The efficacy of botulinum toxin injection in treatment of jaw -closing oromandibular dystonia is well documented in the literature. However, patients with jaw- opening dystonia have little or inferior benefits from botulinum toxin injection .
Is there a scientific evidence to explain, why jaw-opening dystonia patients havenot respond as patients with jaw-closing dystonia?
I don't know if a scientific evidence exist, but I think that benefit depends on injection site and possible adverse events.
Treatment of submentalis muscle complex, including anterior digastric belly muscle, could increase swallowing disorders, limiting the treatment effectiveness. So, lateral pterygoid is actually often the only muscle treated, and it is not so easy to inject. Intra-oral way seems to be the best one.
On the other side, it seems that patient's feeling improve more when jaw-closing dystonia is treated, with the return of an oral feeding.
http://www.ncbi.nlm.nih.gov/pubmed/24847442
http://www.ncbi.nlm.nih.gov/pubmed/25541097
http://www.ncbi.nlm.nih.gov/pubmed/24122897
http://www.ncbi.nlm.nih.gov/pubmed/10599789
I am unaware of good clinical studies in this field. Logically, it should respond, but likely to a lesser degree than jaw-closure. Simply, as Emmanuelle Cugy already stated, as you won't risk dosing botulinum toxin as high as in jaw-closure.
A nice way to inject the medial ptyerygoid is retromandibular, but EMG-control is necessary. It hurts less, and there are no vulnerable structures in the trajectory.
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