This study aims at comparing the effect of trigger points injection of platelet rich plasma and botulinum toxin a on the relief of jaw muscles Myofascial pain . The 1st group includes 20 patients who are supposed to receive 5 units of botulinum toxin A per trigger point in masseter and/or temporalis muscles. The 2nd group will receive ,5 ml of PRP per trigger point in masseter and/or temporalis muscles. The 3rd group will receive .5 ml of physiologic saline per each trigger point in masseter and/or temporalis muscles. The 1st follow up session will be after 1 week then 1 month then 3 months . The patients are advised to limit excessive Mouth opening, yawning or singing. And when pain episode , theta re advised to take only paracetamol as analgesic drug . At the follow up sessions ، measuring the interincisal opening , pressure pain threshold using algometer , VAS to measure the intensity of pain , Likert scale , current pain intensity, worst pain intensity and the need to take analgesics in Numbers. Then comparing the results of these groups to end in rejecting the null hypothesis which says there's an equivalence between the 3 types of injected solutions or accepting it .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Botulinum toxin type A
Plasma that contains concentrated platelets
Physiological saline .9 %
Faculty of dentistry Cairo University
Giza, Egypt
Pressure pain threshold
The amount of force per kilogram needed to induce pain in patients with myofascial pain at the trigger point.. Will be measured using the algometer which presses on the trigger point to induce pain by force measured in kilograms/cm2 If the reading increased among the treatment visits , this means better outcome and decreased pain intensity with effectiveness of the treatment
Time frame: 3 months
Current pain intensity
The amount of pain on VAS at the time of examination from 0-10 With 0 no pain which increases to reach 10 ( the highest pain intensity).. Decrease in pain intensity means better outcome
Time frame: 3 months
Worst pain intensity
The worst pain the patient had suffered from on the previous duration. Using visual analogue scale from (0-10) with 0 least pain and 10 worst pain . Decrease in pain intensity means better outcome
Time frame: 3 months
Inter incisal opening
The measurement in millimeters of the distance between the incisal edge of the upper incisor and the lower incisor Using calibers to measure the effect of myofascial pain on decreasing muscle spasm and the effectiveness of the treatment by time. Increased degree of mouth opening meaning the muscles had relaxed and trigger points released
Time frame: 3 months
Patient satisfaction
Will be measured by Likert scale by faces to indicate whether the treatment was satisfactory to the patient or not and to which degree .it affected their quality of life
Time frame: 3 months
The need for analgesics
The patient will count how many Paracetamol tabs he took at the time from the last visit till now. With decreased amount of analgesics taken between the visits means better outcome
Time frame: 3 months
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