Salivary Antioxidant Profile During Temporomandibular Disorders Treatment
Objectives: The unambiguous cause of temporomandibular disorders (TMD) and the pathophysiologic mechanism underlying the development of pain in the TMD are lacking. There are indications that psychological and mechanical stress factors could contribute to oxidative stress (OS) and lead to TMD. In this study, our aim was to investigate whether stabilization splint, most frequently used therapeutically modality for TMD treatment, would influence antioxidant parameters in saliva.
Methods: The presence of TMD was determined by DC/TMD questionnaire and perception of pain caused by TMD was recorded by the visual analogue scale (VAS). Nine patients with diagnosed TMD were included. Saliva samples were collected twice daily (7:00 AM and 5:00 PM) from all patients at baseline, and at 1st and 3 rd month following treatment. Superoxide dismutase (SOD), total antioxidant capacity (TAC) and uric acid (UA) were analysed using spectrophotometric methods. Friedman ANOVA was performed to compare salivary SOD, TAC and UA levels as well as VAS scores during stabilization splint therapy. The p-values < 0.05 were considered significant.
Results: VAS scores improved significantly across time (p<0.05). Salivary TAC, SOD levels were changed during stabilization splint therapy. Salivary SOD levels increased following therapy (p<0.05) whereas, surprisingly, salivary TAC concentrations decreased. No significant changes of UA were observed during stabilization splint therapy, although slight increase over time was noted.
Conclusions: Those preliminary results showed that significant increase in SOD levels was observed during stabilization splint therapy. Previous studies showed that the activity of SOD, an antioxidant enzyme, is progressively reduced with the advancement of TMDs. This observed rise in SOD levels might indicate that splint therapy in TMD patients increases cleansing capacity from free radicals. The question remains whether TAC decreases in this process to avoid redundant reactions once the increase of SOD effectively compensates the OS.