Oxidative stress markers in patients with tempromandibular disorders:A systematic review and meta-analysis

Abstract

Background: Oxidative stress has a role in many pathologic conditions, including oral diseases and TMD’s Pathophysiology. This study compared the selected oxidative biomarkers’ levels in TMD patients and healthy controls in a systematic review and meta-analysis. Methods: Medline/PubMed ، Scopus, Web of Science, Google Scholar, and Embase were systematically searched for English articles up to October 2022 using MeSH and free keywords. Joanna Briggs Institute (JBI) checklist was used to assess the risk of bias. Differences between biomarker levels in TMD patients were compared to the control group. Results: Ten case-control studies were included based on inclusion and exclusion criteria with a total of 659 patients: 314 with TMD and 345 healthy controls. The studies investigated 15 markers, including total oxidant status, total antioxidant status, and Malondialdehyde. There was a significant difference in the salivary Malondialdehyde of patients with TMD in comparison with healthy people; SMD= 3.22 (95% CI: 0.28 to 6.16); I2 = 96.0%). The Antioxidant status in serum was significantly lower in patients with TMD in comparison with healthy people; WMD= -0.52 (95% CI: -0.90 to -0.14; I2 = 97.0%). The result of Total Oxidant Status was inconclusive. Conclusion: Salivary Malondialdehyde and serum total antioxidative status measurements may be used as a biomarker for diagnosing TMD. Due to the lack of sufficient evidence, it is not possible to express a definite relation between the amount and type of marker and TMD diagnosis, which suggests that more case-control studies with larger sample sizes are required.