Influence of the Hypothalamic-Pituitary-Adrenal Axis on Temporomandibular Disorders. Short Article

Abstract

Background: For some time, the relationship between temporomandibular disorders (TMD) and psychobiological factors has been explored. Psychological stress has been shown to produce chemical changes in the body, one of which is the increase in cortisol levels regulated by the hypothalamic-pituitary-adrenal (HPA) axis. This triggers physiological and pathological bodily changes, such as TMD. Purpose: To analyze current evidence on the influence of the HPA axis on TMD and methods for measuring cortisol levels. Methods: A narrative literature review was conducted using a sample of articles from the PubMed, Google Scholar, ScienceDirect, and Cochrane databases, published between 2008 and 2022. Narrative reviews, systematic reviews, meta-analyses, and in vivo and in vitro studies were included. Results and Conclusions: Initially, 220 titles were identified, of which 27articles were selected for full-text reading and analysis. The evidence links altered HPA axis dynamics to the pathophysiological development of TMD as an adaptive response to environmental stress-inducing factors. Activation of this axis stimulates the production of cortisol, neuropeptides, and inflammatory mediators, leading to characteristic signs and symptoms and increasing the likelihood of joint degeneration.