The effectiveness of guided botulinum toxin "A" injection to the masticatory muscles in the management of condylar and sub condylar fractures: a randomized controlled clinical trial.
Pakinam H Gheeta, Adham A Elashwah, Passent A Younis
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled clinical trial compared ultrasound-guided botulinum toxin A injections into the masseter, temporalis and lateral pterygoid muscles plus closed reduction with closed reduction alone in 16 medically healthy adults aged 18–35 years with unilateral subcondylar fractures. The injection group had lower pain scores, shorter operation time, better reduction accuracy and greater improvement in mouth opening. At 6 weeks, mouth opening was 38.02 ± 3.26 mm versus 17.88 ± 4.49 mm in the control group (p < 0.001). Bone density increased in both groups, with no significant between-group difference.
Key findings
- At 6 weeks, mouth opening was 38.02 ± 3.26 mm with botulinum toxin versus 17.88 ± 4.49 mm with closed reduction alone (p < 0.001).
- Pain scores and operation time were significantly lower in the injection group (both p < 0.001).
- Postoperative reduction accuracy was better with injections, with lower angulation values immediately after surgery and at 6 months (p < 0.02).
- Bone density at the fracture line increased over time in both groups, without a significant between-group difference (p = 0.37).
Why it matters
Reducing pain and improving early jaw mobility and fracture alignment may support recovery after closed treatment of subcondylar fractures. The findings also suggest that the intervention did not measurably impair bone-density progression in this trial. However, the results come from a small group of young, medically healthy adults and should be interpreted in that context.
What to keep in mind
The trial included only 16 medically healthy adults aged 18–35 years with unilateral fractures, limiting how broadly its findings can be applied.