Temporomandibular joint disorders and associated factors in a Turkish pediatric population.

OBJECTIVE: To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. METHODS: A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis. RESULTS: One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16). CONCLUSIONS: Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.

Comparative evaluation of the trabecular structure of the mandibular condyle, the levels of salivary cortisol, MMP-3, TNF-α, IL-1ß in individuals with and without temporomandibular joint disorder.

OBJECTIVE: Temporomandibular disorder (TMD) is still a challenge in terms of diagnosis and management. The aim of this study is to explore if the evaluation of salivary biomarkers and fractal dimension (FD) of mandibular condyle could be useful for interpreting early degenerative changes and the effectiveness of salivary cortisol in determining the stress levels of TMD patients. MATERIALS AND METHODS: 34 patients with TMD, and 34 healthy controls were included in this study. Saliva samples were obtained from all participants between 09:00-12:00 am. Salivary cortisol, IL-1ß, TNF-α, and MMP-3 levels were evaluated with ELISA method. FD of the mandibular condyle was determined by means of box-counting method. Depression and anxiety were determined with PHQ-9 and GAD-7 questionnaires. RESULTS: The salivary cortisol and depression/anxiety were higher in study group; however, not significant (p>0.05). FD of the study group was found significantly lower than the control group (p<0.01). Salivary TNF-α, IL-1ß and MMP-3 levels were showed no significant difference between the two groups (p>0.05). There were no significant correlations between the evaluated parameters. CONCLUSION: Salivary cortisol seems to be a non-invasive way of measuring physiological stress of TMD patients. Fractal analysis may be a useful tool in detecting early structural changes in mandibular condyle. Salivary TNF-α. IL-1ß and MMP-3 have not a diagnostic value in terms of interpreting early degenerative changes.