School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Int J Environ Res Public Health. 2022 Jul 23;19(15):8987. doi: 10.3390/ijerph19158987.
Temporomandibular disorders (TMDs) are a type of idiopathic orofacial pain. Inflammation, particularly elevated circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8), has been linked to pain symptoms. The purpose of this study was to compare hs-CRP, IL-6, and IL-8 biomarkers and pain intensity with different treatment strategies (LLLT, standard conservative treatment, and combination) for TMD patients.
A total of 32 participants were randomly included in the study and divided into three groups (Group I, Group II, and Group III) referred from the Dental Clinic, School of Dental Science, HUSM. Patients received LLLT (Groups II and III) in five sessions for the duration of 10 days. Patients in Groups I and III received standard conservative TMD treatment (diet and stress counseling, jaw exercises, physical therapy, which was a hot towel application) by the principal investigator. All blood samples for biomarkers were performed before starting treatments and directly after finishing the treatment protocols, where all results were recorded.
The result showed a significant difference in the mean IL-8 ( = 0.001) between the three intervention groups (LLLT, standard treatment, and combined treatment). IL-6 showed an increase in the mean of IL-6 levels from baseline to post-treatment with a better mean in the LLLT treatment group without any significant differences. Additionally, there were no significant mean differences found between the groups and in the group for the hs-CRP biomarker.
A statistically non-significant difference was found in hs-CRP and IL-6 before and after LLLT, conservative, and combined treatment strategies of TMD. A statistically significant difference was observed in the mean levels of IL-8 between the LLLT intervention group and the combined treatment group. Although there was no statistically significant correlation between pain intensity and biomarkers, a statistically significant difference was found in pain intensity before and after LLLT, conservative, and combined treatment strategies. TMJ degeneration could be exacerbated by elevated IL-8 levels. Thus, this can be an important biomarker to mark or identify the painful condition of TMJ.
颞下颌关节紊乱（TMD）是一种特发性或面部疼痛。炎症，特别是循环中高敏 C 反应蛋白（hs-CRP）、白细胞介素 6（IL-6）和白细胞介素 8（IL-8）水平升高，与疼痛症状有关。本研究的目的是比较 hs-CRP、IL-6 和 IL-8 生物标志物以及不同治疗策略（LLLT、标准保守治疗和联合治疗）治疗 TMD 患者的疼痛强度。
共有 32 名参与者被随机纳入研究，并分为三组（I 组、II 组和 III 组），由 HUSM 牙科学院牙科诊所转诊。患者接受 LLLT（II 组和 III 组）五次，每次持续 10 天。I 组和 III 组患者接受标准保守 TMD 治疗（饮食和压力咨询、颌运动、物理治疗，即热毛巾应用），由主要研究者进行。所有生物标志物的血液样本均在开始治疗前和治疗方案结束后直接进行，记录所有结果。
结果显示，三组干预组（LLLT、标准治疗和联合治疗）之间的平均 IL-8 存在显著差异（=0.001）。IL-6 显示，从基线到治疗后，IL-6 水平的平均值升高，LLLT 治疗组的平均值更好，但无显著差异。此外，在 hs-CRP 生物标志物方面，各组之间和组内均无显著的平均差异。
在 TMD 的 LLLT、保守和联合治疗策略前后，hs-CRP 和 IL-6 无统计学显著差异。LLLT 干预组和联合治疗组之间的 IL-8 平均水平存在统计学显著差异。尽管疼痛强度与生物标志物之间无统计学显著相关性，但在 LLLT、保守和联合治疗策略前后，疼痛强度存在统计学显著差异。TMJ 退变可因 IL-8 水平升高而加重。因此，这可能是标记或识别 TMJ 疼痛状况的重要生物标志物。
