Montgomery Oral and Facial Surgery

MONTGOMERY ORAL AND FACIAL SURGERY

*LEONARD A. MERLO, D.M.D.

FARZANEH ROSTAMI, D.D.S.

AND ASSOCIATES

*DIPLOMATE, AMERICAN BOARD OF ORAL AND MAXILLOFACIAL SURGERY

*DIPLOMATE, NATIONAL DENTAL BOARD OF ANESTHESIOLOGY

4701 RANDOLPH ROAD, SUITE G10 . ROCKVILLE, MD 20852 . TELEPHONE 301-468-0020

www.montgomeryoralsurgery.com

Surgical Update

Clinical Use of Botulinum Toxins

March 2015, Volume 1, Issue 4

Therapeutic use of Botulinum toxin type A (BTX-A) was first studied in primates. In the late 1970s the toxin was introduced as a therapeutic agent for treatment of strabismus and for the treatment of facial wrinkles in the late 1980s. In the mid and late 1990s BTX-A was utilized for lateral canthal lines (crow’s feet), platysmal banding, orbicularis oris injection, masseter muscle injection and the treatment of temporomandibular joint disorders (TMDs).

Seven different strains of Clostridium have been described (designated A, B,C (1 and 2), D,E,F,G). Humans are not affected by the toxins of strains C and D. BTX is a protease that causes temporary denervation of skeletal muscle by blocking the Ca-mediated release of acetylcoline from nerve endings of alpha and gamma motor neurons.

Clinical effect occurs within approximately 3-7 days ( typically seen after 1-3 days) after administration, followed by 1-2 weeks of maximum effect, which then levels off to a moderate plateau until full nerve recovery within 3-6 months (3 months on average). There are 6 different BTXs available on the market, 5 contain BTX-A (Botox, Dysport, Xeomin, Prosigne and PurTox) and the other contain BTX-B (Myoblast).

Important to keep in mind that Botox is only used for treatment and prevention of dynamic wrinkles.

Cosmetic Uses

Facial Wrinkles

BTX-A is commonly used for treatment of frown lines (Glabella Lines), Bunny Lines (bridge of the nose), forhead horizontal lines, crow’s feet (latreral canthal line), platysmal banding and peri-oral lines (lipstick lines). BTX-A is only FDA approved for treatment of glabellar lines.

Masseteric & Temporalis muscle Hypertrophy

This is due to Congenital asymmetry, habitual asymmetry, jaw clenching during exercise or sleep and other parafunctional habits.

Therapeutic Uses

In the head and neck region it has been used for treatment of hemifacial spasms, facial nerve palsy, TMD, bruxism, masticatory myalgias, hyperdentitis (excessive sweating of the armpits and face) and headaches.

Our doctors are more than happy to assist you with any questions. Please do not hesitate to contact our office.

For more information please visit us at www.montgomeryoralsurgery.com