Akdogan, Emine OrnekOmezli, Mehmet MelihTorul, Damla2024-09-292024-09-2920232468-85092468-7855https://doi.org/10.1016/j.jormas.2023.101417https://hdl.handle.net/20.500.14619/5006Objective: Temporomandibular disorder (TMD) is still a challenge in terms of diagnosis and management. The aim of this study is to explore if the evaluation of salivary biomarkers and fractal dimension (FD) of mandibu-lar condyle could be useful for interpreting early degenerative changes and the effectiveness of salivary corti-sol in determining the stress levels of TMD patients.Materials and Methods: 34 patients with TMD, and 34 healthy controls were included in this study. Saliva samples were obtained from all participants between 09:00-12:00 am. Salivary cortisol, IL-1,6, TNF-a, and MMP-3 levels were evaluated with ELISA method. FD of the mandibular condyle was determined by means of box-counting method. Depression and anxiety were determined with PHQ-9 and GAD-7 questionnaires.Results: The salivary cortisol and depression/anxiety were higher in study group; however, not significant (p>0.05). FD of the study group was found significantly lower than the control group (p<0.01). Salivary TNF-a, IL-1,6 and MMP-3 levels were showed no significant difference between the two groups (p>0.05). There were no significant correlations between the evaluated parameters.Conclusion: Salivary cortisol seems to be a non-invasive way of measuring physiological stress of TMD patients. Fractal analysis may be a useful tool in detecting early structural changes in mandibular condyle. Salivary TNF-a. IL-1,6 and MMP-3 have not a diagnostic value in terms of interpreting early degenerative changes.(c) 2023 Elsevier Masson SAS. All rights reserved.eninfo:eu-repo/semantics/closedAccessBiomarkerFractal analysisMandibular condyleMicrostructure of bone SalivaTemporomandibular disordersArticle10.1016/j.jormas.2023.1014172-s2.0-851490679144Q2124WOS:001001871600001Q2