Botulinum Toxin Injections for Bruxism: Don't Forget About the Apnea

A small study suggests that the injections improve sleep bruxism but highlights an association between bruxism and apnea.

Researchers tested onabotulinum toxin-A (BoNT-A) masseter and temporalis injections for sleep-associated bruxism in a manufacturer-funded trial. After polysomnography to confirm bruxism, participants were randomized to injection of 200 units of BoNT-A (60 into each masseter and 40 into each temporalis) or to placebo injections. The primary efficacy endpoint was the clinical global impression (CGI), and the secondary outcome was a change on a visual analog scale (VAS) for bruxism and for pain, at 4 to 8 weeks after the injections.

Of 23 participants, 13 in the BoNT-A group and 9 in the placebo group completed the trial. CGI improved significantly more in the BoNT group, and the VAS similarly favored the BoNT-A group. Among exploratory outcome…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)