# The Rainbow and the Umbrella of Temporomandibular Disorders—Total Antioxidant Capacity and Total Oxidant Status in Patients with Myofascial Pain with Referral

## TL;DR

This study found that people with temporomandibular myofascial pain have imbalanced antioxidants and oxidants in their saliva compared to healthy individuals.

## Contribution

The study introduces new insights into oxidative stress in temporomandibular disorders through salivary biomarker analysis.

## Key findings

- Patients with myofascial pain had higher total oxidant status and glutathione levels.
- Total antioxidant capacity was lower on average but higher in median values in patients.
- No significant differences were found in oxidative stress index between groups.

## Abstract

Background: Temporomandibular disorders (TMDs) represent an umbrella term encompassing various musculoskeletal dysfunctions, including those affecting the masticatory muscles. This study aimed to compare the salivary levels of non-enzymatic antioxidants and redox balance between patients with temporomandibular myofascial pain with referral and matched healthy controls. Methods: The sample consisted of 44 individuals diagnosed with temporomandibular myofascial pain with referral and a matched control group. The procedure included a clinical examination based on the Diagnostic Criteria for Temporomandibular Disorders and saliva collection. Biochemical analysis included the assessment of reduced glutathione (GSH) levels, total antioxidant status (TAC), total oxidant status (TOS), and the oxidative stress index (OSI). Results: Patients with temporomandibular myofascial pain with referral exhibited higher levels of total oxidant status and glutathione. The mean value of total antioxidant capacity was lower, although the median was higher compared to the control group. No statistically significant differences were observed in the oxidative stress index between the two groups. Conclusions: Patients with temporomandibular myofascial pain with referral exhibit oxidative imbalance, reflected by increased salivary levels of non-enzymatic antioxidants, elevated total oxidant status, and significant differences in antioxidant capacity compared to healthy controls. Individually tailored physical activity, proper nutrition, and targeted supplementation may be necessary to maintain oxidative-antioxidant balance in this patient population.