Changes in masticatory function after injection of botulinum toxin type A to masticatory muscles

J Oral Rehabil. 2013 Dec;40(12):916-22. doi: 10.1111/joor.12111. Epub 2013 Nov 8.


This study examined changes in masticatory function after botulinum toxin type A (BTX-A) injection using objective and subjective tests during 12 weeks. Also, we compared differences in masticatory function between group in which only masseter muscle (M group) was injected and group in which masseter and temporal muscle (M-T group) were injected. Forty subjects were assigned into two groups; M group (n = 20) and the M-T group (n = 20). The Meditoxin(®) was used as BTX-A injection. The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as subjective indicators. Overall, the masticatory function drastically declined after 4 weeks and gradually recovered with time. Compared with the pre-injection state, the masticatory function decreased by 89·2% (MAI), 12·2% (FIA) and 32·2% (VAS) 4 weeks after the injection (P < 0·05). When the results between M group and M-T group were compared, scores of VAS and FIA were significantly different 4 weeks after the injection (P < 0·05), but the MAI score showed no significant difference between two groups. In conclusion, this study showed that masticatory function was significantly decreased after BTX-A injection into the masticatory muscle after 4 and 8 weeks from injection. However, masticatory efficiency measured using MAI could completely recover after 12 weeks. Furthermore, after 8 weeks from the injection, the masticatory function measured after injection into only the masseter muscle was similar to that measured after injection into both masseter and temporal muscle.

Keywords: botulinum toxin type A; masseter muscle; mastication; temporal muscle.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bite Force
  • Botulinum Toxins, Type A / administration & dosage*
  • Botulinum Toxins, Type A / pharmacology
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Masseter Muscle / drug effects
  • Masseter Muscle / physiopathology*
  • Mastication / drug effects
  • Mastication / physiology*
  • Muscle Weakness / chemically induced*
  • Neuromuscular Agents / administration & dosage*
  • Neuromuscular Agents / pharmacology
  • Pain Measurement
  • Recovery of Function
  • Temporal Muscle / drug effects
  • Temporal Muscle / physiopathology*
  • Time Factors


  • Neuromuscular Agents
  • Botulinum Toxins, Type A