Evidence Hub

Effectiveness of intra-oral botulinum toxin injection in comparison to the extra-oral approach on pain and quality of life in patients with myofascial pain: a randomized clinical trial

A. Shabaan, Islam Kassem, Inass Aboulmagd, Islam A. Amer, A. Shaaban, Mohamed Abd-El-Ghafour, S. Refahee

Clinical Oral Investigations, 2024

42 participants · 6 citations

Abstract

To evaluate and compare the effectiveness of the ultrasound-guided intra-oral and extra-oral transcutaneous injection techniques on the clinical outcome variables in patients with myofascial trigger points within the masseter muscle. This prospective randomized trial included 42 patients diagnosed with myofascial pain. Patients were randomly allocated into one of two groups based on the technique of trigger point injection: intraoral and extraoral injection technique groups. Each trigger point was injected with 0.1 ml of botulinum-A toxin guided by ultrasound. Pain intensity, mouth opening, and patient quality of life were monitored six months post-injection. The pain scores were significantly higher in the extraoral group during all follow-up assessments, whereas the MMO was considerably greater in the intraoral group up to three months of follow-up (p < 0.008). However, the difference in MMO ceased to be statistically non-significant after six months of follow-up (p = 0.927). Additionally, the patient’s quality of life score was significantly higher in the intraoral group compared to the extraoral group (p < 0.001) at both the three- and six-month follow-ups. The intraoral injection technique might be an effective treatment modality for myofascial trigger points in the masseter muscle. It produces pain relief, increases mouth opening, and enhances the overall quality of life compared to the extraoral injection technique. The intraoral injection technique for myofascial…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 42 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free