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Botox utilized as a medical prevention of abnormal joint adhesion.

Botox is famous for being used for cosmetic reasons and it is largely used an anti-ageing treatment to try and reverse fine lines and wrinkles on the face. It’s also known to get rid of migraines and headaches caused by possible uncontrollable muscle spasm; Botox inhibits muscle spasms and therefore causes muscle paralysis thus relieving the headache/migraine. Although Botox has a reputation for being an “age-defying elixir” it also has medical uses and can be used as a treatment for certain neuromuscular conditions. 

Botulinum toxin (Botox), one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum (C. botulinum). It has eight different antigenically distinguishable toxins (A, B, C1, C2, D, E, F & G). Type A Botox is the most potent toxin, most widely available and most widely used subtype of Botox.

The bacterium product is given via a neuromuscular injection in very low doses, causing muscle paralysis. It works by irreversibly inhibiting the release of acetyl choline, which is the principal neurotransmitter at the neuromuscular junction; therefore causing muscular paralysis.

It is also really essential and vital to have excellent knowledge and understanding of the functional anatomy of the mimetic muscles and it is absolutely necessary to correctly use botulinum toxins in clinical practise to avoid accidental poisoning and/or unnecessary complications.

Botox Prevents Traumatic Jaw Bone Ankylosis (- caused by jaw muscle injury)

Definition: Ankylosis or anchylosis (from Greek ἀγκύλος, bent, crooked) is a stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease.

TMJ (temporomandibular joint) consists of the lateral pterygoid muscle which is a muscle found at the top of the jaw closer to the ear. The TMJ is in a very intricate and delicate position (in the jaw) making it susceptible to injury especially during rear-end collisions involving cervical whiplash and other blows to the face.

Traumatic TMJA can be induced by trauma, injury or infection; causing rigidity of the jaw bone, making life difficult as it evidently becomes complicated and painful to eat and drink normally. The problematic condition is really difficult to treat as several operations are required, followed by physiotherapy and regular checkups to monitor the condition and to check for possible infections or other problems.  

It has been found that Botox can prevent traumatic TMJA, therefore preventing rigidity of jaw muscle keeping it flexible. It is also vital that it is injected soon after jaw surgery.

How the treatment is carried out:

Muscle size and activity is monitored first. The topical anaesthetic, Lidocaine is given first; the specific dose of Botox A is calculated especially for the patient- a dose of 5-10 units is generally recommended or 20-40 units depending on the patient requirements. Then the injection is monitored by electromyography (ECG) whilst the patient is being injected into the muscle, assuring that the veins are being avoided clearly. It is vital that the patient then receives further checkups to test the function of lateral pterygoid muscle and temporomandibular joint to decide whether they need to reinject with Botox, check for infections, or if the patient needs some further therapy such as open mouth training and physiotherapy.

This new method of treatment is effective for preventing ankylosis of the jaw bone, caused by trauma, and also Botulinum Toxin A is a cost effective method which is useful to make it widely available for patients that require treatment.

Personally I’m against the use of Botox for cosmetic reasons; however it is good to utilise it as a medical cure in certain medical cases such as traumatic TMJA.  There are many other medical cases that can utilise Botox as a cure which can be discussed in future posts.
[2] Injection of botulinum toxin A in lateral pterygoid muscle as a novel method for prevention of traumatic temporomandibular joint Ankylosis: