Mandibular Bone Concavity Potentially Associated with Prolonged Botox Use

A 37-year-old female with no known significant medical history was referred for a general CBCT evaluation. The referring physician noted the patient had been receiving Botox injections. The radiologist identified a well-defined concavity on the buccal aspect of the left posterior mandible, near the area of attachment of the inferior aspect of the masseter muscle. Upon research, the radiologist found instances of possible bone resorption due to prolonged high-dose Botox injections, where mandibular bone may recede from reduced tension as the masseter muscle is relaxed. The referring clinician confirmed he had never seen a presentation like this in his experience working with TMJ patients, and noted he had discontinued using Botox on patients due to evolving perspectives on the treatment. The clinician expressed interest in reviewing past patients for similar findings and noted this would be a valuable case study.