Botulinum toxin in orofacial muscle hypertonicity: Clinical insights and therapeutic applications

Orofacial muscle hypertonicity, characterized by excessive muscle tension in the facial and masticatory regions, can lead to significant functional impairment and aesthetic concerns. Botulinum toxin type A (BoNT-A), widely known for its cosmetic applications, has emerged as a valuable therapeutic tool in dentistry and maxillofacial medicine. This review explores the pharmacological mechanisms, anatomical considerations, and clinical applications of BoNT-A in the treatment of functional disorders such as bruxism, masseter hypertrophy, temporomandibular joint dysfunction, and facial asymmetry. Emphasis is placed on precision-guided injection techniques, region-specific dosing trends, and formulation-specific performance. Adverse effects, although generally mild and self-limiting, are preventable through anatomical expertise and individualized protocols. Preliminary clinical observations and recent East Asian data suggest variations in the response patterns and optimal dosing strategies. This review also highlights the current gaps, including the need for long-term safety data, standardized training for dental practitioners, and comparative evaluations with non-pharmacological therapies. BoNT-A is a minimally invasive interdisciplinary approach for restoring oral function and facial harmony, supporting its integration into modern dental practice.