Evidence map›Paper›PMID 38900335›Full record

SynthesisDrugs2024

Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews.

Giancarlo De la Torre Canales, Mariana Barbosa Câmara-Souza, Malin Ernberg, Essam Ahmed Al-Moraissi, Anastasios Grigoriadis, Rodrigo Lorenzi Poluha, Maria Christidis, Hajer Jasim, Anna Lövgren, Nikolaos Christidis

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Drugs, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Giancarlo De la Torre CanalesDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden.ORCID http://orcid.org/0000-0002-0921-342X
Mariana Barbosa Câmara-SouzaDepartment of Dentistry, Ingá University Center, Uningá, Paraná, Brazil.ORCID http://orcid.org/0000-0002-9961-121X
Malin ErnbergDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden.ORCID http://orcid.org/0000-0003-4152-5439
Essam Ahmed Al-MoraissiDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.ORCID http://orcid.org/0000-0002-3649-9662
Anastasios GrigoriadisDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden.ORCID http://orcid.org/0000-0002-3323-8299
Rodrigo Lorenzi PoluhaDepartment of Dentistry, State University of Maringa, Paraná, Brazil.ORCID http://orcid.org/0000-0001-7180-6448
Maria ChristidisThe Institute of Health Sciences, The Swedish Red Cross University, SE-141 21, Huddinge, Sweden.ORCID http://orcid.org/0000-0001-6804-6855
Hajer JasimDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden.ORCID http://orcid.org/0000-0003-2352-8070
Anna LövgrenClinical Oral Physiology, Department of Odontology, Faculty of Medicine, University of Umeå, Umeå, Sweden.ORCID http://orcid.org/0000-0003-2920-6654
Nikolaos ChristidisDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden. nicolaos.christidis@ki.se.ORCID http://orcid.org/0000-0002-8199-7863

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTemporomandibular disorders (TMDs) encompass several conditions that cause pain and impair function of the masticatory muscles (M-TMDs) and temporomandibular joints. There is a large interest among clinicians and researchers in the use of botulinum toxin-A (BoNT-A) as a treatment for M-TMD. However, due to the lack of consistent evidence regarding the efficacy as well as adverse events of BoNT-A, clinical decision making is challenging. Therefore, this umbrella review aimed to systematically assess systematic reviews (SRs) evaluating BoNT-A treatment effects on pain intensity, mandibular movements, and adverse events in patients with M-TMDs.

methodAn electronic search was undertaken in the databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Epistemonikos, ClinicalTrials.gov, and ICTRP to identify SRs investigating BoNT-A effects on M-TMDs, published from the inception of each database until 6 December 2023. The quality of evidence was rated according to the critical appraisal checklist developed by the umbrella review methodology working group. Only high-quality SRs were included.

resultsIn total, 18 SRs were included. BoNT-A was shown to be more effective than placebo to reduce pain intensity, but not compared to standard treatments. Additionally, BoNT-A was not superior to placebo or standard treatments regarding improvement of mandibular movements. BoNT-A was considered to have a higher risk for adverse events on muscle and bony tissue compared with other treatments.

conclusionThe synthesis in this umbrella review provides the highest level of evidence present. Taken together, there are indications of effectiveness of BoNT-A for treatment of M-TMDs, supported by moderate evidence. However, considering the risk of causing serious adverse events, treatment with BoNT-A is recommended to be the last treatment alternative.

Indexed as

Botulinum Toxins, Type ASystematic Reviews as TopicTemporomandibular Joint DisordersHumansMasticatory MusclesNeuromuscular AgentsBotulinum Toxins, Type ANeuromuscular Agents

Identifiers

PMID38900335
PMCPMC11289222

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.