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Hyperreactive Brain Network May Be Cause of Chronic Pain in Fibromyalgia, Study Suggests

Fibromyalgia is one of the overlapping pain conditions with TMD. This article appeared in Fibromyalgia News Today on January 15, 2018. A new study suggests a hyperreactive brain network may be the underlying cause of chronic pain in fibromyalgia.

Dry Eye Linked to Chronic Overlapping Pain in Veteran Population

There may be a correlation between dry eye and chronic pain in the US military veteran population as is evident by a recent study. Ocular pain was most strongly associated with headaches, tension headaches, migraines, temporomandibular joint disorders, pelvic pain, central pain syndrome, and fibromyalgia in the veteran patient population.

Patients in Los Angeles or New York City Needed for Clinical Study - Comparative Study of Women Considering or Currently Receiving Botox© Injections for TMJ Pain

Are you a woman with "TMJ" pain in facial muscles, who has either: a. recently had Botox© injections for your pain or b. not had Botox© for your pain but has thought about such treatment? If either is true for you, you may qualify for an observational research study centrally administered by the NYU College of Dentistry. It is funded by the National Institutes of Health (NIH). The purpose of this study is to understand potential health risks that may be caused by treating "TMJ pain" with Botox© injections.

Why Head and Face Pain Cause More Suffering

Hate headaches? The distress you feel is not all in your -- well, head. People consistently rate pain of the head, face, eyeballs, ears and teeth as more disruptive, and more emotionally draining, than pain elsewhere in the body.

Migraine and Coronary Artery Disease: A Genetic Connection

There has long been as association between migraine headaches and vascular (blood vessel) dysfunction of some kind, underscored by epidemiological studies and other research. New evidence for a genetic connection now comes from the analysis of several large data sets of each condition based on Genome Wide Association Studies (GWAS).

Repeated Injections of Botox into the Masseter Muscle... A Longitudinal Study

  • Oct 5, 2017

We thank Dr. Susan Herring for writing the following article summary.

Lee HJ, Kim SJ, Lee KJ, Yu HS, Baik HS. Repeated injections of botulinum toxin into the masseter muscle induce bony changes in human adults: A longitudinal study.   Korean J Orthod. 2017 Jul;47(4):222-228. 

The authors of this study examined mandibular bone before and after subjects received Botox injections into each masseter muscle. These volunteers were healthy adults (22-48 years old), both male and female, who wanted injections to slim their faces. (This happens because the Botox causes temporary muscle paralysis and the masseters undergo atrophy when they are not used.) The 20 subjects were randomized into two groups. One group received a single dose of Botox in each muscle while the second group got two doses. The second dose was given 4 months after the first. The bone scans were cone-beam computed tomography (CBCT), a 3-D technique with relatively low radiation. The after-Botox CBCT scan was performed 6 months after the initial injection. The scans were directed at the mandibular angle, where the masseter attaches. The TMJ region was not examined.

Even 6 months after a single injection, the masseter muscles were much smaller than before injection (loss of about 70 mm2). Predictably, the shrinkage was much greater for the two-injection group (loss of about 140 mm2).

The very limited amount of mandibular bone examined is only part of the masseter's attachment, and an unaffected muscle, the medial pterygoid, attaches to it as well. Therefore, it is surprising that the authors were able to document a loss of bone volume which was statistically significant in the 2-injection group. The loss was due to thinning of the bone, because the mandible as a whole did not become smaller. The authors refer to this finding as an "unwanted side effect" of multiple Botox injections of the masseter muscles.

This study was not ideal and leaves many questions unanswered. Sample size was small, there were no uninjected control subjects, differences between the groups at the start were not reported, the bone examination was very restricted, and it is unknown whether full restoration of muscle and bone would eventually have occurred.  

Nevertheless, it is the first prospective, randomized, longitudinal study of the effects of Botox on the human jaw. The finding of bone loss is consistent with the only other human Botox study on jaws, a cross-sectional examination of the condylar bone of TMJ disorder patients who did or did not receive masseter injections (Raphael et al. 2014). The paper by Lee et al. reinforces the idea that thinned and weakened jaw bones are likely side effects of Botox treatment.

 Raphael, K. G., A. Tadinada, J. M. Bradshaw, M. N. Janal, D. A. Sirois, K. C. Chan and A. G. Lurie (2014). Osteopenic consequences of botulinum toxin injections in the masticatory muscles: a pilot study. J Oral Rehabil 41: 555-563.

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TMJ Disorders


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