| Objective To explore the effect of botulinum toxin A(BTX-A)injection into the masseter region on improving the performance of young patients with sleep bruxism.Methods 1.A total of 42 patients with bruxism were recruited and screened by exclusion criteria and inclusion criteria,and 21 cases were simply randomly assigned to experimental group and 21 cases in control group;2.All subjects filled in the 90 symptom checklist-90,SCL-90,Pittsburgh Sleep Quality Index(PSQI),Visual Analogue Scale(VAS)scale before injection in the masseter muscle area,and performed one-night sleep polysoma monitoring to collect data;3.BTX-A was injected by five-point injection method in the masseter muscle area of the experimental group,each person was injected with a total of 20U per masseter muscle,and the control group was injected with the same dose of normal saline for injection at the same site;4.All subjects were injected in the masseter muscle area 4 weeks after filling in the list of 90 symptoms,Pittsburgh sleep quality index,pain visual analogue score scale for evaluation,and again performed one-night sleep polysoma monitoring to collect data;5.SPSS 26.00 software is used to collate and statistically analyze the data.Results 1.Before injection,the PSG sleep parameters of the experimental group and the control group were compared,and the total sleep time,sleep efficiency,sleep latency,sleep awakening index,sleep awakening frequency,the proportion of phase Ⅰ sleep time,the proportion of phase Ⅱ sleep time to phase Ⅲ/Ⅳ sleep time,and the proportion of REM sleep time were not statistically significant(P>0.05);After injection,compared with the control group,the total sleep time,sleep efficiency,sleep latency,sleep awakening index,sleep awakening frequency,proportion of phase Ⅰ sleep time,proportion of phase Ⅱ sleep time,proportion of phase Ⅲ/Ⅳ sleep time,and proportion of REM sleep time in the experimental group had no significant difference(P>0.05).2.Before injection,there were no significant differences between the experimental group and the control group in the parameters of the onset of Rhythmic Mastic Muscle Activity(RMMA)events in PSG,including the RMMA index,the number of episodes per hour,the number of episodes per episode,the average duration of episodes,the peak amplitude of the masseter muscle electrical bursts during the maximum voluntary contraction of the masseter muscle,and the peak amplitude of the masseter muscle electrical bursts during the RMMA episodes(P>0.05);After injection,compared with the control group,there were no significant differences in the four factors(RMMA index,number of episodes per hour,number of episodes per episode,and average duration of seizures)between the test group and the control group,while there were significant differences in the peak amplitude of the myoelectric bursts during the maximum voluntary contraction of the masseter muscle(P<0.001)and the peak amplitude of the myoelectric bursts during the RMMA attack(P<0.001).3.The comparison of SCL-90 psychological factor parameters between the experimental group and the control group before injection showed that there was no significant difference in 11 factors including somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia,psychosis,others and total score(P>0.05);After injection,there was no statistically significant difference between the experimental group and the control group in terms of SCL-90 psychological factor parameters,including 11 factors including somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia,psychosis,others,and total score(P>0.05).4.Before injection,the PSQI sleep factor parameters of the experimental group and the control group were compared,and there were no statistically significant differences in the subjective sleep quality,sleep time,sleep efficiency,sleep disorders,hypnotic drugs,daytime dysfunction,and total score of 8 factors(P>0.05);After injection,there was no significant difference in PSQI sleep factor parameters between the experimental group and the control group in terms of subjective sleep quality,sleep time,sleep efficiency,sleep disorder,hypnotic drugs,daytime dysfunction and total score(P>0.05).5.There was no significant difference in VAS score of pain between the experimental group and the control group before injection(P>0.05);After injection,the VAS score of pain in the experimental group was significantly different from that in the control group(P<0.05).6.All the 42 subjects had no complications such as dizziness,local hematoma,facial stiffness,local facial depression,and chewing weakness.Conclusion 1.The improvement treatment of BTX-A injection into the masseter region in patients with nocturnal bruxism can reduce the masticatory muscle strength during nocturnal bruxism.2.For patients with nocturnal bruxism,BTX-A injection into the masseter region can alleviate the morning onset pain of the facial masticatory muscles.3.Injecting BTX-A into the masseter region to improve nocturnal bruxism is a relatively safe method. |
