{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:05:26Z","timestamp":1791777926049,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stress is recognised as a contributing risk factor for temporomandibular disorders (TMDs), and salivary stress biomarker levels may be altered in such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review aimed to assess the current evidence to determine the association between salivary stress biomarkers and temporomandibular disorders (TMDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Cochrane, Google Scholar and Scopus were searched. Case\u2013control and cross\u2010sectional studies exploring the association of salivary stress biomarkers in adult subjects with TMDs were included. A random effects model was used for quantitative data analysis. Risk\u2010of\u2010bias was assessed using the Newcastle\u2013Ottawa Scale (NOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 5319 studies, 16 studies met the eligibility criteria. All included studies were case\u2013control studies; they included 549 TMD cases and 494 controls. Overall, TMD cases showed higher levels of morning unstimulated salivary cortisol compared to controls (SMD: 1.38, 95% CI: 0.40\u20132.36), whereas the level of evening cortisol between both groups was non\u2010significant (SMD: 0.47, 95% CI: \u22120.00 to 0.95). Also, the qualitative results showed that the salivary oxidative\u2010stress biomarker was increased in the TMD group compared to controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The level of morning salivary cortisol seems to be increased in patients with TMDs compared to controls. This may indicate an association of salivary stress biomarkers and TMDs, although the level of evidence is very low. Therefore, further standardised studies are required to support these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70154","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:20:09Z","timestamp":1770898809000},"page":"1065-1078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Salivary Stress Biomarkers in Subjects With Temporomandibular Disorders (\n                    <scp>TMDs<\/scp>\n                    ): A Meta\u2010Analysis"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3736-1382","authenticated-orcid":false,"given":"Shailaja","family":"Raghavan","sequence":"first","affiliation":[{"name":"College of Dental Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-0452","authenticated-orcid":false,"given":"Faez Saleh","family":"Al\u2010Hamed","sequence":"additional","affiliation":[{"name":"College of Dental Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8197-2041","authenticated-orcid":false,"given":"Tayeb","family":"Al\u2010Hadeethi","sequence":"additional","affiliation":[{"name":"College of Dental Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayar","family":"Danadneh","sequence":"additional","affiliation":[{"name":"Oral Health Research and Promotion Unit Al\u2010Quds University  Jerusalem Palestine"},{"name":"Stem Cell and Regenerative Therapies, School of Basic &amp; Medical Biosciences, Faculty of Life Sciences and Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-8426","authenticated-orcid":false,"given":"Elham S. Abu","family":"Alhaija","sequence":"additional","affiliation":[{"name":"College of Dental Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"National Institute of Dental and Craniofacial Research \u201cFacial Pain \u201dhttps:\/\/www.nidcr.nih.gov\/research\/data\u2010statistics\/facial\u2010pain."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.157"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0975\u20105950.94463"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13005\u2010020\u201000234\u20102"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13260"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.11607\/jop.1151"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/23800844231164076"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034516653743"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010021\u201001485\u20104"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.26574\/maedica.2021.16.4.590"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102842.2008.01926.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.15037"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13692"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/jispcd.JISPCD_177_18"},{"issue":"2","key":"e_1_2_12_16_1","first-page":"93","article-title":"The Etiology of Temporomandibular Disorders: Implications for Treatment","volume":"15","author":"Greene C. S.","year":"2001","journal-title":"Journal of Orofacial Pain"},{"issue":"1","key":"e_1_2_12_17_1","first-page":"S76","article-title":"Assessment of the Relationship Between Stress and Temporomandibular Joint Disorder in Female Students Before University Entrance Exam (Konkour Exam)","volume":"8","author":"Mottaghi A.","year":"2011","journal-title":"Dental Research Journal"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12685"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030517"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102842.2008.01923.x"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010019\u20100791\u20108"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.4314\/tjpr.v21i6.30"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010024\u201005131\u20107"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13589"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.jrms_660_23"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26135971"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.990430"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20102385"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288"},{"key":"e_1_2_12_30_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Chandler J.","year":"2019"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2018.03.011"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3344\/kjp.2014.27.1.30"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016357.2010.494620"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20104052.158075"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1590\/pboci.2021.029"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.4103\/jips.jips_12_23"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.01405"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12118"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102842.2011.02216.x"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.55730\/1300\u20100144.5737"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13100"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.705"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.4103\/jiaomr.jiaomr_83_20"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2016.03.017"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/ors.12473"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2008.10.010"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/7020751"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70154","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joor.70154","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:13:19Z","timestamp":1775535199000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.70154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/joor.70154"],"URL":"https:\/\/doi.org\/10.1111\/joor.70154","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JOOR.70154\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JOOR.70154\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JOOR.70154\/v1\/review1","asserted-by":"object"}]},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]},"assertion":[{"value":"2025-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}