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Review Article

Applications of botulinum toxin

in dentistry: Acomprehensive
review
Department of Conservative Dentistry
and Endodontics, Sardar Patel Post
Graduate Institute of Dental and
Medical Sciences, Departments of
2
Oral and Maxillofacial Surgery and
3
Prosthodontics, Faculty of Dental
Sciences, King Georges Medical
University, Lucknow,
Uttar Pradesh, 1Conservative Dentistry
and Endodonitcs, Clove Dental,
New Delhi, India

Address for correspondence:

Dr.Smriti Kharbanda,
C2/115(Back Side) Janakpuri,
NewDelhi110058, India.
Email:smritikharbanda510@
gmail.com

Sanjeev Srivastava, Smriti Kharbanda1, U. S. Pal2, Vinit Shah3

ABSTRACT
The horizons of treatment options in dentistry are broadening rapidly. In this scenario,
applications of unconventional treatment options like use of botulinum toxin(BT) are
gaining momentum. The use of BT has been popularly accepted in esthetic procedures
like management of facial wrinkles; however, it has been documented to be successful
in a variety of conditions. Of particular interest to this paper are applications of BT in the
maxillofacial region, concerned to dentistry. BT offers a transient, reversible, relatively safe
treatment option to many conditions of interest to a dental practitioner. Dental surgeons by
their virtue of being extensively aware of the anatomy of faciomaxillary region are a potential
pool of operators who can use BT in their armamentarium with minor skill enhancement and
thus widen the perspective of alternative, minimally invasive options to refractory conditions
or invasive protocols.

Key words: Botulinum toxin A, bruxism, gummy smile, temporomandibular joint disorders

Introduction
Botulism is a lifethreatening disease first described by
Kerner.[1] It is caused by botulinum toxin(BT) also known
as botulinum neurotoxin produced under anaerobic
conditions by Clostridium Botulinum. Botulinum is one of
the most lethal toxins known and has found applications
in bioterrorism as well.[2] However, botulinum toxin is a
doubleedged sword. Botulinum is the first toxin to be
accepted for therapeutic uses. Since the first therapeutic
use by Scott for strabismus[3] till today, the spectrum of
therapeutic applications of BTs has widened. BTs can be
differentiated into seven types from A toG. However,
commercially available variants are purified exotoxin
and only BT typeA(BTA) and BT typeB(BTB) are
marketed by various brand names.

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DOI:
10.4103/0975-5950.183860

BTA is marketed as follows:

Botox(Allergan, Irvine, CA) in the USA
Dysport(Speywood Pharmaceuticals, Maidenhead,
UK) in Europe
Xeomin (Merz Pharmaceuticals, Germany) in Germany
Prosigne(Lanzhou Biological Products Institute,
China) in China.
BTB is marketed as follows:
Myobloc(Elan Pharmaceuticals, San Diego, CA) and
Neurobloc(Elan Pharmaceuticals, Shannon, County
Clare, Ireland).

Mechanism of Action
BT produces a transient dosedependent weakening
of muscle activity.[4] It is a neurotoxin and produces
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How to cite this article: Srivastava S, Kharbanda S, Pal US, Shah V.

Applications of botulinum toxin in dentistry: A comprehensive review. Natl
J Maxillofac Surg 2015;6:152-9.

2015 National Journal of Maxillofacial Surgery | Published by Wolters Kluwer - Medknow | 152