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18.07.2011

Eficácia da toxina botulínica tipo A para tratamento da dor miofascial persistente - DTM : um estudo randomizado, controlado, multicêntrico duplo-cego.

 

 

Dor . 2011 21 de abril. [Epub ahead of print]

Eficácia da toxina botulínica tipo A para tratamento da dor persistente miofascial - DTM : um estudo randomizado, controlado, multicêntrico duplo-cego.

Fonte

Unidade de Fisiologia Oral Clínica, Departamento de Medicina Dentária, Karolinska Institutet, Box 4064, SE 141 Huddinge 04, na Suécia.

Resumo

 

Evidence of an effect by botulinum toxins is still lacking for most pain conditions. In the present randomized, placebo-controlled, crossover multicenter study, the efficacy ofbotulinum toxin type A (BTX-A) was investigated in patients with persistent myofascial temporomandibular disorders (TMD). Twenty-one patients with myofascial TMD without adequate pain relief after conventional treatment participated. A total of 50 U of BTX-A or isotonic saline (control) was randomly injected into 3 standardized sites of the painful masseter muscles. Follow-up was performed after 1 and 3months, followed by a 1-month washout period, after which crossover occurred. Pain intensity at rest was the primary outcome measure, while physical and emotional function, global improvement, side effects, and clinical measures were additional outcome measures. There was no main difference between drugs (ANOVA; P=.163), but there was a significant time effect (P<.001), so BTX-A reduced mean (SD) percent change of pain intensity by 30 (33%) after 1month and by 23 (30%) after 3months compared to 11 (40%) and 4 (33%) for saline. The number of patients who received a 30% pain reduction was not significantly larger for BTX-A than after saline at any follow-up visit. The number needed to treat was 11 after 1month and 7 after 3months. There were no significant changes after treatmentin any other outcome measures, with the exception of pain on palpation, which decreased 3months after saline injection (P<.05). These results do not indicate a clinical relevant effect of BTX-A in patients with persistent myofascial TMD painBotulinum toxin type A is not an effective adjunct to conventional treatment in persistent myofascialtemporomandibular disorders.

 

 

 

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