MONTGOMERY ORAL AND FACIAL SURGERY
*LEONARD A. MERLO, D.M.D.
FARZANEH ROSTAMI, D.D.S.
AND ASSOCIATES
*DIPLOMATE, AMERICAN BOARD OF ORAL AND MAXILLOFACIAL SURGERY
*DIPLOMATE, NATIONAL DENTAL BOARD OF ANESTHESIOLOGY
4701 RANDOLPH ROAD, SUITE G10
.
ROCKVILLE, MD 20852
.
TELEPHONE 301-468-0020
www.montgomeryoralsurgery.com
Surgical Update
Clinical Use of Botulinum Toxins
March 2015, Volume 1, Issue 4
Therapeutic use of Botulinum toxin type A (BTX-A) was first studied in primates.
In the late 1970s the toxin was introduced as a therapeutic agent for treatment
of strabismus and for the treatment of facial wrinkles in the late 1980s. In the
mid and late 1990s BTX-A was utilized for lateral canthal lines (crow’s feet),
platysmal banding, orbicularis oris injection, masseter muscle injection and the
treatment of temporomandibular joint disorders (TMDs).
Seven different strains of Clostridium have been described (designated A, B,C
(1 and 2), D,E,F,G). Humans are not affected by the toxins of strains C and D.
BTX is a protease that causes temporary denervation of skeletal muscle by
blocking the Ca-mediated release of acetylcoline from nerve endings of alpha
and gamma motor neurons.
Clinical effect occurs within approximately 3-7 days ( typically seen after 1-3
days) after administration, followed by 1-2 weeks of maximum effect, which
then levels off to a moderate plateau until full nerve recovery within 3-6 months
(3 months on average). There are 6 different BTXs available on the market, 5
contain BTX-A (Botox, Dysport, Xeomin, Prosigne and PurTox) and the other
contain BTX-B (Myoblast).
Important to keep in mind that Botox is only used for treatment and prevention
of dynamic wrinkles.
Dr. Rostami received her BSc in
Chemistry and Biology from
Virginia Commonwealth
University, Richmond, VA. She
completed both her D.D.S. and
Oral and Maxillofacial Surgery
certificate from Virginia
Commonwealth University,
Medical College of Virginia,
Richmond, VA.
Our office participates with
many dental insurances. For
further information please
contact our office and our staff
will gladly assist you.
Cosmetic Uses
Facial Wrinkles
BTX-A is commonly used for treatment of frown lines (Glabella Lines), Bunny Lines (bridge of the nose), forhead
horizontal lines, crow’s feet (latreral canthal line), platysmal banding and peri-oral lines (lipstick lines). BTX-A is only
FDA approved for treatment of glabellar lines.
Masseteric & Temporalis muscle Hypertrophy
This is due to Congenital asymmetry, habitual asymmetry, jaw clenching during exercise or sleep and other
parafunctional habits.
Therapeutic Uses
In the head and neck region it has been used for treatment of hemifacial spasms, facial nerve palsy, TMD, bruxism,
masticatory myalgias, hyperdentitis (excessive sweating of the armpits and face) and headaches.
Our doctors are more than happy to assist you with any questions. Please do not hesitate to contact our office.
For more information please visit us at www.montgomeryoralsurgery.com