{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:19:03Z","timestamp":1791847143261,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Injections of botulinum toxin type A (BoNT\u2010A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)\u2010related myofascial pain (MFP). BoNT\u2010A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo\u2010controlled crossover study was to evaluate the clinical benefit of a moderate dose (50\u2009U) of BoNT\u2010A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010six subjects were randomized into two groups, one which received BoNT\u2010A first and a second which received a saline solution (SS) first. Follow\u2010ups were performed 2, 11, and 16\u2009weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC\/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain\u2010related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The within\u2010group analysis showed a significant improvement in pain intensity and pain\u2010related disability after BoNT\u2010A (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>p<\/jats:italic>\u2009=\u20090.005, <jats:italic>p<\/jats:italic>\u2009=\u20090.011) and SS (<jats:italic>p<\/jats:italic>\u2009=\u20090.003, <jats:italic>p<\/jats:italic>\u2009=\u20090.005, <jats:italic>p<\/jats:italic>\u2009=\u20090.046) injections up to week 16. The between\u2010group analysis of pain\u2010related variables revealed no differences between groups at any time. Nonetheless, BoNT\u2010A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (\u226530%) was 6.3, 57.0, and 19.0 at 2, 11, and 16\u2010week follow\u2010ups favoring BoNT\u2010A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Injections of 50\u2009U of BoNT\u2010A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.13396","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T12:18:38Z","timestamp":1720095518000},"page":"1014-1023","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical benefit of botulinum toxin for treatment of persistent <scp>TMD<\/scp>\u2010related myofascial pain: A randomized, placebo\u2010controlled, cross\u2010over trial"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-1128","authenticated-orcid":false,"given":"V.","family":"Sitnikova","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Faculty of Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"K\u00e4mppi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Faculty of Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"K\u00e4mppi","sequence":"additional","affiliation":[{"name":"Epilepsia Helsinki (Member of ERN EpiCARE), HUS Neurocenter  Helsinki Finland"},{"name":"Department of Neuroscience, Faculty of Medicine University of Helsinki  Helsinki Finland"},{"name":"Helsinki University Central Hospital (HYKS)  Helsinki 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