The novel relationship between polycystic ovary syndrome and temporomandibular joint disorders

Abstract

Introduction: Studies investigating the relationship between sex hormones, inflammatory mediators and joint disorders have reported that sex hormones affect the pathogenesis of joint disorders. We aimed to investigate temporomandibular joint disorder (TJD) in polycystic ovary syndrome (PCOS) and the possible role of systemic mediators and sex hormones in TJD pathogenesis.

Material and methods: PCOS patients (n = 45) and controls (n = 30) aged 20-40 years, were enrolled in this case-control study. TJD diagnosis was performed by the specialist and blood samples were tested in the early follicular phase and on the 21 st (midluteal) day to investigate the levels of estrogen, progesterone, matrix metalloproteinase (MMP) 1-8-9, interleukin (IL)-1ß and Tumor necrosis factor (TNF)-α.

Results: TJD incidence was significantly higher in PCOS than the control group (51.1% and 6.9% respectively, p < 0.01). Midluteal progesterone (p < 0.01) was lower in PCOS group than the controls (p < 0.01). TNF-α (p < 0.01), MMP 1 (p < 0.01) and MMP 8 (p = 0.02) levels were found significantly higher in PCOS than the control group. Further, Progesterone levels were found significantly lower in TJD (+) PCOS patients than TJD (-) PCOS patients. However, significant difference was not found between the PCOS TJD (+) and PCOS TJD (-) patients for estrogen, MMP 1, MMP 8, MMP 9, TNF-α and IL-1ß.

Conclusions: TJD frequency was found significantly increased in PCOS patients. Related with this, TJD co-occurrence should be kept in mind in the diagnosing and treatment process of PCOS due to hormonal alteration.

Keywords: Estrogen; Matrix metalloproteinases; Polycystic ovary syndrome; Progesterone; Temporomandibular joint disorders.