ClinicalTrials.gg
RecruitingNCT05562531Updated Dec 7, 2023

Botulinum Toxin Administration on Masticatory Performance

An observational study in Temporomandibular Disorder and Bruxism, sponsored by Marmara University. Recruiting at 1 site in Turkey. Open to participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-12-07.

Sponsored by Marmara University · Observational

From the registry’s dates

  • Started May 2022; still recruiting 4 years 6 months later.
Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
30
Ages
18 Years to 50 Years
Sex
All
01

Study summary

This study aimed to evaluate the effect of botulinum toxin type A (BTX-A) injection on masticatory performance and nutritional status in temporomandibular disorder patients with bruxism caused by both intra-articular and extra-articular pathologies based on Research Diagnostic Criteria for temporomandibular disorders (TMD). The baseline and end masticatory performance, pain intensity, nutrition and anxiety statuses, and anthropometric measurements will be compared.

Read the detailed description

The main purpose of this study is to determine the effect of BTX-A injection on masticatory performance and nutritional status in TMD patients with bruxism.

Sub-objectives of the study;

Determination of the effect of BTX-A on masticatory performance Determination of the effect of BTX-A on pain intensity Determination of the effect of BTX-A on anthropometric measurements Determination of the effect of BTX-A on nutritional status Determination of the effect of BTX-A on anxiety status.

02

Conditions studied

  • Temporomandibular Disorder
  • Bruxism

Keywords

  • Botulinum Toxins, Type A
  • Mastication
  • Nutritional Status
  • Bruxism
  • Chewing
03

In context

Temporomandibular Joint Disorders

591 studies on the registry are indexed under Temporomandibular Joint Disorders; 149 are open to participants now.

This study's planned enrollment of 30 is below the median of 91 across 165 observational studies indexed under Temporomandibular Joint Disorders.

Browse Temporomandibular Joint Disorders studies →

Lead sponsor

Marmara University is the lead sponsor of 599 studies on the registry; 138 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

Patients who applied to the Marmara University Faculty of Dentistry Department of Oral and Maxillofacial Surgery for bruxism and joint pain will be included in the study. It is aimed to invite all patients who applied to the clinic to the research.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Between 18 and 50 years old,
  • Male or female,
  • Able to communicate
  • Able to read and write
  • Volunteer to participate in the study,
  • At least 3 months of splint treatment and no results
  • Having Class 1 molar occlusion and not using removable prostheses
  • Marmara University, Faculty of Medicine, Department of Oral and Maxillofacial Surgery, patients diagnosed with bruxism or myofascial pain in masticatory muscles will be included in the study.

Exclusion criteria

Exclusion Criteria:

  • Sensitivity to botulinum toxin,
  • Have received botox treatment in the last 6 months,
  • Injection site infection
  • Pregnant or lactating women
  • Those with diseases that may cause systemic neuropathy such as diabetes, hypertension, kidney disease,
  • Those who do not want to sign the consent form,
  • Patients with a history of , radiotherapy or chemotherapy will be excluded from the study.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
30 participants (estimated)
Target follow-up
6 Months
Patient registry
Yes
06

What researchers measure

Primary outcomes

  1. Change from baseline in the masticatory performance at 6 months

    The masticatory performance of patients at the baseline, 1 month and 6 months later will be taken with a color-changeable gum, called "XYLITOL", (70x20x1 mm 3 g; Masticatory Performance Evaluating Gum XYLITOL, Lotte, Tokyo, Japan). Color changeable gum was first developed specifically to evaluate a person's masticatory performance; and it changes color as it is chewed. The gum will be chewed 60 times by the TMD patients. These values will be recorded and compared with the baseline, 1 month and 6 months later. After chewing, the gum colour will be evaluated according to the improved colour scale. Colour scale ranges from 1-10, and the masticatory performance will be evaluated as poor (1-6), normal (7-8), or good (9-10) with the improved color scale.

    Time frame: 6 months

  2. Change from baseline in the nutritional status at 6 months

    The nutritional status of patients at the baseline, 1 month, and 6 months later will be taken with 24-hour recall method. The data obtained from the 24-hour recall method will be analyzed using the "Computer Assisted Nutrition Program, Nutrition Information Systems Package Program (BEBIS)" and the amount of energy, carbohydrates, protein, fat and fiber consumed by participants will be calculated. Intake of energy, macro nutrients and fiber will be compared with the baseline, 1 month and 6 months later.

    Time frame: 6 months

  3. Change from baseline in the BMI at 6 months

    The body weight (kg) and height (m) of the patients at the baseline, and 6 months later will be taken by the researcher and noted in their files. The height of patients will be taken using a stadiometer with the nearest 0.1 cm, while each participant is standing erect against the wall with heels together touching the wall, without shoes. Body composition will be analyzed by Tanita DC-360 (Accurate Technology Co., Ltd. Tianjin, China) according to the standard procedure, and the body weight, percentage of body lean mass, and fat of the participants will be recorded. Body mass index (BMI) will be calculated using weight (in kilograms) divided by the height squared (in square meters).

    Time frame: 6 months

Secondary outcomes

  1. Change in pain intensity

    Change in muscle pain intensity was assessed using a Visual Analogue Scale (VAS) ranging from the absence of pain (score 0) to the most severe pain imaginable. The VAS consist of a line which can be presented horizontally or vertically (10 cm long) with anchor points of "no pain" and "worst possible pain". The patient will be asked to put a mark on the line that best describe the pain severity. The patients' responses' will be recorded and scored according to the VAS scale. Than, the results will be compared with the baseline, 1 month and 6 months later.

    Time frame: 6 months

  2. Change from baseline in the anxiety status at 6 months

    The anxiety status of patients at the baseline, 1 month, and 6 months later will be taken with Beck Anxiety Index. These scores will be recorded and compared with the baseline, 1 month and 6 months later.

    Time frame: 6 months

  3. Change in chewing ability

    In this study, a questionnaire consisting of open and closed-ended questions will be used to determine the chewing difficulties of individuals. With open-ended questions, foods that are difficult to chew and the methods used to consume these foods will be questioned. In the follow-up interviews, closed-ended questions such as the ability to chew the previously listed foods are "easy to chew", "I have a little difficulty", "I have a lot of difficulty / can't chew at all". If individuals say, "I have a little or a lot of difficulty" while chewing hard foods and "I have some or a lot of difficulty" when chewing soft foods, they will be evaluated as "difficulty in chewing".

    Time frame: 6 months

07

Study locations

1 of 1 sites recruiting
  • Marmara University School of Dentistry
    Istanbul, 34854, Turkey
    Recruiting
    • Ferit Bayram, Ph. D. · Contactferit.bayram@marmara.edu.tr · 00902167775074
    • Güleren Sabuncular, Assist. Prof. · Principal investigator
    • Hatice Merve Bayram, Ph. D. · Principal investigator
    • Baturay Ornağ, DDS · Principal investigator
    • Ceren Küçük, Assist. Prof. · Principal investigator
    • Şule Aktaç, Assoc. Prof. · Principal investigator
08

References and documents

Publications

  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988 Dec;56(6):893-7. doi: 10.1037//0022-006x.56.6.893. No abstract available. PubMed 3204199 ↗
  • Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, Chisnoiu R. Factors involved in the etiology of temporomandibular disorders - a literature review. Clujul Med. 2015;88(4):473-8. doi: 10.15386/cjmed-485. Epub 2015 Nov 15. PubMed 26732121 ↗
  • Resende CMBM, Rocha LGDDS, Paiva RP, Cavalcanti CDS, Almeida EO, Roncalli AG, Barbosa GAS. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Feb;129(2):125-132. doi: 10.1016/j.oooo.2019.10.007. Epub 2019 Nov 26. PubMed 31784398 ↗
  • Edwards DC, Bowes CC, Penlington C, Durham J. Temporomandibular disorders and dietary changes: A cross-sectional survey. J Oral Rehabil. 2021 Aug;48(8):873-879. doi: 10.1111/joor.13210. Epub 2021 Jun 11. PubMed 34031904 ↗
  • Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006 Jan;15 Suppl 1(Suppl 1):S17-24. doi: 10.1007/s00586-005-1044-x. Epub 2005 Dec 1. PubMed 16320034 ↗
  • Haketa T, Kino K, Sugisaki M, Amemori Y, Ishikawa T, Shibuya T, Sato F, Yoshida N. Difficulty of food intake in patients with temporomandibular disorders. Int J Prosthodont. 2006 May-Jun;19(3):266-70. PubMed 16752624 ↗
  • Hama Y, Kanazawa M, Minakuchi S, Uchida T, Sasaki Y. Properties of a color-changeable chewing gum used to evaluate masticatory performance. J Prosthodont Res. 2014 Apr;58(2):102-6. doi: 10.1016/j.jpor.2013.12.005. Epub 2014 Jan 23. PubMed 24461959 ↗
  • Kamiyama M, Kanazawa M, Fujinami Y, Minakuchi S. Validity and reliability of a Self-Implementable method to evaluate masticatory performance: use of color-changeable chewing gum and a color scale. J Prosthodont Res. 2010 Jan;54(1):24-8. doi: 10.1016/j.jpor.2009.08.001. PubMed 19837023 ↗
  • Kaynak BA, Tas S, Salkin Y. The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders. Cranio. 2023 Jan;41(1):78-83. doi: 10.1080/08869634.2020.1812808. Epub 2020 Aug 25. PubMed 32840464 ↗
  • Kim HS, Yun PY, Kim YK. A clinical evaluation of botulinum toxin-A injections in the temporomandibular disorder treatment. Maxillofac Plast Reconstr Surg. 2016 Jan 28;38(1):5. doi: 10.1186/s40902-016-0051-7. eCollection 2016 Dec. PubMed 26855937 ↗
  • Komino M, Shiga H. Changes in mandibular movement during chewing of different hardness foods. Odontology. 2017 Oct;105(4):418-425. doi: 10.1007/s10266-016-0292-z. Epub 2017 Feb 1. PubMed 28150182 ↗
  • Kwon KH, Shin KS, Yeon SH, Kwon DG. Application of botulinum toxin in maxillofacial field: part I. Bruxism and square jaw. Maxillofac Plast Reconstr Surg. 2019 Oct 1;41(1):38. doi: 10.1186/s40902-019-0218-0. eCollection 2019 Dec. PubMed 31649901 ↗
  • Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008 Jul;61(7):646-53. doi: 10.1016/j.jclinepi.2007.08.012. Epub 2008 Mar 21. PubMed 18359190 ↗
  • Lee WK, Bae JH, Hu KS, Kato T, Kim ST. Anatomical recommendations for safe botulinum toxin injection into temporalis muscle: a simplified reproducible approach. Surg Radiol Anat. 2017 Mar;39(3):263-269. doi: 10.1007/s00276-016-1739-1. Epub 2016 Sep 8. Erratum In: Surg Radiol Anat. 2018 Jan;40(1):121-122. doi: 10.1007/s00276-017-1921-0. PubMed 27631881 ↗
  • Monteiro DR, Zuim PR, Pesqueira AA, Ribeiro Pdo P, Garcia AR. Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students. J Prosthodont Res. 2011 Jul;55(3):154-8. doi: 10.1016/j.jpor.2010.11.001. Epub 2010 Nov 26. PubMed 21112271 ↗
  • Mumcu G, Inanc N, Ergun T, Ikiz K, Gunes M, Islek U, Yavuz S, Sur H, Atalay T, Direskeneli H. Oral health related quality of life is affected by disease activity in Behcet's disease. Oral Dis. 2006 Mar;12(2):145-51. doi: 10.1111/j.1601-0825.2005.01173.x. Erratum In: Oral Dis. 2006 May;12(3):356. PubMed 16476035 ↗
  • Nasri-Heir C, Epstein JB, Touger-Decker R, Benoliel R. What should we tell patients with painful temporomandibular disorders about what to eat? J Am Dent Assoc. 2016 Aug;147(8):667-71. doi: 10.1016/j.adaj.2016.04.016. Epub 2016 Jun 11. PubMed 27301850 ↗
  • Patel J, Cardoso JA, Mehta S. A systematic review of botulinum toxin in the management of patients with temporomandibular disorders and bruxism. Br Dent J. 2019 May;226(9):667-672. doi: 10.1038/s41415-019-0257-z. PubMed 31076698 ↗
  • Pedroni CR, De Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J Oral Rehabil. 2003 Mar;30(3):283-9. doi: 10.1046/j.1365-2842.2003.01010.x. PubMed 12588501 ↗
  • Reis JP, Macera CA, Araneta MR, Lindsay SP, Marshall SJ, Wingard DL. Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring). 2009 Jun;17(6):1232-9. doi: 10.1038/oby.2008.664. Epub 2009 Feb 5. PubMed 19197258 ↗
  • Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997 Aug;25(4):284-90. doi: 10.1111/j.1600-0528.1997.tb00941.x. PubMed 9332805 ↗
  • Tarkowska A, Katzer L, Ahlers MO. Assessment of masticatory performance by means of a color-changeable chewing gum. J Prosthodont Res. 2017 Jan;61(1):9-19. doi: 10.1016/j.jpor.2016.04.004. Epub 2016 May 17. PubMed 27211494 ↗
  • Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making. 2001 Jul-Aug;21(4):329-34. doi: 10.1177/0272989X0102100408. PubMed 11475389 ↗
  • Villa S, Raoul G, Machuron F, Ferri J, Nicot R. Improvement in quality of life after botulinum toxin injection for temporomandibular disorder. J Stomatol Oral Maxillofac Surg. 2019 Feb;120(1):2-6. doi: 10.1016/j.jormas.2018.10.007. Epub 2018 Oct 29. PubMed 30385428 ↗
  • Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990 Aug;13(4):227-36. doi: 10.1002/nur.4770130405. PubMed 2197679 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 7, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05562531
Lead sponsor
Marmara University
Responsible party
Ferit Bayram (Assist. Prof., Marmara University) — Principal investigator
First posted
Sep 30, 2022
Start date
May 1, 2022
Primary completion
Oct 1, 2023
Completion
Dec 1, 2023 (estimated)
Last update
Dec 7, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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