Toxina Botulínica no Tratamento de Pacientes com Disfunção Temporomandibular e Cefaleia: uma Revisão de Escopo

Abstract

Temporomandibular disorder (TMD) and primary headaches are challenging topics in the areas of dentistry and medicine. With global distribution, they represent the second most common cause of chronic facial pain. TMD affects around 30% of the world's adult population, while headaches affect more than 46% of individuals. Presenting overlap and coincidences in their etiology, the diagnosis and treatment of both promote intercessions. In this aspect, the applicability of botulinum toxin remains as a second-line resource for refractory cases. With the aim of mapping information on the topic, this scoping review was carried out using the elements of the PCC acronym, where P represents the population defined by TMD and headache sufferers, the first C is equivalent to the concept of toxin use botulinum A and the second C translates the context of patients refractory to initial therapy. The question was formulated: “What has been produced in the scientific literature about the use of botulinum A in patients with temporomandibular disorder and headache refractory to first-line therapy?” The databases used were: Pubmed / Medline, LILACS, Cochrane and the gray literature analysis included Google Scholar and Clinical Trials.com. Two researchers, in a blind and standardized manner, used the Rayyan reference manager to judge the inclusion and exclusion criteria in the selection of articles. For mapping, various study designs were included within the domain of patients undergoing treatment for TMD and headaches, without restrictions on language or year of publication. Disagreements at this stage were resolved by a third evaluator. The articles selected for full reading were followed by data extraction in a pre-established form. The studies did not present uniformity in their designs and there was no consensus on their outcomes. Pain improvement was observed in more than 80% of studies, while the increase in mouth opening amplitude was the data that presented the most controversial results. Analysis of quality of life remained a gap to be explored. Future studies with extended follow-up time and uniform designs will enable the provision of data applicable to clinical pain management.