Highly sensitive C – reactive protein as a marker for Temporomandibular pain: an 11-year follow-up study

Authors: Banafa Aa, Suominen ALb,c,d and Sipilä Kb,e,f

Affiliations:
aFaculty of Health Sciences, School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; bInstitute of Dentistry,University of Eastern Finland, Kuopio, Finland; cDepartment of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland; dPublic Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland; eResearch Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; fOral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.

Aim of Investigation:
High levels of highly sensitive C-reactive protein (hs-CRP) (inflammation marker) has been observed in chronic pain conditions. We aim to investigate the association between the level of hs-CRP and temporomandibular disorder (TMD) pain in Finnish adults over 11 years.

Material and methods:
The sample was based on the nationally representative Health 2000 and Health 2011 surveys in Finland. It comprised 1,210 Finnish Adults who underwent clinical TMD examination (pain on palpation of the masticatory muscles and temporomandibular joints) and also on self-report in 2011. Serum level of hs-CRP was measured using an ultrasensitive immunoturbidimetric test. Four subgroups were formed based on the presence of TMD pain; No TMD pain, TMD pain only at baseline, TMD pain only in the follow-up and TMD pain at baseline and in the follow-up. Association was evaluated using multinomial logistic regression with the baseline level of hs-CRP as the predictor and No TMD pain as the reference.

Results:
In men, high baseline level of hs-CRP increased the odds of having TMD pain only at baseline by 1.1 (95% CI 1.0-1.2, p=0.046) and having TMD pain at baseline and the follow-up by 1.1 (95% CI 1.0-1.2, p=0.048), but did not associate with having TMD pain only in the follow-up. In women, hs-CRP did not associate with the occurrence of TMD pain in any of the categories.

Conclusion:
Chronic TMD pain may be induced by inflammation in men.

Acknowledgements and/or Funding Source: This work was funded through employment with the University of Eastern Finland.