Evaluation of estrogen values and tnf-α, IL-1ß, IL-6, IL-8, IL-10 and IL-12 synovial fluid leves in woman patients with temporomandibular joint disorders

Temporomandibular joint disorders (TMD) are a collective term embracing a number of clinical problems that involve the masticatory muscles, the temporomandibular joint (TMJ) or both. Temporomandibular joint (TMJ) diseases predominantly afflict women, suggesting a role for female hormones in the disease process. As an sex hormone estrogens have been suggested to play an important role in the development of temporomandibular joint disorders. The aim of this study was to evaluate the estrogen values and TNF-α, IL-1ß, IL-6, IL-8, IL-10 and IL-12 synovial fluid leves in women patients with temporomandibular joint disorders. Our study consisted of 36 patients with unilateral TMDs. Patients divided into two sub groups according to their estrogen levels (High and low estrogen groups) and treatment success (Succesful and unsuccessful). Arthrocentesis treatment was performed on all patients and followed for six months at least. During this procedure synovial fluid samples were collected to determine cytokine levels. Patient's blood samples were also tested to determine serum estrogen levels. Estrogen and cytokines levels were evaluated pre-operatively and clinical findings were recorded both pre-operatively and post-operatively. These clinical and laboratory findings were evaluated and estimated. The study results showed that even high estrogen levels are poor prognostic indicator for effectiveness arthrocentesis, this procedure was successful at reducing the pain in both high and low estrogen levels. Although cytokines levels in successful and unsuccessful groups showed insignificant difference, TNF-α were significantly related with low estrogen levels. Chronic pain was associated to high IL-1ß levels and the pain with palpation on TMJ was also associated with low levels of IL-8 and IL-12. As a result, it is found that serum estrogen level sare associated to different clinical and biochemical findings. Additionally the patients with a serum estrogen level higher than 36.48 pq/ml are at risk for TMD and poor arthrocentesis outcome.