Injecting Lateral Pterygoid Muscle by Botulinum Toxin Type A With 2 Different Methods : 3D Guided Appliance and Electromyography (EMG) .

NCT ID: NCT06633445

Last Updated: 2025-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-01

Study Completion Date

2024-09-01

Brief Summary

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The goal of this study is to evaluate intra-oral botulinum toxin type A injection into lateral pterygoid muscle using a surgical guide synthesized by virtual planning based on CT with soft tissue window.

* To evaluate improvement of maximum interincisal opening (MIO) before and after injection.
* To assess change in disc position before and after injection.
* To evaluate recovery of symptoms as clicking, tenderness of TMJ and tenderness of lateral pterygoid muscle after injection.

Researchers will compare intra-oral botulinum toxin type A injection using a surgical guide synthesized by virtual planning based on CT with soft tissue window to conventional EMG guided botulinum toxin injection into lateral pterygoid muscle in patient with anterior disc displacement with reduction.

Participants will be injected with botulinum toxin type A by intraoral approach.

Detailed Description

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Conditions

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Anterior Disc Displacement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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3D guided botulinum toxin injection arm

Group Type EXPERIMENTAL

botulinum toxin type A injection in lateral pterygoid muscle

Intervention Type PROCEDURE

* Needle insertion guide will be placed on upper teeth.
* Needle will be inserted from needle insertion sleeve and 25-30 units of botulinum toxin type A will be injected.
* Aspiration will be done before injection, and then, the patient will be asked to manipulate the mandible to activate the lateral pterygoid muscle.

Electromyography botulinum toxin injection arm

Group Type ACTIVE_COMPARATOR

botox injection in lateral pterygoid muscle

Intervention Type PROCEDURE

* A 27- gauge needle electrode will be inserted lateral to the maxillary tuberosity, just above the maxillary molars to inject 25-30 units of botulinum toxin type A under electromyographic guidance.
* Aspiration will be done before injection, and then the patient will be asked to manipulate the mandible to activate the lateral pterygoid muscle.
* The intramuscular injection will be confirmed when the electromyographic device produces a distinct loud sound.

Interventions

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botulinum toxin type A injection in lateral pterygoid muscle

* Needle insertion guide will be placed on upper teeth.
* Needle will be inserted from needle insertion sleeve and 25-30 units of botulinum toxin type A will be injected.
* Aspiration will be done before injection, and then, the patient will be asked to manipulate the mandible to activate the lateral pterygoid muscle.

Intervention Type PROCEDURE

botox injection in lateral pterygoid muscle

* A 27- gauge needle electrode will be inserted lateral to the maxillary tuberosity, just above the maxillary molars to inject 25-30 units of botulinum toxin type A under electromyographic guidance.
* Aspiration will be done before injection, and then the patient will be asked to manipulate the mandible to activate the lateral pterygoid muscle.
* The intramuscular injection will be confirmed when the electromyographic device produces a distinct loud sound.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients of both sexes that are diagnosed with ADDWR according to DC/TMD.
2. Their age range between 20 and 45 years.
3. Angle class I maxilla-mandibular relation.

Exclusion Criteria

1. Patients with degenerative joint disease, musculoskeletal, neuromuscular disorders, cardiovascular, bleeding disorders, breathing difficulties, neurological disorders.
2. Pregnancy and lactating women.
3. History of surgical TMJ intervention.
4. Botox hypersensitivity
5. History of tumors or maxillofacial trauma.
6. Posteriorly edentulous saddles or anterior open bite.
7. Patient contraindicated to MRI examination
Minimum Eligible Age

20 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mahmoud Akram Khodir

OTHER

Sponsor Role lead

Responsible Party

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Mahmoud Akram Khodir

Assistant Lecturer of oral and maxillofacial surgery

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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faculty of dentistry, Alexandria university

Alexandria, , Egypt

Site Status

Countries

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Egypt

References

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Raafa N, Melek L, Zoheir H, Mansour E, Sakr A. A novel fully guided technique for botulinum toxin injection in lateral pterygoid muscle using muscle segmentation for TMJ disc displacement with reduction: a randomized controlled trial. BMC Oral Health. 2025 Jun 21;25(1):957. doi: 10.1186/s12903-025-06372-w.

Reference Type DERIVED
PMID: 40544291 (View on PubMed)

Other Identifiers

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3D guided Botox injection

Identifier Type: -

Identifier Source: org_study_id

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