The use of botulinum toxin for grinding in patients with Rett syndrome-Case report

Spec Care Dentist. 2024 May-Jun;44(3):737-742. doi: 10.1111/scd.12918. Epub 2023 Aug 22.

Abstract

Aims: Rett syndrome (RTT) is a neurodevelopmental disorder caused by a mutation in the methyl-CpG-binding protein 2 (MECP2) gene. It is characterized by profound and severe motor disability. Patients with RTT grind their teeth, causing damage to their permanent teeth. This article aims to describe the case of an 8-year-old child with RTT and the methods of botulinum toxin-based treatment for teeth grinding.

Methods and results: Surface electromyography (sEMG) was used to monitor the effects of treatment. The masseter and temporal muscles, responsible for the elevation of the mandible, were injected with botulinum toxin. The results of the sEMG examination performed 1 week, 1 month and 4 months after toxin administration were compared to the sEMG conducted before treatment. The research demonstrates a significant reduction in both grinding frequency and tension of the masseter and temporal muscles.

Conclusion: Possible adverse effects after chronic use of botulinum toxin were discussed. The article also emphasizes the need for masticatory muscle rehabilitation during botulinum toxin therapy. However, it is necessary to repeat this procedure on a larger group of children with RTT to establish our efforts' efficacy.

Keywords: Rett syndrome; botulinum toxin; case report; methyl‐CpG‐binding protein; surface electromyography.

Publication types

  • Case Reports

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use
  • Bruxism / drug therapy
  • Child
  • Electromyography*
  • Female
  • Humans
  • Masseter Muscle / drug effects
  • Neuromuscular Agents / therapeutic use
  • Rett Syndrome* / drug therapy