Stabilization splint versus botulinum toxin injection on masticatory muscles activity in patients with temporomandibular disorders: A narrative review

Gouda, Kerolos Ghobrial; Rezkallah, Soheir Shehata; Khalil, Aya Abdelhamid

doi:10.21608/bijpt.2025.377234.1084

Stabilization splint versus botulinum toxin injection on masticatory muscles activity in patients with temporomandibular disorders: A narrative review

Document Type : Original Article

Authors

¹ Biomechanics,faculty of physical therapy, deraya university, new minya ,elminya

² Basic Sciences Department, Faculty of Physical Therapy, Cairo University.

³ Biomechanics department, faculty of physical therapy. Cairo university

10.21608/bijpt.2025.377234.1084

Abstract

Background: This narrative review synthesizes findings from the past five years of literature to examine how various therapeutic interventions influence masticatory muscle activity—particularly Root Mean Square (RMS) and Mean Frequency (MF)—as assessed by surface electromyography (SEMG) during both resting states and functional tasks in
individuals diagnosed with temporomandibular disorders (TMD). Purpose: Key parameters analyzed included changes in RMS (indicative of muscle activation) and MF (indicative of muscle endurance). Clinical outcomes were assessed to determine the long term efficacy of each intervention. Methods: English-language full-text articles from scientific journals published within the past five years were considered for evaluation. Web of Science, PubMed (MEDLINE), Scopus, and Google Scholar were searched. Only five papers related to this topic were from different databases. Results: Several SEMG studies have been performed, revealing that stabilization splints and Botox injections influence temporomandibular muscle activity. Stabilization splints significantly increased RMS values over time (p < 0.05), supporting neuromuscular adaptation and stability. In contrast, Botox injections resulted in RMS suppression, demonstrating temporary muscle relaxation. Regarding MF, Botox caused a significant decline (p < 0.05), suggesting short term reduction in muscle activity, whereas splint therapy stabilized or improved MF, reinforcing its role in muscle endurance. Conclusion: Stabilization Mandibular splints emerge as the superior long-term intervention for TMJ dysfunction by promoting neuromuscular stability and endurance, whereas Botox injections provide temporary relief but may lead to prolonged muscle suppression.

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