ArticleBMC oral health2026
Clinical and early biochemical responses to botulinum toxin type-A in refractory masticatory myofascial pain: a pilot single-arm study.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06840730 (Investigation of the Relationship Between Clinical Results of Onabotulinum Toxin A Application and Pain Mediators in the Treatment of Myospasm-Related Masticatory Muscle Disorder), which is not on this map. Not yet cited in PubMed.
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.
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.
Investigation of the Relationship Between Clinical Results of Onabotulinum Toxin A Application and Pain Mediators in the Treatment of Myospasm-Related Masticatory Muscle Disorder
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMasticatory myofascial pain (MMP) is a common subtype of temporomandibular disorders (TMD) characterized by muscle tenderness and pain during jaw function. Botulinum toxin type-A (BoNT-A) is often used for refractory cases unresponsive to conservative therapies; however, its biological mechanisms remain unclear. This exploratory pilot study aimed to evaluate both clinical outcomes and biochemical changes following BoNT-A injections in patients with refractory MMP.
methodsTwenty-seven patients diagnosed with refractory MMP according to DC/TMD criteria received intramuscular BoNT-A injections into the masseter and temporalis muscles. Pain intensity (VAS), pressure pain threshold (PPT), maximum mouth opening (MMO), and oral health-related quality of life assessed using the OHIP-14 were recorded at baseline (T0) and 28 days post-treatment (T1). Serum and saliva samples were collected to measure inflammatory cytokines (IL-1β, IL-6, TNF-α) and neuropeptides (CGRP, NGF) using ELISA. Data were analyzed using the paired t-test or Wilcoxon signed-rank test, as appropriate.
resultsAt 28 days, improvements were observed in pain (VAS, p < 0.001), PPT for the masseter and temporalis muscles (p < 0.001), and OHIP-14 scores (p < 0.001), while MMO remained unchanged. Changes in cytokine levels were smaller and more variable. In contrast, CGRP and NGF concentrations increased in both serum and saliva and showed the strongest evidence of change among the evaluated biomarkers.
conclusionBoNT-A produced measurable clinical improvements and modulated biochemical profiles in refractory MMP. Similar trends observed in serum and saliva suggest that salivary biomarkers may provide a noninvasive approach for monitoring biochemical responses. Given the exploratory design and limited sample size, these findings should be interpreted with caution. Larger, controlled trials with extended follow-up are needed to clarify BoNT-A's mechanisms and long-term effects.
trial registrationClinicalTrials.gov (NCT06840730), retrospectively registered (2025-02-21).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.