Procedures included:
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TMD, implants, surgery, prominent gums, gummy smile, bruxism, clenching cases, orthodontic relapse, depressed orthodontic appearance, masseteric hypertrophy, trigeminal neuralgia, along with myofascial and neck pain(Bansal, Jain, Joshi and Agarwal 2014).
Mechanism of action:
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The botulinium toxin inhibits action of acetylcholine on motor nerves.
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Inhibition of acytlcholine on autonomic nerves at the junction on glands and smooth muscle (Bansal, Jain, Joshi and Agarwal 2014).
Preparation:
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Kept cold until use.
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Follow MIFU.
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Add preservative-free 0.9% saline.
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1.0ml syringe.
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Between 26-30 gauge.
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Skin preparation with alcohol wipes.
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Dosing is dependent on use, size of muscle, medications, and medical status.
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Generally, smaller injections in more sites are recommended.
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Proper targeting of the muscle.
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First appearance 1-3 days, peak 1-4 weeks, decline 3-4 mos (Bansal, Jain, Joshi and Agarwal 2014).
Contraindications:
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Pregnancy & lactation.
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Neuromuscular diseases.
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Motor neuron diseases(Bansal, Jain, Joshi and Agarwal 2014).
Adverse effects:
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Facial nerve palsy.
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Muscle weakness.
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Hematoma.
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Flu-like symptoms.
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Pain associated with injection site.
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Usually resolve with in a few days to weeks(Bansal, Jain, Joshi and Agarwal 2014).
Who can administer Botox:
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Physicians, surgeons, registered nurses, nurse practitioners, dentists.
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There is specific programs for each profession.
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Specialized training is required.
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Includes a theoretical portion
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Includes a clinical portion
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Time is dependent on profession
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Registration with the Canadian board of aesthetic medicine
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Available for beginners and advanced professionals (CBAM 2025)
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