Patients with a common type of temporomandibular disorder (TMD) had lower calcium and vitamin D levels, indicating that calcium metabolism may be linked to these jaw conditions. The results were published on October 21 in the Journal of Stomatology, Oral and Maxillofacial Surgery.
Those with temporomandibular joint disk displacement with reduction (DDWR) had deficiencies in calcium and vitamin D compared to patients who didn't have TMDs, the authors wrote. Severe vitamin D deficiency may negatively affect calcium metabolism by causing a drop in calcium and magnesium levels and may pose a risk for TMDs, the authors wrote.
"These results revealed that vitamin D and calcium deficiency should be investigated and corrected in patients with TMD," wrote the authors, led by Dr. Ömer Ekici of Afyonkarahisar Health Sciences University in Turkey.
Worldwide, vitamin D deficiency and insufficiency affect more than 1 billion people. The vitamin affects cell proliferation and differentiation in skeletal muscle cells, and it moves calcium and phosphorus across the skeletal cell membranes. Additionally, vitamin D prevents muscle degeneration and reverses myalgia.
TMDs also are common, affecting between 5% and 12% of the population. However, the etiology and pathogenesis of TMDs are not completely understood, so treatments are not always successful. Therefore, a better understanding of the origin of TMDs would help identify and eliminate possible pathogenic factors.
To explore the relationship between the factors that affect calcium metabolism and TMDs, vitamin D levels, and related biochemical parameters in patients with these jaw joint disorders, a prospective observational study of 100 patients was conducted. Half of the patients had TMDs, and the other 50 did not.
TMD diagnostic criteria were used to diagnose DDWR. Then, patients' levels of alkaline phosphatase, vitamin D, parathyroid hormone, calcium, magnesium, and phosphorus were compared. A p value of < 0.005 was considered a significant difference, they wrote.
Patients with DDWR had lower calcium levels (p < 0.005) than healthy controls. Additionally, severe vitamin D deficiency (< 10 ng) was significantly more common in the TMD group (n = 19) than in the control group (n = 8), the authors wrote.
The study's limitations included that there was no bone mineral density assessment information for patients. However, the authors noted that they wanted more accurate and reliable results by including only those with DDWR instead of a heterogeneous TMD group, which has been used in previous research.
Clinicians should consider evaluating patients with TMDs for deficiencies and suggest supplementation if appropriate. In the future, more randomized clinical trials should be conducted to better understand the possible connection TMDs and deficiencies, the authors wrote.
"Nevertheless, investigation of possible effects on TMD symptoms in response to vitamin D supplementation in individuals with low vitamin D levels is important to determine the precise role of vitamin D in TMD," Ekici et al wrote.