• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.17-23
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• 2009

배경: 보툴리눔 독소 A형은 강직성 질환을 비롯한 여러 질환의 치료제로 널리 사용되고 있다. 최근에 보툴리눔 독소 A형은 근육비대를 치료하기 위해 널리 이용되고 있다. 하지만 보툴리눔 독소의 근육비대의 치료효과에 대해서 알려진 바가 거의 없다. 본 연구는 토끼 정강뼈 근육에 보툴리눔 A, B형을 주입 후 시간경과에 따른 근육의 위축을 확인하여 근육비대의 치료에 보툴리눔 B형이 효과적인지 확인하고자 하였다. 방법: 36마리의 토끼를 4그룹으로 분류하였다(1 그룹: 생리식염수 주사: 2 그룹: 보툴리눔 독소 A, B - 2U, 3 그룹: 보툴리눔 독소 A, B - 5U, 4 그룹: 보툴리눔 독소 A, B - 10U). 정강뼈근육에 보툴리눔 독소 A, B형을 주입 후 1, 2, 4주에 정강뼈 근육의 부피를 측정하였다. 신경자극기를 이용하여 독소 주입 후 1, 2, 4주의 근육의 단일 수축을 확인하여 근육기능의 변화여부를 확인하였다. 결과: 보툴리눔 독소 B형을 주입시 통계적으로 유의하지 않지만 A형에 비해 근육 부피의 감소가 관찰되었다(P>0.05). 반면, 근육의 단일 수축은 보툴리눔의 용량에 관계없이 B형을 주입한 근육에서 더 높게 관찰 되었다. 결론: 보툴리눔 독소 B형을 주입한 경우 근육 기능의 회복속도는 빠른 반면 근육의 위축은 A형에 비해 더 오랫동안 지속되었다. 따라서 근육비대의 치료에 있어 보툴리눔 독소 B형이 A형보다 보다 더 효과적이라고 사료된다.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.171-178
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• 2012

Botulinum toxin type A (BoNT-A) has been applied successfully to treat chronic migraine, dystonia, spasticity and temporomandubular disorders(TMDs) as well as frontal wrinkle and glabella wrinkle. Recently it has been reported that BoNT-A, reversibly blocks presynaptic acetylcholine release, also inhibits the release of substance P, CGRP(calcitonin gene related peptide) and glutamate related to peripheral sensitization and neurogenic inflammation in sensory nerve, In this study we reviewed animal nerve injury model such as rat and rabbit and identify the analgesic effect and mechanism of nerve injury pain after dental treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.247-251
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• 2011

Botulinum toxin type A (BoNT-A) is used for treating bilateral masseter hypertrophy since 1994. Recently there have been more clinical studies in this area, with some authors reporting that BoNT-A can reduce the size of the masseter muscle, as documented by photography, ultrasonography, computed tomography, and 3D(three dimensional) laser scan. However, earlier studies were only for bilateral masseter hypertrophy cases, not for unilateral masseter hypertrophy cases. The aim of this study was to use 3D laser scanning to evaluate changes in the external facial contour induced by unilateral BoNT-A injection. BoNT-A was injected into hypertrophic masseter muscle unilaterally in 10 patients with asymmetric masseter hypertrophy. The clinical effects of unilaterally injected BoNT-A were evaluated before the injection and 4, 8, and 12weeks after the injection using 3D laser scan. And the mean values of both sides (injection and non-injection sides) were compared with. At injection side, mean values of the volume and the bulkiest height at each time point diminished significantly between pre-injection and 4, 8, and 12weeks post-injection. At non-injection side, in contrast, mean values of the volume and the bulkiest height diminished also but less than that of injected side, and there was no statistical significance. In this limited study, we concluded that the unilaterally BoNT-A injection side showed greater mean values of the reduction of muscle volume than non-injection side at 4, 8, and 12 weeks after the injection.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.391-398
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• 2013

Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.1-6
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• 2017

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.299-306
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• 2014

Botulinum toxin (BoNT) has been used for a wide spectrum of therapeutic and cosmetic indications, and the range of indications is continually increased. Though BoNT is a powerful poison, the fact that not only the effect but also the adverse effect of it fader about 6 months after injection makes clinicians to neglect its dangerous property in clinical application. But Many reports about the adverse effects including death of BoNT injection have been reported, the FDA edited in additional warnings about hospitalizations and deaths. In this study, we intended to look through the metabolic process in human body, possible adverse effect, matters to be attended in application, and cases reports about deaths of BoNT by reviewing the previous studies.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.61-72
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• 2021

A beautiful smile is made when it is symmetrical and gums are displayed less than 2 - 3 mm. Excessive gingival display also known as "gummy smile" is often recognized to be unaesthetic. Causes of gummy smile can be caused by delayed eruption, vertical maxillary excess, hypermobile upper lip, or a short upper lip. Meanwhile botulinum toxin which is an exotoxin produced from Clostridium botulinum, works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles. The application site and weakens the muscle tone is drawing attention as a gummy smile treatment caused by hypermobile upper lip. There have been many studies about the method of injecting botulinum toxin into muscles around the lips, but there is still no standardized research method and treatment method, so there is controversy over the therapeutic effect. The aim of this study is to review the previous studies about the predictors of indication and effects of gummy smile treatment using botulinum toxin injection. Especially we tried to propose a protocol for optimal dose and efficient injection point through the anatomical considerations for gummy smile treatment using botulinum toxin.

• Journal of dental hygiene science
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• v.16 no.6
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• pp.458-463
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• 2016

This study aimed to assess changes in maximum bite force and psychological elements in patients with bruxism treated with botulinum toxin who visited the hospital with a chief complaint of masseter hypertrophy. From among the subjects with masseter hypertrophy as the chief complaint, 10 patients with and 10 without bruxism were selected. We measured bite force prior to botulinum toxin injection and at 2, 4, 8, and 12 weeks after the injection and assessed changes in psychological elements by using Symptom Checklist 90 Revision. The study results showed statistically significant differences in maximum bite force on both the right and left sides between the patients with and those without bruxism, according to periodic changes (p<0.05). Depression elements showed statistically significant changes in the patients with bruxism (p<0.05). In the bruxism and non-bruxism groups, the patients recovered from anxiety in accordance with the periodic changes (p<0.05). Our study results indicate that the patients with bruxism show significant changes in interpersonal sensitivity, depression, and anxiety according to the treatment periods, and that occlusal force and depression were significantly related. Therefore, when setting a treatment plan for bruxism, multilateral psychological elements must be considered, along with functional elements.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.53-67
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• 2013

This study was aimed to evaluate the masticatory efficiency after botulinum toxin type A (BTX-A) injection during 12 weeks using objective and subjective test. Also, we compared the difference of masticatory efficiency between group that injected into the masseter muscle only (M-group) and group that injected into the masseter and temporalis muscle (M-T group). The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as the subjective indicators. It was concluded that masticatory efficiency was significantly lowered after a BTX-A injection into the masticatory muscle, but it gradually recovered in a predictable pattern by the 12 weeks. The disturbance of subjective masticatory efficiency was lasted longer than objective masticatory efficiency. The masticatory efficiency was lower in M-T group than M group. It was statistically significant in the VAS and FIA at 4 weeks, but the MAI showed no significancy. After 4weeks, there was rapid recovery of muscle function in M-T group, and the difference between two groups was not significant. It could be concluded that there will be no serious disturbance of mastication compared to injection is done only into the masseter muscle, even if injection is done into the masseter and temporalis muscle in dose of this study. According to the food properties, it was confirmed that people feel more discomfort on taking hard and tough foods after BTX-A injection and not only hard foods, but also intake of soft and runny foods were influenced by botulinum toxin injection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.21-24
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• 2009

Various laryngeal injection techniques andmaterials have been introduced and widelyused. In this section, office-base laryngeal injection with Cidofovir, Steroid and Botulinum toxin will be described including a suitable approach for the injection, treatment efficacy, side effects and its pitfalls.