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Uso da toxina botulínica como meio terapêutico em medicina dentária : revisão de literatura
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Abstract(s)
Em 1822, Justinus Kerner, um médico, poeta alemão e um dos mais importantes
pioneiros no estudo da toxina botulínica, foi o primeiro a publicar uma pesquisa na qual
desenvolveu a hipótese de utilizar esta toxina para fins terapêuticos. Atualmente, quase
dois séculos após esta observação, as aplicações terapêuticas da toxina botulínica estão
em expansão em Medicina Dentária, e constantemente estão a surgir novos estudos sobre este potente e versátil fármaco.
A toxina botulínica do tipo A é a toxina biológica mais potente, tem uma difusão limitada no local injetado e sua ação é reversível com o tempo. Estas propriedades farmacológicas favoráveis, juntamente com seus efeitos terapêuticos polivalentes, permitem o uso deste fármaco em diversas aplicações em Medicina Dentária,
nomeadamente bruxismo, sialorreia, implantologia e disfunções temporomandibulares
tais como dor miofascial, hipertrofia do músculo masséter e luxação da articulação
temporomandibular. Apesar de ainda com grau de evidência discutível, os estudos
demonstram que os tratamentos com a toxina botulínica, não são considerados como
primeira linha, mas apresentam resultados promissores nestas aplicações, quando
realizados por um clínico qualificado.
No entanto, estes resultados positivos devem ser interpretados com cautela, visto
que ainda há muitas questões relacionadas com esta toxina no organismo humano, tal
como evidenciado em recentes estudos sobre os potenciais riscos de alterações ósseas
mandibulares após aplicações de toxina botulínica nos músculos mastigatórios.
Com o intuito de confirmar a real segurança e eficácia do uso terapêutico da toxina
botulínica nas diversas aplicações em Medicina Dentária, verifica-se a necessidade da
realização de novos estudos baseados em níveis mais elevados de evidência científica.
Pretende-se com esta monografia proceder à revisão de literatura científica acerca
das atuais aplicações terapêuticas da toxina botulínica na Medicina Dentária.
In 1822, Justinus Kerner, a German doctor, poet and one of the most important pioneers in the study of botulinum toxin, was the first to publish a research in which he developed the hypothesis of using this toxin for therapeutic purposes. Today, almost two centuries after this observation, the therapeutic applications of botulinum toxin are expanding in dentistry, and new studies on this powerful and versatile drug are constantly emerging. Botulinum toxin type A is the most potent biological toxin, it has a limited diffusion in the injected place and its action is reversible with time. These favorable pharmacological properties, together with its polyvalent therapeutic effects, allow the use of this drug in various applications in dentistry, including bruxism, sialorrhoea, implantology and temporomandibular dysfunctions such as myofascial pain, hypertrophy of the masseter muscle and dislocation of the temporomandibular joint. Although the degree of evidence is still debatable, the studies show that treatments with botulinum toxin are not considered as first line, but present promising results in these applications, when performed by a qualified clinician. However, these positive results should be interpreted with caution, since there are still many issues related to this toxin in the human body, as evidenced in recent studies on the potential risks of mandibular bone changes following applications of botulinum toxin to masticatory muscles. In order to confirm the real safety and efficacy of the therapeutic use of botulinum toxin in the various applications of dentistry, there is a need for further studies based on higher levels of scientific evidence. The aim of this monograph is to review the scientific literature on the current therapeutic applications of botulinum toxin in dentistry.
In 1822, Justinus Kerner, a German doctor, poet and one of the most important pioneers in the study of botulinum toxin, was the first to publish a research in which he developed the hypothesis of using this toxin for therapeutic purposes. Today, almost two centuries after this observation, the therapeutic applications of botulinum toxin are expanding in dentistry, and new studies on this powerful and versatile drug are constantly emerging. Botulinum toxin type A is the most potent biological toxin, it has a limited diffusion in the injected place and its action is reversible with time. These favorable pharmacological properties, together with its polyvalent therapeutic effects, allow the use of this drug in various applications in dentistry, including bruxism, sialorrhoea, implantology and temporomandibular dysfunctions such as myofascial pain, hypertrophy of the masseter muscle and dislocation of the temporomandibular joint. Although the degree of evidence is still debatable, the studies show that treatments with botulinum toxin are not considered as first line, but present promising results in these applications, when performed by a qualified clinician. However, these positive results should be interpreted with caution, since there are still many issues related to this toxin in the human body, as evidenced in recent studies on the potential risks of mandibular bone changes following applications of botulinum toxin to masticatory muscles. In order to confirm the real safety and efficacy of the therapeutic use of botulinum toxin in the various applications of dentistry, there is a need for further studies based on higher levels of scientific evidence. The aim of this monograph is to review the scientific literature on the current therapeutic applications of botulinum toxin in dentistry.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Toxina botulínica Medicina dentária Sialorreia Implantes dentários