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A Clinical Decision-Making Algorithm for Botulinum Toxin Use in Temporomandibular Disorders and Bruxism.

Journal of clinical medicine 2026 Vol.15(2)

Scheiwiler AN, Ilhan M, Waldvogel OV, Seifert LB, Thieringer FM, Berg BI

PMC 전문 ↗ 원문 ↗ DOI ↗

관련 도메인

보툴리눔독소 주사 Botulinum Toxin Injection

Abstract

Temporomandibular disorders (TMD) and bruxism are prevalent conditions managed by dentists. However, treatment choices-especially concerning botulinum toxin (BTX)-often lack consistency. This study aimed to develop and assess a structured clinical decision-making algorithm for BTX use in patients with TMD and bruxism. A treatment algorithm was designed through a qualitative analysis of the literature and aligned with German S3 guidelines. A total of 227 dentists assessed three clinical case vignettes reflecting routine clinical practice. Each vignette was evaluated first without and subsequently with the algorithm, focusing on typical indications for botulinum toxin treatment. Data were collected via online survey (SurveyMonkey) and analyzed using Microsoft Excel. Participants were stratified by gender and clinical experience (≤5 years vs. >5 years). Of the 227 dentists contacted, 103 responded, and 56 completed the survey (57.1% male; mean age: 34.5 ± 10.6 years). BTX decision accuracy significantly improved for Case 1 (62.5% → 87.5%, = 0.0013) and Case 2 (14.3% → 87.5%, < 0.0001), but not for Case 3 (44.6% → 46.4%, = 1.000). Confidence increased, and uncertainty decreased, particularly among less experienced dentists. The algorithm also significantly influenced both first- and second-line treatment choices, aligning them more closely with guideline-based therapy. Usefulness was confirmed by 78.6% of respondents, with no significant differences based on gender or experience. The proposed algorithm significantly improved diagnostic accuracy, treatment consistency, and confidence in the use of BTX for TMD and bruxism. It facilitates evidence-based, experience-independent decision-making and potentially represents a useful clinical tool in dental practice.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 botulinum toxin 보툴리눔독소 주사 dict 3
해부 Case 3 scispacy 1
약물 second-line scispacy 1
질환 Temporomandibular Disorders C0039494
Temporomandibular Joint Disorders
 scispacy 1
질환 Bruxism C0006325
Bruxism
 scispacy 1
질환 TMD → Temporomandibular disorders C0039494
Temporomandibular Joint Disorders
 scispacy 1
질환 BTX scispacy 1
기타 Toxin scispacy 1
기타 botulinum toxin (BTX)-often scispacy 1
기타 patients scispacy 1
기타 BTX scispacy 1

📑 인용 관계

이 논문이 참조한 문헌 42

외부 PMID 30건 (DB 미수집)

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필러 주입술 (21) 안검성형술 (14) 유방 (10) 안면거상술 (10) 지방흡입 (9) 코성형술 (8) 히알루론산 (7) 유방성형술 (6)

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