BTX-A Is Superior to Splints in Early Bruxism-Related Masseter Reduction

Background: Masseteric hypertrophy (MH) is associated with sleep or awake bruxism. Occlusal splints have long been used to control bruxism by redistributing occlusal forces and reducing muscle hyperactivity. Botulinum toxin type A (BTX-A) is widely used to reduce muscle activity by inhibiting acetylcholine release at neuromuscular junction. Ultrasonography is a useful tool to measure muscle thickness. Objective: To compare and measure reduction of MH using occlusal splint versus Botox ® injections. Design: Randomized nonblinded trial. Participants/Methods: From April to July 2023, patients with history of bruxism were recruited. Inclusion criteria were presence of occlusal wear, history of clenching/grinding, morning stiffness in temporomandibular joint, and clinically detectable MH. Participants were assigned to 1 of 4 groups: control (C), occlusal splint only (O), BTX-A only (B), and combination of occlusal splint and BTX-A (OB). The control group only received conservative recomme more...