A prospective single arm study of salivary cortisol changes in muscular temporomandibular disorders patients following computer-guided occlusal adjustments

Abstract

Statement of problem: The relationship between occlusomuscular temporomandibular disorders (TMD) and stress measured by salivary cortisol and the effect that disclusion time reduction (DTR) therapy may have on cortisol levels remains unclear. Objective evidence is lacking as to whether modifying the occlusal dynamics with DTR therapy will objectively reduce stress responses in affected patients. Purpose: The purpose of this clinical study was to evaluate the stress levels among patients with occlusomuscular TMD by measuring salivary cortisol levels before and after DTR therapy. Material and methods: Thirty patients diagnosed with occlusomuscular TMD had salivary cortisol level samples collected and assayed by passive drool at baseline and 1-month after DTR therapy with enzyme-linked immunosorbent assay (ELISA). All 30 participants were treated with the T-Scan 10 Novus digital occlusion analyzer synchronized with temporalis and masseter surface electromyography (sEMG) to achieve disclusion times of less than 0.5 seconds during left and right lateral excursive movements. The Kolmogorov-Smirnov tested normality and the Student’s paired t test evaluated pre-and posttreatment cortisol levels, the disclusion times, and muscular comparisons (P