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Cerebral palsy and bruxism: Effects of botulinum toxin injections—A randomized controlled trial

Journal article
Authors Birgitta Johansson Cahlin
Christopher Lindberg
Lars Dahlström
Published in Clinical and Experimental Dental Research
ISSN 2057-4347
Publication year 2019
Published at Institute of Odontology
Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Odontology, Section 1
Language en
Keywords botulinum toxin, bruxism, cerebral palsy, oral physiology, oral rehabilitation, TMD
Subject categories Dentistry


Objective: Cerebral palsy (CP) includes disturbances in muscular control caused by perinatal brain injury. Masticatory muscle involvement hampers functions such as chewing and talking. Bruxism and temporomandibular disorders are overrepresented. Neuromuscular blocks with botulinum toxin type A (BTX-A) may alleviate problems due to muscular hyperactivity. The aim was to evaluate masticatory muscle BTX-A injections in subjects with CP and bruxism. Methods: A prospective, parallel, randomized, placebo-controlled, and double-blind trial in 12 patients with CP was performed. End points were alterations in objective and subjective oral capacities after two BTX-A or corresponding placebo injections. Matched, healthy references were also evaluated. Results: The reference group demonstrated stronger and more efficient oral functions compared with the CP group. Subjective and objective oral capacities appeared to vary considerably between CP patients and also over time in this patient group and were poorly correlated. No significant effect of BTX-A compared with placebo on outcome variables was observed at group level, but continued treatment with BTX-A was requested by the majority of the patients. Conclusion: The evidence is unable to support the use of BTX-A for the treatment of affected masticatory muscles in CP, but the findings are inconclusive in certain respects. Larger, more homogeneous groups of CP patients need to be evaluated in future trials. ©2019 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.

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