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Objectives: To understand the importance of this indication and how to treat it

Introduction: Bruxism is a quite frequent disease. It is characterized by teeth grinding and/or clenching. I might occur during night but also during the day. Bruxism does not only ruin the teeth but is also linked to e.g. orofacial pain; headaches and sleep disorders. Botulinum toxin A is an effective, but still not commonly used, treatment of bruxism.

Materials / method: Rough literature search, but mostly eminence based

Results: Meanwhile the number of clinical trials for this intervention has increased and there is good evidence that the treatment of the masseter with botulinum toxin reduces grinding and clenching. There are differences in reported dosages and injection schemes. I usually treat in Caucasians only the masseter with a starting dose of 40 abo-BoNT-A (Dysport) U per site. With this dosage patients report a decrease of masseter activity, less headache and when repeated a change in the muscle mass leading to a more oval face.

Conclusion: Botulinumtoxin against bruxism is an effective and safe treatment. When dosed reasonably grinding and often pain will decrease considerably.

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Objectives: To understand the action and indications of botulinum toxin A by managing muscle balance for face symetrisation.
This communication objective is to help doctors understand and deal with face asymetry and facial palsy management.

Introduction: Face asymetry is very common. We address cosmetic and therapeutic patients with face asymetry : congenital asymetry, facial palsy...
Botulinum toxin has dramatically changed and improved the paradigm and management of facial palsy and face asymetry.

Conclusion: Management of facial asymetry is based on a combined approach where botulim toxin is crucial. It is used in most cases of face asymetry, and at any stage of the facial palsy.

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