Main Article Content
Objective: Orofacial pain (OFP) are the conditions that affect quality of life, psychological and socioeconomic
status. The treatment goal is to reduce pain and function. The aim of this systematic review and meta analysis was to determine the efficacy of botulinum toxin (BTX) for reduce pain and restore normal function that compared with placebo, standard treatment, and/or active treatment in orofacial pain (OFP) patients.
Material and Methods: Electronic search for randomized controlled trial (RCT) was made until March 2017.
Search strategies and study selection was conducted following PRISMA guideline. Publications were assessed for risk-of-bias using the Cochrane Handbook. The outcomes were VAS score, MOA (mouth opening assessment), HD (headache day), and NDI (number of drug pills ingest). STATA was utilized to conduct direct meta-analysis.
Results: Eighteen RCT (946 patients) met the inclusion were divided into three groups for pooled outcomes.
In group 1, BTX-A subjects had a significantly lower VAS score when compared to the NSS group (pooled WMD= -1.81, 95% CI: -3.23 to - 0.39). In group 2, the BTX-A subjects had significantly lower HD than the NSS subjects (pooled WMD = -1.66 95% CI: -2.64 to -0.69), and a significantly lower NDI than the NSS subjects (pooled WMD = -2.51 95% CI: -4.42 to -0.60). In group 3, we could not analyze the outcome because there were only 2 studies in this group.
Discussion: BTX-A subjects showed significant pain relief in group 1, and the BTX-A subjects had significantly
lower HD and significantly lower NDI than the NSS subjects in group 2.
Conclusion: More rigorous design of trials should be carried out in future study to help the clinicians decisions.
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