Identificador: TDX:504
Autors:
Forteza González, Gabriel
Resum:
INTRODUCTIONIn the current literature, Masticatory Myofascial Pain Syndrome (MMPS), affects even 25% of general population. It affects mostly women (75-88,5%) from 20 to 40 years old. Main symptoms are trismus, facial pain, weakness and limitation of function in masseter (79-84%) and temporal (56-65%) muscles, followed by internal and external pterygoid and digastric muscles. Sternocleidomastoid, Splenius, Trapezius, perioral and frontal muscles can be also painful. Masseter complaint characteristically presents a taut or trigger band, localized in the middle of the muscle, painfull on palpation. MMPS often associates to depression, anxiety, and sleep disorders.Current literature on chronic pain considers that masticatory MMPS is due to central and peripheral mechanisms of Neuromuscular System, like MPS of trunk and limbs, though its exact origin is still uncertain. Different theories associate an excess of muscle activity, with final toxic metabolites release. Predisposing factors are bad body postures, sedentary life, nutritional imbalance- especially vitamin deficiency-, parafunctional habits, sleeps disorders and joint disorders.Most often, MMPS therapy has included prolonged use of non esteroidal anti-inflammatory agents, oclusal splints, muscle relaxants, antidepressives, or physical and behavioral therapies. Demonstrated useful local treatments are dry needling and infiltration of diverse agents, including physiologic saline solution. Hypothesis: Botulinum Toxin is an effective therapeutic method in MMPS.Objectives: To evaluate efficacy, side effects, of Botulinum Toxin A (BTA) in a group of voluntary patients affected of MMPS, by means of a parallel, double-blind, randomized study.MATERIAL AND METHODSA prospective, uni-centric, randomized, controlled, and double
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