Title: 1386 - Autoimmunity May Cause Inflammation and Comorbidities in Temporomandibular Disorders


Ji-Woon Park (Presenter)
Seoul National University

Chunghwan Son, Seoul National University
Seo Eun Park, Seoul National University
Jin-Woo Chung, Seoul National University, School of Dentistry


Objectives: The aim of this study was to investigate the presence of autoantibodies and level of comorbidities in temporomandibular disorders(TMD) patients and compare their levels according to pain disability groups to seek the possible role of autoimmunity in the etiopathogenesis of TMD pain.

Methods: Venous blood was harvested from 69 female TMD patients in their 20-30s. The presence of autoimmune indices(anti-nuclear antibody, rheumatoid factor, ss-DNA, ds-DNA, extracted nuclear antigens, IgG-anti-beta2-glycoprotein I antibody, anticardiolipin antibody, lupus anticoagulant(LAC), IgA, IgG, IgM and complements 3 and 4) and cytokines(interleukin levels, TNF-α, FGF, GM-CSF, VEGF) were analyzed. Comorbidities were evaluated through comprehensive psychological, sleep, autonomic symptom and widespread pain screening. Collected data was statistically compared between high and low disability groups of the Graded Chronic Pain scale.

Results: Pain intensity(p<0.001), number of disability days(p<0.001), depression(p=0.016) and somatization(p=0.034) scores, BAI(Beck's anxiety index)(p=0.016), COMPASS(Composite autonomic symptom score)(p=0.017), FIQ(Fibromyalgia impact questionnaire)(p=0.016), and SS(symptom severity)(p=0.011) scores were significantly higher in the high disability group. IgG blood levels were significantly higher in the high disability group. LAC, complements 3 and 4, IgA, IgG, and IgM levels were increased in the high disability group. TMD pain intensity showed a significant correlation with complement 4 level(p<0.05). IgG level showed a significant correlation with the number of disability days due to pain(p<0.05), depression(p<0.05), ESS(Epworth sleepiness scale)(p<0.05), BDI(p<0.05), BAI(p<0.01), COMPASS(p<0.05), and FIQ(p<0.01) scores.

Conclusions: Significantly higher level of IgG was found in high disability TMD patients along with other autoimmune indices. Although TMD is associated with low-grade-inflammation, a certain group of patients with elevated IgG levels may show a longer pain duration and higher prevalence of comorbidities. These results may point towards the existence of a nonspecific autoimmune disposition in a subgroup of TMD patients. IgG may be considered as a screening test for the detection of TMD patients with high pain disability levels.

This abstract is based on research that was funded entirely or partially by an outside source:
National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2017015377)

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE