{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:47:23Z","timestamp":1790970443789,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,17]],"date-time":"2014-05-17T00:00:00Z","timestamp":1400284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Institutional Review Board of the New York University School of Medicine"},{"name":"New York University College of Dentistry"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Patients with temporomandibular muscle and joint disorder (\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    ) increasingly seek and receive treatment for their pain with botulinum toxin (Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    ; botulinum toxin A). Used intramuscularly in therapeutic doses, it produces localised paresis. Such paresis creates risk of reduced bone mineral density, or \u2018disuse osteopenia\u2019. Animal studies have frequently used Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    as a model of paralysis to induce bone changes within short periods. Osteopenic effects can be enduring in animals but have yet to be studied in humans. This is the first study in humans to examine bone\u2010related consequences of Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    injections in the masticatory muscles, comparing oral and maxillofacial radiologists\u2019 ratings of trabecular bone patterns in the condyles of patients with\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    exposed to multiple masticatory muscle injection sessions with Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    to a sample of patients with\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    unexposed to masticatory muscle injections with Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    . Cone\u2010beam computed tomography (\n                    <jats:styled-content style=\"fixed-case\">CBCT<\/jats:styled-content>\n                    )\u2010derived images of bilateral condyles were evaluated in seven patients with\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    receiving 2+ recent Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    treatment sessions for facial pain and nine demographically matched patients with\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    not receiving Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    treatment. Two oral and maxillofacial radiologists evaluated\n                    <jats:styled-content style=\"fixed-case\">CBCT<\/jats:styled-content>\n                    images for evidence of trabecular changes consistent with osteopenia. Both evaluators noted decreased density in all participants exposed to Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    and in none of the unexposed participants (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00\u00b7001). No other abnormalities associated with reduced loading were detected. These findings need replication in a larger sample and over a longer time period, to ensure safety of patients with\n                    <jats:styled-content style=\"fixed-case\">TMJD<\/jats:styled-content>\n                    receiving multiple Bo\n                    <jats:styled-content style=\"fixed-case\">NTA<\/jats:styled-content>\n                    injections for their pain.\n                  <\/jats:p>","DOI":"10.1111\/joor.12180","type":"journal-article","created":{"date-parts":[[2014,5,17]],"date-time":"2014-05-17T01:54:54Z","timestamp":1400291694000},"page":"555-563","source":"Crossref","is-referenced-by-count":71,"title":["Osteopenic consequences of botulinum toxin injections in the masticatory muscles: a pilot study"],"prefix":"10.1111","volume":"41","author":[{"given":"K. 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