Muscle Hypertrophy, as it has few adverse effects and good results, with high satisfaction rates. In the future, the standardization of clinical trials is recommended. More studies on Caucasian subjects are needed, as most studies are performed on Asian subjects.
Aim: The proposed review aims to evaluate the effects of Botulinum Toxin type A in patients with bilateral or unilateral Masseter Muscle Hypertrophy, in order to obtain clinical recommendations based on comparable clinical cases. Materials and methods: The literature search was conducted by two investigators independently, between December 2021 and February 2022, in the Cochrane, LILACS, Pubmed, Scopus, Web of Science and B-on databases. After a careful selection, 34 articles were obtained in English, between 1994 and 2021. The most data from each of the studies were compiled in tables. The Critical Appraisal Skills Program (CASP) checklist was used to analyze the risk of bias in each article. Later the Robvis tool was used to summarize the information in Summary and Traffic Light Plots. Subsequently, meta-analyses and meta-regressions were performed to assess the percentage of reduction of masseter muscle thickness in the 3rd month. Results: Treatments were performed bilaterally and unilaterally, with injections of Botulinum Toxin type A in 1354 individuals. Significant post-treatment differences were observed in most patients, with high satisfaction rates ranging from 70-100%. A percentage of masseter muscle thickness reduction of 8.1% was obtained in the 3rd month, with a confidence interval of 95%, with a standard deviation of (5.5; 10.7). It was found that the covariates “Middle Age” and “Region” did not interfere in the mean value of the percentage of masseter muscle thickness reduction (p>0.05). Conclusion: It is concluded that Botulinum Toxin type A is a safe, predictable and effective way to treat Masseter Muscle Hypertrophy, as it has few adverse effects and good results, with high satisfaction rates. In the future, the standardization of clinical trials is recommended. More studies on Caucasian subjects are needed, as most studies are performed on Asian subjects.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Toxina botulínica tipo A Hipertrofia do músculo masséter Músculo masséter Percentagem de redução de espessura do músculo masséter