Different types of injection in temporomandibular disorders (TMD) treatment

Introduction. Intramuscular injections of botulinum toxin of type A (BoNTA) can release tension from masticatory and cervical muscles. Intra-articular injections relieve pain and sometimes diminish joint clicking and locking that occur during mouth opening. Methods. Intramuscular injection of BoNTA is performed in our department since 2002. Injected muscles are masseter and temporal muscles. Later on, intra-articular injections of sodium hyaluronate were added, followed on a later stage by intra-articular injections of BoNTA for patients presenting with pain higher than 5/10 on an analogic visual scale. Results. Eighty-five percent of the patients treated with intramuscular BoNTA injection improved. Total or partial pain relief was obtained in 95 % of the patients after intra-articular sodium hyaluronate injections. Seventy-six percent of the 56 patients treated by mean of intra-articular BoNTA injections improved, sometimes with a complete pain relief. Discussion. These different techniques allow for good results, even if they do not represent a revolution in the treatment of temporomandibular disorders. In the hands of experienced practitioners, they have a low morbidity, are well accepted and are cost-effective. (C) 2016 Published by Elsevier Masson SAS.