덴탈 프리스케일로 평가한 보툴리눔 A형 독소 반복 주사 후 근육의 약화
Muscle Weakness after Repeated Injection of Botulinum Toxin Type A Evaluated by Dental Prescale.
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A형 보툴리눔 독소(botulinum toxin type A, BTX-A)는 교근 비대의 치료에 성공적으로 적용되어 왔지만 주사 부위 근육의 약화를 초래한다. 이 연구는 BTX-A를 사람 교근에 주사한 후 최대 교합력(Maximum Bite Force, MBF)의 변화를 측정하고, 반복 주사의 효과를 평가하기 위해 시행되었다. 30명의 자원자들을 18주간 추적 관찰하고, 최대 교합력을 측정하였다. 1차 주사로부터 18주가 경과한 후 시술에 만족한 16명은 제외하고 나머지 14명에게 반복 주사를 시행하였고, 다시 18주간 측정하였다. 평균 최대 교합력은 주사 2주 후 20% 감소하였다가 4주부터 점차 회복되었으며, 12주 뒤에는 주사 이전 수준으로 회복되었다. 최대 교합력은 주사 전과 주사 2주, 4주, 8주 후에서 유의한 차이를 보였다(p<.05). 반복 주사군(n=14)의 최대 교합력은 6주에 두드러진 감소를 보였다가(p<.05) 12주간 점차 회복되었다. 실험군이 경험한 불편감의 수준은 일반적인 저작에는 거의 영향을 미치지 않았다.
Abstract
Botulinum toxin type A(BTX-A) has been applied successfully to treat masseteric hypertrophy. However it can cause muscle weakness. This study was designed to measure the change in maximum bite force(MBF) after BTX-A injection into human masseter muscle and to evaluate the influence of a booster(repeated) injection. Thirty volunteers completed 18-week follow-up and MBF was measured. At 18 weeks after the first injection, a booster injection was given to 14 patients and they were followed up until 18 weeks from the booster injection. The mean MBF was approximately 20% lower at 2 weeks than before the injection, and it recovered gradually after 4 weeks to return to the preinjection level at 12 weeks. The MBF differed significantly between before the injection and at 2, 4, and 8 weeks after the injection(p<0.05). In booster injection group(n=14),the MBF decreased markedly at 6 weeks(p<0.05),and it recovered gradually in 12 weeks. The MBF was significantly reduced after booster injection of BTX-A into the human masseter muscle. The degree of discomfort experienced by the subjects had little effect on normal mastication.
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