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Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain : a randomized double-blind clinical trial

datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorCanales, Giancarlo De la Torre
dc.contributor.authorPoluha, Rodrigo Lorenzi
dc.contributor.authorBonjardim, Leonardo Rigoldi
dc.contributor.authorErnberg, Malin
dc.contributor.authorConti, Paulo César Rodrigues
dc.date.accessioned2026-03-20T12:52:40Z
dc.date.available2026-03-20T12:52:40Z
dc.date.issued2024-02
dc.description.abstractThe antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann–Whitney test was used for all comparisons between groups. The BoNT-A group had a significant decrease in pain intensity at follow-ups compared with the SS group (p < 0.001). QST assessment revealed higher pressure pain threshold values in the masseter muscle for BoNT-A group compared to SS (p < 0.03) at all follow-ups. No differences were found for mechanical pain threshold and wind-up ratio values (p > 0.05) in the entire study. The BoNT-A group presented the most efficient CPM effect (p < 0.03) only at the 1 month follow-up in the masseter muscle. There was a significant time effect for BoNT-A in all psychosocial variables (p < 0.05) and a drug effect in the Central Sensitization Inventory (p < 0.01), Pittsburgh Sleep Quality Index (p < 0.004), and Healthy Survey 36 (p < 0.05) at 6 months follow-up. The study demonstrates that a single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.eng
dc.identifier.citationDe la Torre Canales, G., Poluha, R.L., Bonjardim, L.R. et al. Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain: a randomized double-blind clinical trial. Sci Rep 14, 4201 (2024). https://doi.org/10.1038/s41598-024-54906-z
dc.identifier.doi10.1038/s41598-024-54906-z
dc.identifier.issn2045-2322
dc.identifier.urihttp://hdl.handle.net/10400.26/62327
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer Nature
dc.relation.hasversionhttps://doi.org/10.1038/s41598-024-54906-z
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectTemporomandibular disorders
dc.subjectMyofascial pain
dc.subjectBotulinum toxin type A
dc.titleBotulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain : a randomized double-blind clinical trialeng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.startPage4201
oaire.citation.titleScientific Reports
oaire.citation.volume14
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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