{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:49Z","timestamp":1787015869139,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T00:00:00Z","timestamp":1594598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004488","name":"Hrvatska Zaklada za Znanost","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004488","name":"Hrvatska Zaklada za Znanost","doi-asserted-by":"publisher","award":["IP\u20102019\u201004\u20106211"],"award-info":[{"award-number":["IP\u20102019\u201004\u20106211"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2021,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate stress effect of COVID\u201019 pandemic and Zagreb earthquakes on symptoms of temporomandibular disorders (TMD).<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n One hundred and two previously diagnosed TMD patients were contacted by email to participate in an online survey about impact of those events on current and\/or new symptoms, perceived stress, anxiety and symptom intensity in time\u2010points at the baseline, following pandemic and following earthquake. We compared data between earthquake\u2010affected and non\u2010affected respondents.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Response rate was 79.4%. Effects stress had on deterioration of symptoms were significantly different between earthquake\u2010affected and non\u2010affected (\n p<\/jats:italic>\n \u00a0=\u00a0.024). In earthquake\u2010affected, numerical pain rating scale (NPRS) scores significantly increased between baseline and after COVID\u201019 (\n p<\/jats:italic>\n \u00a0>\u00a0.001) and between baseline and after earthquakes (\n p<\/jats:italic>\n \u00a0>\u00a0.05). However, scores insignificantly dropped from COVID\u201019 to after earthquakes time\u2010points. In earthquake\u2010affected, positive correlation was found between impact of COVID\u201019 on stress and NPRS (\n p<\/jats:italic>\n \u00a0<\u00a0.001) and between earthquakes\u2019 impact on stress and NPRS (\n p<\/jats:italic>\n \u00a0<\u00a0.001). Earthquake\u2010affected respondents reported significantly more new behavioral habits when compared to non\u2010affected (\n p<\/jats:italic>\n \u00a0=\u00a0.048).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A series of stressful events do not necessarily have a cumulative effect, but are likely to have a complex interaction (e.g., acute stress might trigger the protective mechanisms), which could have decreased pain scores after the earthquakes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/odi.13488","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T15:55:10Z","timestamp":1592063710000},"page":"688-693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["COVID\u201019 pandemic and Zagreb earthquakes as stressors in patients with temporomandibular disorders"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-851X","authenticated-orcid":false,"given":"Ema","family":"Vrbanovi\u0107","sequence":"first","affiliation":[{"name":"Department of Removable Prosthodontics School of Dental Medicine University of Zagreb Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8524-5661","authenticated-orcid":false,"given":"Iva Z.","family":"Alajbeg","sequence":"additional","affiliation":[{"name":"Department of Removable Prosthodontics School of Dental Medicine University of Zagreb Zagreb Croatia"},{"name":"Department of Dentistry University Clinical Center Zagreb Zafgreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7936-2554","authenticated-orcid":false,"given":"Ivan","family":"Alajbeg","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Clinical Center Zagreb Zafgreb Croatia"},{"name":"Department of Oral Medicine School of Dental Medicine University of Zagreb Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2001.23371"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3913(91)90177-X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2003.01467.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-7757-2018-0210"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.15244\/pjoes\/39702"},{"issue":"1","key":"e_1_2_9_7_1","first-page":"10","article-title":"The effect of stress on the defense systems","volume":"3","author":"Drago\u015f D.","year":"2010","journal-title":"Journal of Medicine and Life"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2012.03.012"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa013404"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1006\/jesp.1993.1010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.24869\/psyd.2020.6"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jopr.12704"},{"key":"e_1_2_9_13_1","volume-title":"Stress Appraisal and Coping","author":"Lazarus R. 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