A Randomized Controlled Trial Evaluating the Levels of the Biomarkers hs-CRP, IL-6, and IL-8 in Patients with Temporomandibular Disorder Treated with LLLT, Traditional Conservative Treatment, and a Combination of Both

Abdalwhab Ma Zwiri; Wan Muhamad Amir W Ahmad; Jawaad Ahmed Asif; Khoo Suan Phaik; Adam Husein; Nur Karyatee Kassim; Zuryati Ab-Ghani

doi:10.3390/ijerph19158987

A Randomized Controlled Trial Evaluating the Levels of the Biomarkers hs-CRP, IL-6, and IL-8 in Patients with Temporomandibular Disorder Treated with LLLT, Traditional Conservative Treatment, and a Combination of Both

Int J Environ Res Public Health. 2022 Jul 23;19(15):8987. doi: 10.3390/ijerph19158987.

Authors

Abdalwhab Ma Zwiri¹, Wan Muhamad Amir W Ahmad¹, Jawaad Ahmed Asif^{1

2}, Khoo Suan Phaik³, Adam Husein^{1

2}, Nur Karyatee Kassim^{1

2}, Zuryati Ab-Ghani^{1

2}

Affiliations

¹ School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
² Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
³ Department of Oral Diagnostic and Surgical Sciences, School of Dentistry, International Medical University, Bukit Jalil 57000, Kuala Lumpur, Malaysia.

Abstract

Temporomandibular disorders (TMDs) are a type of idiopathic orofacial pain. Inflammation, particularly elevated circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8), has been linked to pain symptoms. The purpose of this study was to compare hs-CRP, IL-6, and IL-8 biomarkers and pain intensity with different treatment strategies (LLLT, standard conservative treatment, and combination) for TMD patients.

Methods: A total of 32 participants were randomly included in the study and divided into three groups (Group I, Group II, and Group III) referred from the Dental Clinic, School of Dental Science, HUSM. Patients received LLLT (Groups II and III) in five sessions for the duration of 10 days. Patients in Groups I and III received standard conservative TMD treatment (diet and stress counseling, jaw exercises, physical therapy, which was a hot towel application) by the principal investigator. All blood samples for biomarkers were performed before starting treatments and directly after finishing the treatment protocols, where all results were recorded.

Results: The result showed a significant difference in the mean IL-8 (p = 0.001) between the three intervention groups (LLLT, standard treatment, and combined treatment). IL-6 showed an increase in the mean of IL-6 levels from baseline to post-treatment with a better mean in the LLLT treatment group without any significant differences. Additionally, there were no significant mean differences found between the groups and in the group for the hs-CRP biomarker.

Conclusions: A statistically non-significant difference was found in hs-CRP and IL-6 before and after LLLT, conservative, and combined treatment strategies of TMD. A statistically significant difference was observed in the mean levels of IL-8 between the LLLT intervention group and the combined treatment group. Although there was no statistically significant correlation between pain intensity and biomarkers, a statistically significant difference was found in pain intensity before and after LLLT, conservative, and combined treatment strategies. TMJ degeneration could be exacerbated by elevated IL-8 levels. Thus, this can be an important biomarker to mark or identify the painful condition of TMJ.

Keywords: IL-6; IL-8; LLLT; TMD biomarkers; TMD treatment; hs-CRP.

Publication types

Randomized Controlled Trial

MeSH terms

Biomarkers
C-Reactive Protein
Conservative Treatment
Facial Pain
Humans
Interleukin-6
Interleukin-8
Low-Level Light Therapy* / methods
Temporomandibular Joint Disorders* / psychology
Temporomandibular Joint Disorders* / therapy
Treatment Outcome

Substances

Biomarkers
Interleukin-6
Interleukin-8
C-Reactive Protein

Associated data

ANZCTR/ACTRN12620000442909

Grants and funding

This research received no external funding.