Botulinum Toxin Therapy for Managing Sleep Bruxism: A Randomized and Placebo-Controlled Trial
Shim YJ
Published in Toxins
Methodology
Randomised placebo-controlled trial; botulinum toxin type A versus saline injected into each masseter muscle; audio-video polysomnography in a sleep laboratory before injection and at 4 and 12 weeks, scored per the American Academy of Sleep Medicine manual, analysed by repeated measures ANOVA.
Key Findings
30 people with sleep bruxism were randomised to botulinum toxin type A or saline injections into each masseter muscle, with audio-video polysomnography before injection and at 4 and 12 weeks; 23 completed (13 treatment, 10 placebo). No sleep bruxism episode variable showed a significant time-by-group interaction, meaning the injections did not reduce how often grinding occurred. The peak amplitude of masseter electromyography bursts during bruxism did show a significant interaction (p = 0.001) and fell in the treatment group across 12 weeks (p < 0.0001). The authors conclude a single injection cannot stop bruxism episodes but can reduce their intensity.
Conclusions
A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.
Limitations
Only 23 of 30 randomised participants completed, leaving very small groups; the benefit is limited to a physiological measure of muscle intensity rather than reduced grinding episodes, and follow-up ended at 12 weeks.
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Study Details
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