77 Romanian JouRnal of medical PRactice – Vol. XV, no. 1 (70), 2020 PRACTICA MEDICALĂ Corresponding author: Lecturer Bogdan Dragomir, MD, PhD E-mail: dragomirbo@gmail.com The use of botulinum toxin in the management of bruxism and facial arthromyalgia syndrome Lecturer Raluca A. DRAGOMIR 1 , MD, PhD, Assist. Prof. Cristian Ilie DROCHIOI 1 , MD, PhD, Assist. Prof. Alexandra CARP 1 , MD, PhD, Lecturer Bogdan DRAGOMIR 2 , MD, PhD, Lecturer Otilia BOISTEANU 1 , MD, PhD, Assoc. Prof. Victor-Vlad COSTAN 1 , MD, PhD 1 Oral and Maxillofacial Surgery Department, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania 2 Orthodontics and Facial Orthopedics, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania Abstract Objectives. The focus of this study is to determine the outcomes of botulinum toxin injections in patients with symptomatic bruxism. Material and methods. We reviewed the medical records of patients with brux- ism and facial arthromyalgia syndrome treated by botulinum toxin injections. We evaluated the initial complaints, clinical findings, technique of neurotoxin administration, previous treatments and post-injec- tion outcomes. Results. Pain related symptoms were significantly decreased in all patients one month fol- lowing administration and maintained three months post-injection. Complications of the technique were mild and rarely encountered. Conclusions. Botulinum toxin is effective in reducing the associated symp- toms of bruxism, and its administration is generally safe if careful injection technique is employed and ade- quate doses used. Keywords: bruxism, botulinum toxin, arthromyalgia, temporomandibular joint, injection, masseter INTRODUCTION The spectrum of indication for botulinum tox- in administration gradually increased over time as new benefits of this treatment were discovered, with wide applications ranging from cosmetic pur- poses, to treating muscular contractures, spastic- ity, dystonia and even neuromuscular pain (1-4). The effects of botulinum toxin administration were attributed mainly to the well-established property of inhibiting the release of acetylcholine at the synapse level, therefore inducing absence of stimulation of the effector, whether it is a muscle or a gland with resulting obvious benefits in the treatment of conditions involving such structures (1). Additionally, multiple studies underlined the effects of botulinum toxin concerning the inhibi- tion of the release of several mediators of inflam- mation and peripheral neurotransmitters from the sensory nerve fibers, resulting in decreased pain (5-7). Considering multiple interrelating mechanisms involved in the development of bruxism and facial arthromyalgia syndrome, including neuro-mus- cular, structural, mechanical, behavioral and psy- Clinical studies Ref: Ro J Med Pract. 2020;15(1) DOI: 10.37897/RJMP.2020.1.15