WCPR 2027

Background: Temporomandibular myofascial pain syndrome (MPS) is frequently triggered or exacerbated by bruxism-induced muscular overload. Managing this condition requires a multimodal approach targeting both mechanical and neuromuscular factors to break the cycle of chronic pain.

Objectives: To evaluate the clinical efficacy of a combined therapeutic protocol—associating medical management, botulinum toxin injections, and occlusal splints—in patients suffering from bruxism and associated myofascial pain.

Methods: A clinical review was conducted on 18 patients diagnosed with severe bruxism and concomitant cranio-cervical myofascial pain. The comprehensive treatment protocol included:

1. Medical therapy: Standardized pharmacological and behavioral support.
2. Botulinum toxin (BoNT-A) injections: Targeted delivery into the masticatory (masseter, temporalis) and cervical muscles.
3. Nocturnal occlusal splints: Customized relaxation appliances worn nightly.
   Patients were clinically re-evaluated at a 3-month post-treatment follow-up. Primary outcomes included pain intensity (Visual Analog Scale, VAS) and headache frequency.

Results: At the 3-month mark, all 18 patients (100%) achieved a clinically significant reduction in pain intensity, with Visual Analog Scale (VAS) scores decreasing by more than 50% compared to baseline. This clinical improvement was accompanied by a marked decrease in the frequency and severity of secondary headache episodes. Botulinum toxin injections successfully attenuated trigger point sensitivity in both the masticatory and cervical regions. Concurrently, nocturnal splints effectively prevented mechanical dental overload.

Conclusion: Combined therapy utilizing botulinum toxin, relaxation splints, and medical management offers a highly effective and synergistic strategy. Achieving a >50% pain reduction and a significant decrease in headache frequency across the entire cohort at 3 months highlights the value of targeted, multimodal neuromuscular intervention for patients suffering from severe bruxism and secondary myofascial pain.

Keywords: Bruxism; Myofascial Pain Syndrome; Botulinum Toxin; Occlusal Splint; Masticatory Muscles, neck pain.

Professor Chouakri is affiliated with the University of Health Science in Algeria. With an academic background in health sciences, Professor Chouakri is associated with the field of healthcare and medical education. Based in Algeria, Professor Chouakri maintains an academic and professional connection with the healthcare sector and is committed to contributing to the advancement of health sciences through academic engagement and professional collaboration.