Implications of Estrogen Hormones on the Physiopathology of Temporomandibular Joint Dysfunction

Klein Zhi^*
*Correspondence: Klein Zhi, Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, USA, Email:

Introduction

Temporomandibular Joint Dysfunction is a multifaceted disorder characterized by pain and functional impairment in the temporomandibular joint and surrounding muscles. Recent research has highlighted the significant role of estrogen hormones in the physiopathology of TMJD. This mini-review explores the relationship between estrogen and TMJD, discussing hormonal influences on joint tissues, pain perception, and disease progression. Understanding these interactions may guide more effective management strategies for TMJD, particularly in populations with fluctuating estrogen levels. Temporomandibular Joint Dysfunction encompasses a range of disorders affecting the TMJ, including pain, restricted movement, and clicking or popping sounds. The etiology of TMJD is complex, involving both mechanical and biochemical factors.

Description

Emerging evidence suggests that estrogen hormones play a crucial role in the development and progression of TMJD. This review examines the effects of estrogen on TMJ physiopathology, highlighting the hormonal influences on tissue structure, pain mechanisms, and clinical outcomes. Estrogen receptors are present in TMJ cartilage, ligaments, and surrounding muscles. ERα and ERβ modulate various cellular processes, including inflammation and tissue remodeling. Estrogen influences cartilage metabolism by regulating chondrocyte function. Estrogen deficiency or excess can lead to alterations in matrix synthesis and degradation, contributing to TMJ degeneration. Estrogen affects bone density and turnover. Alterations in estrogen levels can lead to changes in the TMJ bone structure, impacting joint function and contributing to dysfunction [1,2].

Estrogen modulates collagen synthesis and muscle tone. Variations in estrogen levels may affect the resilience and function of TMJ-associated ligaments and muscles. Estrogen influences nociceptive pathways, altering pain perception. Estrogen can modulate the activity of neurotransmitters and receptors involved in pain processing. Variations in estrogen levels can affect pain sensitivity and perception, potentially exacerbating TMJD symptoms during certain hormonal phases, such as menstruation or menopause. Women are more commonly affected by TMJD, suggesting a role for estrogen in disease susceptibility. The prevalence and severity of TMJD may vary with hormonal fluctuations across the menstrual cycle or during hormonal treatments. Studies indicate that TMJD symptoms can fluctuate with the menstrual cycle, supporting a link between estrogen levels and pain intensity. Estrogen has both pro-inflammatory and anti-inflammatory effects. It influences the production of cytokines and other mediators involved in TMJDrelated inflammation [3].

Chronic inflammation in TMJD may be influenced by estrogen levels, affecting disease progression and response to treatment. HRT may influence TMJD symptoms and progression. The effects of HRT on TMJD are complex, with potential benefits and drawbacks depending on the individual’s hormonal status and disease characteristics. Further research is needed to elucidate the precise mechanisms through which estrogen influences TMJD. Understanding these mechanisms will enhance the ability to target hormonal influences in treatment. There is considerable variability in hormonal responses among individuals. Personalized approaches to managing TMJD, considering hormonal status, may improve outcomes. Integrating hormonal considerations into TMJD management could involve hormonal assessments and tailored therapies. Exploring the benefits of hormonal modulation, such as adjusting HRT, may offer new treatment avenues [4,5].

Conclusion

Estrogen hormones play a significant role in the physiopathology of Temporomandibular Joint Dysfunction, influencing tissue structure, pain perception, and disease progression. The complex interactions between estrogen and TMJD highlight the need for further research to better understand these relationships and improve diagnostic and therapeutic strategies. By incorporating hormonal factors into TMJD management, healthcare providers can develop more effective, individualized treatment approaches.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Berger, Marcin, Leszek Szalewski, Magdalena Bakalczuk and Grzegorz Bakalczuk, et al. "Association between estrogen levels and temporomandibular disorders: a systematic literature review." Menopause Rev 14 (2015): 260-270.

   Google Scholar, Crossref, Indexed at

2. Navarro-Pardo, Esperanza, Carol A. Holland and Antonio Cano. "Sex hormones and healthy psychological aging in women." Front Aging Neurosci 9 (2018): 439.

   Google Scholar, Crossref, Indexed at

3. MacKendrick, Norah A. and Hannah Troxel. "Like a finely-oiled machine: Self-help and the elusive goal of hormone balance." Soc Sci Med 309 (2022): 115242.

   Google Scholar, Crossref, Indexed at

4. Robinson, Jennifer L., Pamela M. Johnson, Karolina Kister and Michael T. Yin, et al. "Estrogen signaling impacts temporomandibular joint and periodontal disease pathology." Odontology 108 (2020): 153-165.

   Google Scholar, Crossref, Indexed at

5. McDaniel, Jennifer S., Ramya Akula Suresh Babu, Mary M. Navarro and Richard G. LeBaron. "Transcriptional regulation of proteoglycan 4 by 17β‐estradiol in immortalized baboon temporomandibular joint disc cells." Eur J Oral Sci 122 (2014): 100-108.

   Google Scholar, Crossref, Indexed at