Abstract
BackgroundThe 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).ObjectiveThe 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.MethodologySaliva 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.ResultsPsychological 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.ConclusionIndividuals 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.
Highlights
The clinical care of chronic pain requires personalised understanding of the mechanisms involved
According to the Diagnostic Criteria for Temporomandibular disorders (TMD) (DC/TMD), TMDM can be subdivided into myalgia and myofascial pain depending on whether pain is localised during palpation or spreads within or beyond the palpated muscular territory.[3,6]
The main result of our study showed that the total antioxidative capacity (TAC) levels were higher in TMDM, whereas total oxidant status (TOS) levels were lower, compared to healthy controls
Summary
The clinical care of chronic pain requires personalised understanding of the mechanisms involved. 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. 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. The clinical care of chronic pain disorders has evolved to a point where multiple biopsychosocial approaches coexist in order to manage a person who suffers.[1] But this requires an understanding of the different components of pain in an individual, including the pathophysiological mechanisms—which is essential for personalised treatment.[1,2] In temporomandibular disorders (TMD), these are not yet well characterised. According to the Diagnostic Criteria for TMD (DC/TMD), TMDM can be subdivided into myalgia and myofascial pain depending on whether pain is localised during palpation (myalgia) or spreads within (myofascial pain) or beyond (myofascial pain with referral) the palpated muscular territory.[3,6]
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