Treatment of temporomandibular disorders with botulinum toxin.

Temporomandibular disorder (TMD) is a collective term used to characterize a heterogeneous group of conditions involving the temporomandibular joint (TMJ) and its contiguous tissues. Although the pathologies behind TMDs have not been completely explained, the symptoms associated with these disorders are similar and are most commonly manifest as pain in the orofacial region. In preliminary studies, botulinum toxin has been used successfully to treat various pain syndromes, including TMDs. Because of the complex nature of TMDs and proximity of affected muscles to facial nerves, correct injection technique and appropriate dosing guidelines are very important for successful results. This article describes common TMDs and their treatment with botulinum toxin. Dosing guidelines and illustrations of affected muscles and target injection sites are provided.