Myogenous temporomandibular disorders and salivary markers of oxidative stress-A cross-sectional study

Víctor Ignacio Madariaga, Hajer Jasim, Bijar Ghafouri, Malin Ernberg, Víctor Ignacio Madariaga, Hajer Jasim, Bijar Ghafouri, Malin Ernberg

Abstract

Background: The clinical care of chronic pain requires personalised understanding of the mechanisms involved. Temporomandibular disorders (TMD) are the most common chronic orofacial pain conditions, and oxidative stress has been proposed to be implicated in their pathophysiology, especially in arthrogenous TMD. However, few studies have explored oxidative stress in myogenous TMD (TMDM).

Objective: The aims of this study were to compare the salivary oxidative stress profiles between individuals with TMDM and healthy controls, and to explore associations of these markers with clinical characteristics.

Methodology: Saliva samples were collected from 39 individuals with TMDM and 37 age and sex-matched healthy volunteers. Psychological stress levels and clinical characteristics were assessed in all participants. The samples were analysed for total oxidant status (TOS), total antioxidative capacity (TAC) and superoxide dismutase activity (SODa). Comparisons between groups were performed using parametric and non-parametric tests depending on data distribution.

Results: Psychological stress was higher in TMDM compared to controls (P < .001). TAC levels were significantly higher (P < .05) whereas TOS levels were significantly lower (P < .05) in TMDM compared to controls. There were no differences in SODa levels between groups and no correlations were found between clinical characteristics and oxidative stress markers.

Conclusion: Individuals with TMDM showed higher levels of antioxidative markers, but lower levels of oxidative markers. These results can be explained in part by chronicity and adaptation to the disease and other factors, such as psychological stress. Longitudinal studies must be conducted to clarify the role of oxidative stress in TMDM.

Keywords: antioxidants; craniomandibular disorders; myalgia; myofascial pain syndromes; oxidative stress; saliva.

Conflict of interest statement

The authors declare no conflicts of interests.

© 2020 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Experimental timeline. Each potential participant was asked to respond a questionnaire by telephone. Those who met the requirements were invited for a clinical assessment, and during that session, if they met the inclusion criteria, saliva samples were collected and processed on the same day. At the end of the recruitment period, stored saliva samples were analysed all together [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Comparison of salivary oxidative stress markers. (A) TOS (µmol H2O2 Equiv./L), (B) TAC (µmol‐TE/L) and (C) SODa (% inhibition) were compared between individuals with myogenous temporomandibular disorders (TMDM) and healthy subjects. Additionally, (D) TOS, (E) TAC and (F) SODa were compared between TMDM subgroups (myofascial pain and myalgia). Statistical analyses were performed using Mann‐Whitney U test. *= statistically significant (P < .05). SODa, Extracellular superoxide dismutase activity; TAC, total antioxidative capacity; TOS, Total oxidant status

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