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Chen X, Cheng Z, Xu J, Wang Q, Zhao Z, Jiang Q. Causal effects of life course adiposity on temporomandibular disorders: A Mendelian randomization study. J Oral Rehabil 2024; 51:278-286. [PMID: 37830131 DOI: 10.1111/joor.13607] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Previous studies investigated the associations between obesity and temporomandibular disorders (TMDs), but the evidence for the causal inferences was unclear. OBJECTIVE We aimed to investigate the causal link between life course adiposity and TMDs. METHODS Mendelian randomization (MR) studies were performed using genetic instruments for birth weight (BW) (N = 261 932), childhood body mass index (BMI) (N = 39 620), childhood body size (N = 454 718), adult BMI (N = 99 998), body fat percentage (N = 454 633) and TMDs (N = 211 023). We assessed the overall effect of each life course adiposity factor via inverse-variance weighted (IVW), weighted median, and MR-Egger methods and performed extensive sensitivity analyses. Additionally, multivariable MR was conducted to evaluate the direct and indirect effects of childhood BMI on TMDs while accounting for BW and adult BMI, and vice versa. RESULTS Univariable MR analyses revealed a causal effect of low childhood adiposity on an increased risk of TMDs (childhood BMI: IVW OR: 0.65, 95% CI: 0.54-0.78, p < .001; childhood body size: IVW OR: 0.56, 95% CI: 0.43-0.73, p < .001). No causal association existed between genetically predicted BW, adult BMI, or body fat percentage and TMDs. In the multivariable MR analyses, the effects of childhood BMI on TMDs occurrence remained significant and direct, even after adjusting for BW and adult BMI (multivariable IVW OR: 0.78, 95% CI: 0.61-0.99, p = .048). No pleiotropy and heterogeneity were detected (p > .05). CONCLUSION Low childhood BMI might causally increase the risk of TMDs through a direct pathway.
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Affiliation(s)
- Xin Chen
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Zheng Cheng
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Junyu Xu
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Qianyi Wang
- Department of Cardiology, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Zhibai Zhao
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Qianglin Jiang
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
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Pavlou IA, Spandidos DA, Zoumpourlis V, Adamaki M. Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review). Exp Ther Med 2023; 26:563. [PMID: 37954114 PMCID: PMC10632959 DOI: 10.3892/etm.2023.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023] Open
Abstract
Stress has been well-documented to have a significant role in the etiopathogenesis of bruxism. Activation of the hypothalamic-pituitary-adrenal axis (HPA) and subsequent release of corticosteroids lead to increased muscle activity. Neurological studies have demonstrated that chronic stress exposure induces neurodegeneration of important neuronal structures and destabilization of the mesocortical dopaminergic pathway. These disruptions impair the abilities to counteract the overactivity of the HPA axis and disinhibit involuntary muscle activity, while at the same time, there is activation of the amygdala. Recent evidence shows that overactivation of the amygdala under stressful stimuli causes rhythmic jaw muscle activity by over activating the mesencephalic and motor trigeminal nuclei. The present review aimed to discuss the negative effects of certain vitamin and mineral deficiencies, such as vitamin D, magnesium, and omega-3 fatty acids, on the central nervous system. It provides evidence on how such insufficiencies may increase stress sensitivity and neuromuscular excitability and thereby reduce the ability to effectively respond to the overactivation of the sympathetic nervous system, and also how stress can in turn lead to these insufficiencies. Finally, the positive effects of individualized supplementation are discussed in the context of diminishing anxiety and oxidative stress, neuroprotection and in the reversal of neurodegeneration, and also in alleviating/reducing neuromuscular symptoms.
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Affiliation(s)
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
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Im YG, Han MY, Baek HS. Association of Serum Vitamin D Level with Temporomandibular Disorder Incidence: A Retrospective, Multi-Center Cohort Study Using Six Hospital Databases. Nutrients 2023; 15:2860. [PMID: 37447187 DOI: 10.3390/nu15132860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The relationship between serum vitamin D levels and temporomandibular disorders (TMDs) remains unclear. Therefore, this study aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and TMD incidence using large-scale health data. Clinical data from the electronic health records of six secondary or tertiary hospitals in Korea were used to evaluate the relationship between serum 25(OH)D levels and TMD incidence. The data were converted to the Observational Medical Outcomes Partnership Common Data Model. A cohort study was designed using the Cox proportional hazards model to examine the hazard ratio (HR) of TMD development after propensity score matching (PSM). An aggregate meta-analysis of the HR was subsequently performed. After 1:4 PSM, a target group with deficient 25(OH)D levels (<20 ng/mL) (N = 34,560) and comparator group with non-deficient 25(OH)D levels (≥20 ng/mL) (N = 47,359) were pooled from six hospital databases. HR meta-analysis demonstrated a significant association between deficient 25(OH)D levels and TMD incidence (pooled HR: 1.50; 95% confidence interval: 1.07-2.12). In conclusion, deficient 25(OH)D levels were found to be associated with an increased TMD risk. Therefore, vitamin D deficiency is a potential risk factor for TMD development.
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Affiliation(s)
- Yeong-Gwan Im
- Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Man-Yong Han
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Republic of Korea
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Szulc M, Świątkowska-Stodulska R, Pawłowska E, Derwich M. Vitamin D 3 Metabolism and Its Role in Temporomandibular Joint Osteoarthritis and Autoimmune Thyroid Diseases. Int J Mol Sci 2023; 24:ijms24044080. [PMID: 36835491 PMCID: PMC9964750 DOI: 10.3390/ijms24044080] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this review was to present the metabolism of vitamin D3, as well as to discuss the role of vitamin D3 in bone metabolism, temporomandibular joint osteoarthritis (TMJ OA), and autoimmune thyroid diseases (AITD) on the basis of the literature. Vitamin D3 plays a significant role in human health, as it affects the calcium-phosphate balance and regulates the bone metabolism. Calcitriol impresses the pleiotropic effect on human biology and metabolism. Its modulative function upon the immune system is based on the reduction of Th1 cell activity and increased immunotolerance. Vitamin D3 deficiency may lead to an imbalance in the relationship between Th1/Th17 and Th2, Th17/Th reg, and is considered by some authors as one of the possible backgrounds of autoimmune thyroid diseases (AITD), e.g., Hashimoto's thyroiditis or Graves' disease. Moreover, vitamin D3, through its direct and indirect influence on bones and joints, may also play an important role in the development and progression of degenerative joint diseases, including temporomandibular joint osteoarthritis. Further randomized, double blind studies are needed to unequivocally confirm the relationship between vitamin D3 and abovementioned diseases and to answer the question concerning whether vitamin D3 supplementation may be used in the prevention and/or treatment of either AITD or OA diseases.
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Affiliation(s)
- Michał Szulc
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Elżbieta Pawłowska
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
| | - Marcin Derwich
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
- Correspondence: ; Tel.: +48-660-723-164
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Ekici Ö, Çelik S. The relationship of biochemical factors related to calcium metabolism with temporomandibular disorders. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101315. [PMID: 36280111 DOI: 10.1016/j.jormas.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the relationship between calcium metabolism-related biochemical factors (alkaline phosphatase, vitamin D, parathyroid hormone (PTH), calcium, phosphorus and magnesium), and temporomandibular joint (TMJ) disk displacement with reduction (DDWR). MATERIALS AND METHODS This prospective observational study included patients with temporomandibular disorders (TMDs) (n = 50) and healthy controls (n = 50) of similar age and sex. The diagnosis of TMJ DDWR was made using the diagnostic criteria for temporomandibular joint disorders (DC/TMD). Both groups were compared in terms of serum alkaline phosphatase, 25 (OH) vitamin D, PTH, calcium, magnesium, and phosphorus levels. P<0.005 was accepted as a significant difference. RESULTS There was no significant difference between the groups in terms of age, gender, and body mass index (BMI). Calcium levels of patients with TMD were statistically significantly lower than control patients (p<0.05). While there was no significant difference between the two groups in terms of mean VIT D, the number of people with severe Vit D deficiency (<10 ng) in the TMD group was significantly higher than in the control group (p<0.05). There was no statistically significant difference between the groups in terms of serum alkaline phosphatase, magnesium, phosphorus and PTH levels. CONCLUSION The differences in serum calcium and vitamin D levels seen in the study indicate that biochemical factors related to calcium metabolism may be associated with TMJ DDWR. These results suggest that calcium and vitamin D deficiency should be evaluated and corrected in patients with TMD.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Sefa Çelik
- Department of Medical Biochemistry, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
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Nemati M, Tabrizi R, Rasooli F, Ghafari S. Is the Prevalence of Vitamin D deficiency in Patients with Temporomandibular Disorder Higher than Healthy Control Group? J Maxillofac Oral Surg 2022; 21:1205-1208. [PMID: 36896049 PMCID: PMC9989067 DOI: 10.1007/s12663-021-01522-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Vitamin D plays an essential role in subchondral bone, cartilage, and periarticular muscle. This study aims to assess the prevalence of vitamin D deficiency in temporomandibular disorder (TMD) patients. Materials and methods This is a cross-sectional study. Subjects were assigned into two groups based on having signs and symptoms of TMD: Group 1: subjects had TMD, and group 2 healthy group (control group). The serum level of vitamin D was measured in the two groups. The independent t test was used to compare the serum level of vitamin D between the study and control groups. Results One hundred ten subjects were studied into two groups (55 subjects in each group). The mean serum level of vitamin D was 18.13 ± 6.38 ng/mL in the study group and 31.83 ± 7.00 ng/mL in the control group. Analysis of the data demonstrated a significant difference in the mean serum level of vitamin D between the study and control groups (p = 0.001). Conclusion It seems the serum level of vitamin D is lower in TMD patients than in the healthy control group.
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Affiliation(s)
- Majid Nemati
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faezeh Rasooli
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Ghafari
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ferrillo M, Lippi L, Giudice A, Calafiore D, Paolucci T, Renò F, Migliario M, Fortunato L, Invernizzi M, de Sire A. Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review. J Clin Med 2022; 11:jcm11216231. [PMID: 36362456 PMCID: PMC9655046 DOI: 10.3390/jcm11216231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Although a growing body of literature has been emphasizing the role of vitamin D in oral health, there is still a gap of knowledge regarding the correlation between temporomandibular disorders (TMDs) and vitamin D. Therefore, the aim of this systematic review was to assess the linkage between hypovitaminosis D and TMDs to map the current literature in this field. On 10 September 2022, PubMed, Scopus, and Web of Science databases were systematically searched from the date of their inception to identify the studies that had assessed patients with TMDs. The primary outcome assessed in this review was the relationship between hypovitaminosis D and TMDs. Out of the 329 studies identified, 13 studies met the eligibility criteria and were included in the present work. Seven studies assessed the relationship between vitamin D and TMDs, reporting that vitamin D serum levels are lower in patients with TMDs. Our results suggested that vitamin D receptor (VDR) polymorphisms might have a role in TMDs’ development. However, the quality assessed underlined that only one study did not present a serious risk of bias. Further good-quality studies are needed to clarify the linkage between vitamin D deficiency and TMDs, but the evidence currently available has suggested potential correlations.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Teresa Paolucci
- Physical Medicine and Rehabilitation, Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, University G. D’Annunzio, 66100 Chieti, Italy
| | - Filippo Renò
- Innovative Research Laboratory for Wound Healing, Health Sciences Department, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Mario Migliario
- Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Leonzio Fortunato
- Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +390961712418
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
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Dadjoo S, Michelogiannakis D, Rossouw PE, Javed F. Potential adjunct therapies for the management of temporomandibular disorders: An evidence-based review. Cranio 2022:1-11. [PMID: 35156534 DOI: 10.1080/08869634.2022.2036437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD). METHODS The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. The eligibility criteria were the following: (a) original clinical studies and (b) randomized controlled clinical trials (RCTs). RESULTS Adjuvant therapies were comprised of acupuncture, manual therapy, jaw exercises, dietary modifications, botulinum toxin therapy, and photobiomodulation. Short-term follow-up results from each of these RCTs showed beneficial effects in terms of pain reduction and improvements in jaw movement among patients with TMD. There are no long-term follow-up results in this regard. CONCLUSION The most effective adjunct treatment for managing TMD remains unknown, primarily due to a lack of sufficient scientific evidence.
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Affiliation(s)
- Shaahin Dadjoo
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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ŞATIR Ö, ŞATIR S. Temporomandibular Joint Disease and Vitamin D Level in Fibromyalgia. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1030953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Xiao M, Hu ZH, Jiang HH, Fang W, Long X. Role of osteoclast differentiation in the occurrence of osteoarthritis of temporomandibular joint. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:398-404. [PMID: 34409794 DOI: 10.7518/hxkq.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to explore the role of osteoclast differentiation in the occurrence of temporomandibular joint osteoarthritis (TMJOA). METHODS A mouse TMJOA model was constructed. Micro-CT was used to observe the changes in condylar bone during the development of TMJOA. Hematoxylin-eosin (HE) staining was used to observe the histological structure changes of the condyle of TMJOA mice. Tartrate resistant acid phosphatase (TRAP) staining was used to observe the presence of osteoclasts in TMJOA joint tissue. The synovial fluid of patients with TMJ-OA was collected to determine the effect on osteoclast differentiation. RESULTS Micro-CT revealed that the condyle of the TMJOA group had the most obvious damage in the second and third weeks, and the shape of the condyles also changed in a beak-like manner. HE staining showed that the condyle cartilage and subchondral bone structure of TMJOA mice were disordered in the second week. TRAP tissue staining showed that the number of osteoclasts of the TMJOA group obviously increased in the second week. Results of cell experiments showed that the number of osteoclast differentiation significantly increased after stimulation of synovial fluid from TMJOA patients, and the cell volume increased. CONCLUSIONS TMJOA animal models and TMJOA patient synovial cell experiments could induce osteoclast differentiation, indicating that osteoclast differentiation plays an important role in TMJOA occurrence.
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Affiliation(s)
- Mian Xiao
- Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan 430000, China
| | - Zhi-Hui Hu
- Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan 430000, China
| | - Heng-Hua Jiang
- Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan 430000, China
| | - Wei Fang
- Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan 430000, China
| | - Xing Long
- Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan 430000, China
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A comprehensive review on biomarkers associated with painful temporomandibular disorders. Int J Oral Sci 2021; 13:23. [PMID: 34326304 PMCID: PMC8322104 DOI: 10.1038/s41368-021-00129-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/05/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023] Open
Abstract
Pain of the orofacial region is the primary complaint for which patients seek treatment. Of all the orofacial pain conditions, one condition that possess a significant global health problem is temporomandibular disorder (TMD). Patients with TMD typically frequently complaints of pain as a symptom. TMD can occur due to complex interplay between peripheral and central sensitization, endogenous modulatory pathways, and cortical processing. For diagnosis of TMD pain a descriptive history, clinical assessment, and imaging is needed. However, due to the complex nature of pain an additional step is needed to render a definitive TMD diagnosis. In this review we explicate the role of different biomarkers involved in painful TMD. In painful TMD conditions, the role of biomarkers is still elusive. We believe that the identification of biomarkers associated with painful TMD may stimulate researchers and clinician to understand the mechanism underlying the pathogenesis of TMD and help them in developing newer methods for the diagnosis and management of TMD. Therefore, to understand the potential relationship of biomarkers, and painful TMD we categorize the biomarkers as molecular biomarkers, neuroimaging biomarkers and sensory biomarkers. In addition, we will briefly discuss pain genetics and the role of potential microRNA (miRNA) involved in TMD pain.
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12
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Kui A, Buduru S, Labunet A, Balhuc S, Negucioiu M. Vitamin D and Temporomandibular Disorders: What Do We Know So Far? Nutrients 2021; 13:nu13041286. [PMID: 33919716 PMCID: PMC8070666 DOI: 10.3390/nu13041286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 02/07/2023] Open
Abstract
Background and aims. Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. Methods. A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. Results.Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation.Conclusion.Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.
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Affiliation(s)
- Andreea Kui
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Smaranda Buduru
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Anca Labunet
- Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
- Correspondence:
| | - Silvia Balhuc
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Marius Negucioiu
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
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The Association between Temporomandibular Disorder and Sleep Apnea-A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176311. [PMID: 32872653 PMCID: PMC7504469 DOI: 10.3390/ijerph17176311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 12/19/2022]
Abstract
An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research Database aimed to understand the association between SA and TMD. We identified adult patients with suspected SA (identified with diagnostic codes) and excluded those diagnosed with TMD prior to SA. Patients with SA diagnosis after polysomnography were also identified as probable SA patients. The index dates were the dates of their initial SA diagnosis. Ten control subjects were matched, by age and sex, to each SA patient, and were assigned the same index dates as the SA patients. In total, 10,408 suspected SA patients (including 4105 probable SA patients) matched to 104,080 control subjects (including 41,050 subjects matched to the probable SA patients) in this study. The TMD incidence rate was significantly higher in the SA patients than in the control subjects (2.8 vs. 1.0 per thousand-patient-year in probable SA patients vs. the corresponding control subjects, with an adjusted incidence rate ratio [95% confidence interval] = 2.5 [2.3–2.7], p < 0.0001). SA patients significantly showed a higher cumulative incidence of TMD than the corresponding control subjects (p < 0.0001). Multivariable Cox regression analysis revealed SA as an independent risk factor for the development of TMD (adjusted hazard ratio = 2.5 [1.7–3.7], p < 0.0001). In summary, this study confirmed an increased TMD incidence in the SA patients. While treating TMD patients, dentists should pay careful attention to the potential underlying SA.
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Relation of vitamin D and BsmI variant with temporomandibular diseases in the Turkish population. Br J Oral Maxillofac Surg 2020; 59:555-560. [PMID: 33863594 DOI: 10.1016/j.bjoms.2020.08.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/15/2020] [Indexed: 11/21/2022]
Abstract
Vitamin D (VD) levels and several variants in the vitamin D receptor (VDR) gene are associated with the occurrence of diseases of the bones and cartilage. The aim of this research was to study and compare the association of the BsmI variant in the VDR gene as well as VD levels in disc displacement with reduction (DDR) between patients and healthy controls. This was a case-control study, in which 104 patients of DDR and 102 healthy individuals were studied. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose temporomandibular diseases. The VDR BsmI variant was investigated, after extraction of genomic DNA, by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the VD level in serum was measured. The serum VD level was significantly different between the patient and the control group (mean (SD) 13.20 (11.02) ng/mL versus 18.44 (10.03) ng/mL, respectively) (p=0.008). Serum VD assessment revealed that serious vitamin D deficiency was more prevalent in the patients than the controls (50.96% versus 21.56%) (p=0.00001). Logistic regression analysis revealed that the bb genotype and b allele carriers of VDR BsmI variant were significantly associated with increased risk of DDR (p=0.022 and p=0.01, respectively). VDR BsmI BB genotype was higher in the control group than the patient group (p=0.045). Genotype distributions for BsmI variant in the controls and the patients were confirmed using the Hardy-Weinberg equilibrium equation. The BsmI variant of the VDR gene and VD deficiency play role in DDR aetiopathogenesis in a Turkish population. Vitamin D level and VDR BsmI variation may be effective in a possible genetic-based DC/TMD Axis III to be created in the future.
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Serum Analysis in Patients with Temporomandibular Disorders: A Controlled Cross-Sectional Study in Norway. Pain Res Manag 2019; 2019:1360725. [PMID: 31687055 PMCID: PMC6800918 DOI: 10.1155/2019/1360725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/15/2019] [Accepted: 09/13/2019] [Indexed: 02/07/2023]
Abstract
Temporomandibular disorder (TMD) is characterized by pain and dysfunction in the temporomandibular join (TMJ) and the masticatory apparatus. Associations with autoimmune diseases, inflammatory conditions, and nutrition deficiencies have been reported in previous studies of TMD patients. To evaluate essential proteins, hormones, electrolytes, and vitamins in serum from TMD patients, a standard blood sample analysis was performed in 60 TMD patients and 60 healthy controls matched for age and gender, retrieving 19 different analyses. We found that TMD patients had significantly higher values of hemoglobin (p=0.036), cobalamin (p=0.023), albumin (p=0.005), parathyroid hormone (PTH) (p=0.038), and vitamin D (p=0.005), and significantly lower values of creatinine (p=0.006) and potassium (p=0.011), compared to controls. In the TMD group, most of the determinants had a wider range, and several subjects, compared to the control group, had values outside the normal reference area. However, most of the TMD patients and controls had values within normal biological range. Our findings could not associate any severe systemic disease, malnutrition, or systemic inflammation with the TMD. Results from our study suggest that serum analyses should neither be used as a biomarker of TMD nor a diagnostic tool for an individual subject with TMD.
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