engleski

Vrijednosti salivarnih biljega oksidativnog stresa u ispitanika s temporomandibularnim poremećajima

Temporomandibular disorders (TMD) are associated with an altered oxidative status ; however, the impact of treatment on changes in the oxidative status has not yet been clarified. With the aim of assessing their interaction with TMD, levels of selected salivary oxidative stress (OS) markers (glutathione peroxidase, superoxide dismutase (SOD), total antioxidant capacity (TAC), uric acid (UA), 8-hydroxydeoxyguanosine and malondialdehyde (MDA)) and salivary cortisol were compared between 34 chronic TMD patients and 33 healthy control subjects. Also, changes in the OS and clinical treatment outcomes (spontaneous pain, oral-health- related quality of life, self-perceived stress functional limitations, maximal and pain-free mouth opening, characteristic pain intensity) were followed during a 6-month treatment period where patients were randomly allocated to two treatment groups – stabilization splint group and placebo splint group. The changes were compared after the 1st, 3rd and 6th months in the two treatment groups, as well as between the treatment groups when divided into diagnostic subgroups (myofascial pain and disc displacement) and when classified according to pain intensity (high-intensity pain and low-intensity pain). Both the TAC and the individual oxidants (MDA and UA) were significantly higher in TMD patients compared to the control (p<0.05). This data suggests a compensatory increase in the antioxidant defence mechanism as a response to higher levels of stress. After 6 months of treatment, a significant reduction in the TAC was observed in both treatment groups (p<0.05). Moreover, a significant reduction was present for oxidant MDA levels and the oxidant (MDA) to antioxidant (SOD) ratio in patients with high- intensity pain (p<0.05). In patients treated with a stabilization splint, changes in the oxidative status were followed by a significant decrease of pain, improvement of health-related quality of life and functional limitations of the lower jaw. To sum up, a stabilization splint showed better treatment effectiveness during a 6-month period compared to a placebo splint. The oxidative status was altered in TMD patients compared to healthy controls and was demonstrated to be affected by splint therapy in favour of antioxidants. Both the intensity and source of the pain should be considered important factors in future investigations evaluating salivary OS markers in TMD patients.

oxidative stress ; temporomandibular disorders ; orofacial pain ; cortisol ; stabilization splint ; salivary diagnostics

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