• Preventive Nutrition and Food Science
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• v.12 no.4
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• pp.251-258
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• 2007

Thermal resistance and heat activation characteristics of Clostridium botulinum ATCC 25763 spores were evaluated. The effects of nisin and pH on the activation and subsequent germination were also investigated. Spores of C. botulinum were not inactivated by heat treatments up to $92^{\circ}C$ for 2 hr. Heat treatment at $85^{\circ}C$ for 90 min was selected as the optimal activation condition based on monitoring subsequent germination. L-alanine alone or in combination with L-cysteine was not sufficient to germinate the spores of this strain. Tryptone-Peptone- Glucose-Yeast extract (TPGY) broth supplemented with L-alanine was used as a suitable germination medium. Decreasing pH of activation suspension increased the degree of phase darkening, i.e., germination. In addition, the presence of nisin during activation increased the degree of phase darkening. The majority of spore populations were dormant at a pH of less than 2.8, and these populations required heat activation to increase the culturability on TPGY agar medium. However, extended heating in the presence of nisin at pH 2.8 decreased the spore count; however, heat activation was less necessary at pH 3.4, compared at pH 2.8.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.391-398
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• 2013

Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

• The Journal of the Korean dental association
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• v.55 no.5
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• pp.365-369
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• 2017

In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.151-157
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• 2016

Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.

• Clinical Pain
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• v.19 no.1
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• pp.49-53
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• 2020

Piriformis muscle syndrome is a condition that causes direct muscle pain around piriformis muscle or sciatica from irritated sciatic nerve and the diagnosis remains debatable. The main treatment is symptomatic relief from conservative therapy such as medication and piriformis stretching exercise, and various therapeutic injections including local anesthetic, corticosteroid, botulinum toxin can be considered for diagnostic and therapeutic purposes. In this case, a 54-year-old male who had sciatica and gait disturbance showed piriformis muscle hypertrophy in the pelvis MRI. From imaging studies, electrodiagnostic study and physical examination, he was diagnosed with piriformis muscle syndrome. He underwent trigger point injection and botulinum toxin injection into the piriformis muscle, and pain and gait disturbance significantly improved. This case reports a case of piriformis muscle syndrome with clinical symptom of gait disturbance, which was improved by botulinum toxin injection.

• Anatomy and Cell Biology
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• v.56 no.3
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• pp.322-327
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• 2023

The aim of this study was to elucidate the intramuscular arborization of the teres minor muslce for effective botulinum neurotoxin injection. Twelve specimens from 6 adult Korean cadavers (3 males and 3 females, age ranging from 66 to 78 years) were used in the study. The reference line between the 2/3 point of the axillary border of the scapula (0/5), where the muscle originates ant the insertion point of the greater tubercle of the humerus (5/5). The most intramuscular neural distribution was located on 1/5-3/5 of the muscle. The tendinous portion was observed in the 3/5-5/5. The result suggests the botulinum neurotoxin should be delivered in the 1/5-3/5 area of the teres minor muscle.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.2
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• pp.171-178
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• 2007

Botulinum toxin type A (BTX-A) has a local effect at the neuromuscular junction by blocking acetylcholine release and thus causing paralysis and atrophy of the affected muscles. In dentistry, Botulinum toxin type A(BTX-A) is used for the treatment of masseteric hypertrophy, temporomandibular disorder, and severe bruxism related neurologic disorder. We hypothesized that the muscle atrophy after BTX-A injection into masseter muscle in growing rats, could affect the jaw growth. The purpose of this study was to determine the effects of the BTX-A injected into the masseter muscle on the jaw growth in rats. Rats were divided into four groups(group 1; control group, group 2; saline injection group, group 3; BTX-A injection group, group 4; baseline control group). Group 4 was sacrificed at the beginning of the experiment to provide baseline values of jaw measurements. The weight, length and width of jaw in those groups were measured every weeks. This study reported that the mandibular body length, condylar length, coronoid process length, anterior region height, coronoid process height and condylar height of the jaw in BTX-A injection group were shorter than those of the control and saline injection groups(P<0.05). In conclusion, BTX-A injected into the masseter muscle may affect the undergrowth of the jaw in rats.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.311-313
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• 2005

Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.268-272
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• 2000

Thoracic sympathicotomy has been used safely and successfully to treat essential hyperhidrosis. However, it has been difficult to treat compansatory hyperhidrosis after thoracic sympathicotomy and focal hyperhidrosis. The sweat glands were innervated by post-ganglionic sympathetic fibers with acetylcholic serving as the transmitter. Botulinum A toxin has been reported to block neuro-transmission at the cholinergic autonomic nerve terminals. Prospecting its effect for the sweat gland, we treated 5 patients with focal hyperhidrosis with botulinum A toxin. Three patients received bilateral thoracic sympathectomy (1 case) and sympathicotomy(2 case) via VAT. The hyperhidrosis area was marked with betadine and was subdivided into squares of 2$\times$2 cm(4$\textrm{cm}^2$) each. Botulinum A toxin was injected intracutaneously in a dosage of 2.5U/0.1ml(100U/4ml) /4$\textrm{cm}^2$. A total dose of 100U of Botulinum A toxin was injected into the affected sites. Subjective assessment of sweat production by the patients using a visual analogue scale showed a 20~70% improvement. During the follow-up period, no toxic effects were observed.