{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:58:30Z","timestamp":1793761110277,"version":"4.6.1"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2014\/15863-7"],"award-info":[{"award-number":["2014\/15863-7"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>This study assessed the safety and efficacy of three different doses of BoNT-A for persistent myofascial pain (MFP). One hundred female subjects were randomly assigned into five groups (n = 20): oral appliance (OA), saline solution (SS) and three BoNT-A groups with different doses. Pain intensity and pressure pain threshold were evaluated up to 24 weeks after treatment. Adverse effects related to muscle contraction, masticatory performance, muscle thickness and mandibular bone volume were also assessed. Changes over time were compared within and between groups. The \u201cnparLD\u201d package and Wilcoxon signed-rank test were used to analyze the data. BoNT-A reduced pain intensity (p &lt; 0.0001) and increased pressure pain threshold (p &lt; 0.0001) for up to 24 weeks compared to the placebo. No differences were found between BoNT-A and OA at the last follow-up. A transient decline in masticatory performance (p &lt; 0.05) and muscle contraction (p &lt; 0.0001), and a decrease in muscle thickness (p &lt; 0.05) and coronoid and condylar process bone volume (p &lt; 0.05) were found as dose-related adverse effects of BoNT-A. Regardless of the dose, BoNT-A was as effective as OA on MFP. Notwithstanding, due to BoNT-A dose-related adverse effects, we suggest the use of low doses of BoNT-A in MFP patients that do not benefit from conservative treatments.<\/jats:p>","DOI":"10.3390\/toxins12060395","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:50:49Z","timestamp":1592268649000},"page":"395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Efficacy and Safety of Botulinum Toxin Type A on Persistent Myofascial Pain: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-342X","authenticated-orcid":false,"given":"Giancarlo","family":"De la Torre Canales","sequence":"first","affiliation":[{"name":"Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Alvarez-Pinzon","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-8542","authenticated-orcid":false,"given":"Victor Ricardo Manuel","family":"Mu\u00f1oz-Lora","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1391-6216","authenticated-orcid":false,"given":"Leonardo","family":"Vieira Peroni","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4707-4838","authenticated-orcid":false,"given":"Amanda","family":"Farias Gomes","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-0997","authenticated-orcid":false,"given":"Alfonso","family":"S\u00e1nchez-Ayala","sequence":"additional","affiliation":[{"name":"Department of Dentistry, State University of Ponta Grossa, Paran\u00e1 84030-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Haiter-Neto","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Manfredini","sequence":"additional","affiliation":[{"name":"Department of Dentistry, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-2987","authenticated-orcid":false,"given":"C\u00e9lia Marisa","family":"Rizzatti-Barbosa","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Sao Paulo 13414-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00784-010-0444-4","article-title":"Correlation of RDC\/TMD axis I diagnoses and axis II pain-related disability. 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