(PR092) Current Perspectives on the Adjunctive Use of Botulinum Toxin A in Endodontic Practice for Nonodontogenic Pain Management

The use of botulinum toxin A (BoNT-A) in dentistry for aesthetics and pain management solutions for TMD and myofascial pain has increased in recent years. Despite its growth in popularity, there is limited research on its use in endodontics, a specialty that often receives referrals for nonodontogenic pain that mimics or coexists with dental pain. Rather than referring patients elsewhere for conditions outside the traditional scope of endodontics, incorporating BoNT-A could offer an effective alternative treatment when root canal therapy is otherwise unwarranted. This approach may enhance patient care and expand therapeutic options available within endodontic practices.

Objective: This study examined endodontists' views on the use of BoNT-A as adjunctive treatment for painful nonodontogenic conditions overlapping with dental pain.

Methods: A 23-question survey was distributed to 3,979 to AAE members, with 211 responses analyzed from U.S.-based endodontists. Descriptive statistics, bivariate analysis, and logistic regression were performed with significance at α = 0.05.

Results: 9.14% of endodontists currently use BoNT-A, primarily for managing myofascial/orofacial pain (49.22%) and TMD (41.97%). 50.9% of respondents believed BoNT-A could aid in treating nonodontogenic pain conditions. Significant association with belief included: improvements in patient satisfaction (p = .00007), profitability (p = .038), future incorporation of BoNT-A (p = .0005), and support for BoNT-A training in endodontic residency programs (p = .049).

Conclusion: These results underscore endodontists’ willingness to incorporate the use of BoNT-A for management of nonodontogenic pain in practice; furthermore, formal training may be the key to bridging the gap between knowledge and execution of BoNT-A therapeutics for multifactorial pain management in endodontics.