Literature Review

Therapeutic uses and efficacy of botulinum toxin in orofacial medicine

¹ Resident at Paris Hospitals, Paris, France
² Maxillofacial Surgery Service, Hôpital Pitié Salpêtrière, Paris, France
³ Maxillofacial Surgery Service, Georges-Pompidou European Hospital, Paris, France
⁴ Dental Surgery Service, Bretonneau Hospital, Paris, France
⁵ Faculty of Dental Surgery, Paris Descartes University, Montrouge, France

^* Correspondence: bayet.kinz@gmail.com

Received: 13 November 2016
Accepted: 10 September 2017

Abstract

Introduction: Botulinum toxin, primarily known for its use in cosmetic surgery, is also used for therapeutic purposes in many medical fields. It works as a muscle relaxant and inhibits glandular secretions. In the orofacial sphere, the use of this toxin is proposed in particular for disabling myofascial pain and aberrant salivary disorders. Methodology: A critical analysis of the literature, based on PUBMED data, concerning the orofacial indications of botulinum toxin was carried out. Results: The literature is abundant regarding the therapeutic interest of this toxin for several oral pathologies, but scientific merits vary markedly from one indication to another. Discussion: The musculorelaxant and antisecretory action of this toxin appears to be demonstrated in the case of bruxism, limitation of the mouth opening and in hypersialorrhea. On the other hand, its medical benefit is still not supported by scientific evidence for masseter hypertrophy, tonicity of the levator labii superioris muscles, sialocele fistulae and Frey's syndrome. Conclusion: Additional high-level studies, unbiased, randomized controlled trials, are required to eliminate the uncertainties that persist about the clinical impact of botulinum toxin and to justify the development of recommendations for good practice valid and credible.