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Comparison of Temporomandibular Joint Arthroscopy With Botulinum Toxin Injection Versus Placebo

Phase 4
Completed
Conditions
Temporomandibular Joint Disorders
Interventions
Drug: Incobotulinumoxin A
Procedure: TMJ surgical arthroscopy
Registration Number
NCT04810429
Lead Sponsor
Instituto Portugues da Face
Brief Summary

There are several studies that have considered Botulinum toxin A (BoNT-A) injections are effective in treating symptoms for Temporomandibular Joint (TMJ) disorders. BoNT-A injections improve the hyper-tonicity of mandibular muscles and its consequent joint load reduction. Also injections of BoNT-A, for patients with articular disc displacement, resulted in pain relief and return of the normal movements of the mandible. The main goal of this study is to test the beneficial impact of BoNT-A injections in the masticatory muscles of patients submitted to TMJ surgical arthroscopy.

Detailed Description

Study Objective:

To investigate the potential performance of incobotulinumtoxin-A (BTXA) in patients submitted to TMJ surgical arthroscopy. Besides the acceptable good outcomes of TMJ arthroscopy, the authors believe that using a single injection of BTXA into the temporalis and masseter muscles could reduce joint loading and pain, improving TMJ arthroscopy results.

The proposed explanation for this study:

TMJ arthroscopy is a minimal invasive surgical technique for different types of temporomandibular joint (TMJ) internal derangements. Besides the acceptable outcomes of TMJ arthroscopy, the authors believe that adding to this treatment a single injection of BTXA into the temporalis and masseter muscles could reduce joint loading, improving TMJ arthroscopic results.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
15
Inclusion Criteria
  • Patients with TMJ with indication for arthroscopy
  • Age between 12-60 years old
  • Minimum level of pain for inclusion should be 5/10 (on a 0-10 VAS scale)
Exclusion Criteria
  • Previous treatment to TMD
  • Previous use of facial Botulinum Toxin
  • Any contraindication for the use of BTXA according to XEOMIN SmPC

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IncobotulinumoxinATMJ surgical arthroscopyTMJ arthroscopy and Dose of IncobotulinumoxinA to be injected 100 U distributed in 2 syringes with 1 ml each: 25U (0.5ml) in Right Masseter / 25U (0.5ml) in Left Masseter / 25U (0.5ml) in Right Temporalis / 25U in Left Temporalis.
PlaceboTMJ surgical arthroscopyTMJ arthroscopy and Saline solution NaCl 0,9% in 2 syringes with 1 ml each. Injected in Right Masseter (0.5ml), Left Masseter (0.5ml), Right Temporalis (0.5ml) and Left Temporalis (0.5ml).
IncobotulinumoxinAIncobotulinumoxin ATMJ arthroscopy and Dose of IncobotulinumoxinA to be injected 100 U distributed in 2 syringes with 1 ml each: 25U (0.5ml) in Right Masseter / 25U (0.5ml) in Left Masseter / 25U (0.5ml) in Right Temporalis / 25U in Left Temporalis.
Primary Outcome Measures
NameTimeMethod
VAS score5 weeks after injection and TMJ arthroscopy

Improvement in TMJ pain: measured by the patient using a Visual Analogue scale (VAS), with a range from 0 to 10, with 0 being no pain and 10 having maximum unbearable pain. VAS score will be measured every week before surgery and in the fifth week after surgery.

Secondary Outcome Measures
NameTimeMethod
Maximum Mouth Opening5 weeks after injection and TMJ arthroscopy

in cm

Muscle Tenderness5 weeks after injection and TMJ arthroscopy

Masseter muscle, temporalis muscle, temporalis tendon, and lateral capsule of the TMJ) - Muscle sensitivity scale (0-3)

GICS5 weeks after injection and TMJ arthroscopy

Global Impression of change by the subject

Palpable joint click5 weeks after injection and TMJ arthroscopy

Yes or No

Diet consistency tolerated5 weeks after injection and TMJ arthroscopy

regular diet, basic diet, liquid diet

Trial Locations

Locations (1)

Instituto Português da Face

🇵🇹

Lisboa, Portugal

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