{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:19:00Z","timestamp":1791847140966,"version":"4.3.4"},"reference-count":44,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merz Therapeutics Iberia SLU"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Background: Myogenous temporomandibular disorders (TMDs) are a common subtype of orofacial pain. Evidence regarding treatment with botulinum toxin type A (BoNT-A) remains heterogeneous, and its use is generally limited to refractory cases. This study evaluated 12-month clinical outcomes following an incobotulinumtoxinA protocol (the \u00c2ngelo Botulinum Toxin Protocol\u00ae) in adults with DC\/TMD-confirmed myogenous TMD unresponsive to conservative therapy. Methods: This retrospective observational study reviewed records from 98 adults treated with incobotulinumtoxinA following the predefined injection protocol. All patients had failed \u2265 3 months of conservative management and completed \u2265 12 months of follow-up. Outcomes included myalgia severity (0\u20133), patient-reported orofacial pain intensity (VAS 0\u201310), and maximum mouth opening (MMO). Favorable outcome criteria required myalgia 0\u20131 or VAS \u2264 2 and MMO \u2265 35 mm. Results: Myalgia significantly decreased at 12 months (2.69 \u00b1 0.64 to 0.43 \u00b1 0.85; p &lt; 0.001). Patient-reported orofacial pain intensity also improved (2.44 \u00b1 2.54 to 0.37 \u00b1 1.33; p &lt; 0.001). MMO remained stable, indicating preserved mandibular mobility. Overall, 79.6% of patients met the predefined favorable outcome criteria. Reintervention was required in 12 patients; 7 received additional incobotulinumtoxinA injections, and 5 underwent TMJ arthrocentesis. No complications were observed. Conclusion: This protocol was associated with improvements in muscular pain and orofacial discomfort while preserving mandibular mobility. However, given the retrospective design and absence of a control group, these findings should be interpreted as hypothesis generating.<\/jats:p>","DOI":"10.3390\/toxins18050220","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T08:01:39Z","timestamp":1778140899000},"page":"220","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Effectiveness of IncobotulinumtoxinA Using a Standardized Protocol in the Management of Myogenous Temporomandibular Disorders: A 12-Month Retrospective Study"],"prefix":"10.3390","volume":"18","author":[{"given":"David Faustino","family":"\u00c2ngelo","sequence":"first","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"},{"name":"Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, 2430-028 Marinha Grande, Portugal"},{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisbon, Portugal"},{"name":"Servi\u00e7o de Estomatologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, 1349-019 Lisbon, Portugal"},{"name":"Clinica Universit\u00e1ria de Estomatologia, Centro Hospitalar Universit\u00e1rio Lisboa Norte (CHUNL), 1648-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5750-2875","authenticated-orcid":false,"given":"Henrique Jos\u00e9","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Sarkis","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Santos","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maffia","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"},{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sanz","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Salvado","sequence":"additional","affiliation":[{"name":"Clinica Universit\u00e1ria de Estomatologia, Centro Hospitalar Universit\u00e1rio Lisboa Norte (CHUNL), 1648-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","first-page":"CD012850","article-title":"Occlusal interventions for managing temporomandibular disorders","volume":"9","author":"Singh","year":"2024","journal-title":"Cochrane Database Syst. 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