Relationship between Parafunctional Habits and Salivary Biomarkers

Pain and salivary biomarkers of stress in temperomandibular disorders were affected by maxillary splints

BACKGROUND

Longitudinal intervention studies on treatment options in temporomandibular dysfunction (TMD) including self reports and salivary biomarkers of stress are rare and the exact therapeutic function of occlusal splints widely unknown.

METHODS

We examined the therapeutic effects of a Michigan splint with occlusal relevance in patients with TMD using a placebo-controlled, delayed-start design. Two intervention groups received a Michigan splint, while one of them had a placebo palatine splint for the first 3 weeks. We collected pain intensities (at rest and after five occlusal movements), salivary measures associated with stress (cortisol and alpha-amylase) and self-reported psychological distress (stress, anxiety, catastrophizing) at baseline and 3 and 7 weeks after onset of intervention.

RESULTS

At baseline, we observed increased pain intensity and psychological distress in TMD patients compared to 11 matched healthy controls. Baseline anxiety was linked to movement pain intensity through stress. Over therapy reductions in pain intensity and morning cortisol were more pronounced in those patients starting immediately with the Michigan splint, while psychological distress decreased similarly in both groups.

CONCLUSION

Our results suggest that perceived stress plays a role for the association between anxiety and TMD pain and underlines the need for an interdisciplinary perspective on the pathogenesis and therapy of TMD in a setting where psychotherapeutic knowledge is still scarce or rarely applied.

Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

BACKGROUND

The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent.

METHODS

Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias.

RESULTS

Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

Salivary biomarkers and temporomandibular disorders: A systematic review

Temporomandibular disorders (TMD) are a common condition affecting the musculoskeletal group evoking clinical signs such as pain, restricted mouth opening, and disability in the temporomandibular joint (TMJ), masticatory musculature, and the osseous structures in the surroundings. Saliva is a strong proponent of a diagnostic and prognostic tool for TMDs. Hence, a systematic review was undertaken to answer the research question "What is the role of salivary biomarkers in the identification of TMD?" A thorough literature search was performed in databases of PubMed, Embase, and Google Scholar till February 2022. Every included study was characterized by Study ID, location, sample size, demographic information, biomarker analysis, assessment method, and results. Newcastle-Ottawa scale was used to assess the methodological quality of all qualifying research. A total of eight articles were included for the review after screening the titles, abstracts, and full-text articles. The review included articles of observational design with a control group. TMD disorders were confirmed both clinically and radiographically in the study of Shoukri et al. TMDs are commonly prevalent in maxillofacial conditions. Despite the availability of various diagnostic techniques, certain limitations are remarkable. The researchers are yet to ascertain a gold standard biomarker to identify TMD.

Probable Bruxism and Psychological Issues among Dental Students in Serbia during the COVID-19 Pandemic

The COVID-19 pandemic has drastically changed the routine way of life, having consequences in many segments of life, including dental practice and education. The aim of this study was to evaluate the frequency of probable bruxism in a sample of dental students in Serbia and to estimate the potential association between psychological factors related to the COVID-19 pandemic and the presence of bruxism. A cross-sectional study included 178 dental students in Serbia, who were interviewed using a specially-designed self-administered online questionnaire, which consisted of three sections, and after that, a clinical examination for the presence of bruxism symptoms in the oral cavity. Psychological status was evaluated using the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S). Saliva samples were taken to analyze salivary cortisol levels. The prevalence of probable bruxism was 34.8%. Respondents with probable bruxism had significantly higher DASS-21 and FCV-19S scores and mean values of salivary cortisol compared to non-bruxers. A history of COVID-19 infection, high stress, and fear of COVID-19 scores were associated with the presence of probable bruxism. The findings suggest that the COVID-19 pandemic has had a great psychological impact and impact on the presence and worsening of bruxism symptoms in a sample of dental students in Serbia.

[Salivary cortisol concentrations according to gender in the different stages of human development. A review of the literature]

Salivary cortisol secretion (Corts) is an individual adaptation reflex to internal / external stressors, which involves several biological and social factors. The aim of this study was to perform a review on variations in Corts concentrations in relation to biological differences of sex and gender socialization in the different stages of human development. MEDLINE / PubMed and Google Scholar were used to search for scientific evidence. 20 original English-language articles published from 2010-2020 were selected, including clinical trials and observational studies. The relationship between Corts and gender was historically discussed considering evolutionary and biological aspects. However, it cannot be explained as a cause-effect view and depends on unique sociocultural factors, which in sensitive periods of human development alter the hypothalamic-pituitary-adrenal axis and condition coping with stress.