The therapeutic use of botulinum toxin in cervical and maxillofacial conditions

DATA SOURCES: Medline, Cochrane Library and bibliographies of identified articles. STUDY SELECTION: Studies of high methodological quality (systematic reviews or randomised controlled trials; RCT) were selected if considered use of botulinum toxin (BTX) either prophylactically or therapeutically, as an adjunct to dental implant therapy for temporomandibular disorders or for other maxillofacial conditions such as bruxism, masseteric hypertrophy, oromandibular dystonia or cervical dystonia. DATA EXTRACTION AND SYNTHESIS: Only studies with high levels of evidence were evaluated. Four RCT met the search criteria in the area of cervical dystonia and chronic facial pain. RESULTS: No RCT were identified that evaluated dental implant therapy along with use of BTX. Four RCT did meet the search criteria in the area of cervical dystonia and chronic facial pain. People who had cervical dystonia exhibited significant improvements in baseline functional, pain and global assessments compared with placebo, whereas individuals with chronic facial pain improved significantly compared with placebo in terms of pain. CONCLUSIONS: During the period of study, no references were found evaluating use of BTX in dental implantology. Nevertheless, it appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity.