A complex treatment of irreducible displacement of the temporomandibular joint disc and myofascial pain disorders with the use of botulinum toxin

Background. An irreducible displacement of the articular disc (IDD) is one of the TMJ conditions characterized by complexity of clinical manifestations, severity and is always accompanied by myofascial pain disorders. Objective. To improve the results of treatment of patients with TMJ IDD and myofascial pain syndromes. Methods. We performed a clinical examination and treatment of 38 patients with irreducible displacement of the TMJ articular disc and myofascial pain disorders. As additional research methods, we used CBCT, MRI, EMG. A step-by-step treatment was conducted, including a drug therapy, injection of botulinum toxin type A (BTA) in the masticatory, temporal, lateral pterygoid muscles (LPM) bilaterally; repositional splint therapy; arthrocentesis with the lavage of both articular spaces. Results. The overall effectiveness of the treatment was 97.4%. Out of 38 patients, 34 (89.5%) were treated without arthrocentesis with the complete restoration of the mandibular movement volume and elimination of pain syndrome...