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Srpski arhiv za celokupno lekarstvo 2018 Volume 146, Issue 1-2, Pages: 20-25
https://doi.org/10.2298/SARH161221172B
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Salivary cortisol responses to acute stress in students with myofascial pain

Božović Đorđe (University of East Sarajevo, Faculty of Medicine, Department of Oral Rehabilitation, Foca, Bosnia and Herzegovina)
Ivković Nedeljka ORCID iD icon (University of East Sarajevo, Faculty of Medicine, Department of Oral Rehabilitation, Foca, Bosnia and Herzegovina)
Račić Maja (University of East Sarajevo, Faculty of Medicine, Department for Primary Care and Public Health, Foča, Bosnia and Herzegovina)
Ristić Siniša (University of East Sarajevo, Faculty of Medicine, Department of basic medical sciences - physiology, Foca, Bosnia and Herzegovina)

Introduction/Objective. Temporomandibular disorders (TMD) are characterized by the appearance of musculoskeletal pain and dysfunction of the masticatory system. The aims of this study were to evaluate the salivary cortisol levels in students with chronic myofascial pain (MFP) related to TMD during oral exam, as well as to analyze the correlation between salivary cortisol levels, TMD-related MFP, the level of anxiety, depression symptoms, somatization, and perceived stress. Methods. The study included 60 university students, who were allocated either into the group of students with MFP (n = 30) or into the control group of healthy students (n = 30). The level of salivary cortisol was measured on the exam day and during the control day when the students had no exams. Depression symptoms, somatization, perceived stress and anxiety were evaluated according to Axis II RDC/TMD, Perceived Stress Scale and State–Trait Anxiety Inventory. Results. Levels of salivary cortisol were significantly higher in the group of students with MFP in all phases of measurements compared to the control group (p < 0.01). Students with MFP also showed significantly higher depression symptoms, somatization, and trait anxiety scores than the control group. No significant group differences were found on the scales measuring state anxiety and perceived stress. The level of salivary cortisol was found to be in correlation with depression symptoms, state anxiety, and perceived stress, but not with chronic pain, somatization, and trait anxiety in students with TMD. Conclusion. Salivary cortisol could be an important indicator of psychological distress in TMD.

Keywords: temporomandibular disorders, saliva, chemistry, hydrocortison, metabolism, stress, metabolism