{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:08:18Z","timestamp":1788930498651,"version":"build-2803163510"},"reference-count":75,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Bialystok","award":["N\/ST\/MN\/16\/001\/1113"],"award-info":[{"award-number":["N\/ST\/MN\/16\/001\/1113"]}]},{"name":"Medical University of Bialystok","award":["B.SUB.23.308"],"award-info":[{"award-number":["B.SUB.23.308"]}]},{"name":"Medical University of Bialystok","award":["B.SUB.25.382"],"award-info":[{"award-number":["B.SUB.25.382"]}]},{"award":["N\/ST\/MN\/16\/001\/1113"],"award-info":[{"award-number":["N\/ST\/MN\/16\/001\/1113"]}],"id":[{"id":"https:\/\/ror.org\/00y4ya841","id-type":"ROR","asserted-by":"publisher"}]},{"award":["B.SUB.23.308"],"award-info":[{"award-number":["B.SUB.23.308"]}],"id":[{"id":"https:\/\/ror.org\/00y4ya841","id-type":"ROR","asserted-by":"publisher"}]},{"award":["B.SUB.25.382"],"award-info":[{"award-number":["B.SUB.25.382"]}],"id":[{"id":"https:\/\/ror.org\/00y4ya841","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Background: Temporomandibular disorders constitute multifaced systemic impairments capable of compromising overall physiological homeostasis. This study compares oxidative and nitrosative stress biomarkers between patients with temporomandibular myofascial pain with referral and healthy controls. Methods: We enrolled 44 individuals with temporomandibular myofascial pain with referrals and 44 controls. The procedure involved clinical examination based on the Diagnostic Criteria for Temporomandibular Disorders and saliva collection. Biochemical determination involved advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), thiobarbituric-acid-reactive substances (TBARS), and total nitric oxide (NO). Results: Median concentrations of TBARS and total NO were significantly elevated in the study group relative to the controls (TBARS: 6.078 vs. 1.486; total NO: 138.6 vs. 23.82), whereas the concentration of AOPPs was significantly lower (151.1 vs. 505.3). Multiple regression revealed that myofascial pain was an independent predictor of the observed differences, even after we adjusted for age and salivary flow rate (TBARS: \u03b2 = 4.78 [95% CI: 2.020, 7.541], adjp = 0.0018; total NO \u03b2 = 128.4 [95% CI: 82.70, 174.1] adjp = 0.0004; AOPP \u03b2 = \u2212755.7 [95% CI: \u22121228, \u2212283.5] adjp-value = 0.0028. Conclusions: Myofascial pain with referral is independently associated with oxidative imbalance, highlighting the relevance of TBARS and total NO as promising severity biomarkers. The unexpected decrease in AGE and AOPP levels requires standardized studies to confirm diagnostic utility.<\/jats:p>","DOI":"10.3390\/antiox15091133","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:53:28Z","timestamp":1788789208000},"page":"1133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Relevance of Oxidative Imbalance in Patients with Temporomandibular Disorder\u2014Myofascial Pain with Referral: An Exploratory Case\u2013Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-2075","authenticated-orcid":false,"given":"Joanna","family":"Ku\u0107","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Medical University of Bialystok, M. Sk\u0142odowskiej-Curie 24A Street, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5609-3187","authenticated-orcid":false,"given":"Mateusz","family":"Maciejczyk","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Environmental Health, Medical University of Bialystok, Mickiewicza 2C Street, 15-022 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Krzysztof Dariusz","family":"Szarejko","sequence":"additional","affiliation":[{"name":"Private Health Care, Physical Therapy and Rehabilitation, Warszawska 79 Street, 15-201 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4350-0369","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"\u017bendzian-Piotrowska","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Environmental Health, Medical University of Bialystok, Mickiewicza 2C Street, 15-022 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Walery","family":"Tarnawski","sequence":"additional","affiliation":[{"name":"Center for Implantology and Orthodontics \u201cRoyal Dental\u201d, Raciborska 69 Street, 44-200 Rybnik, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"}]},{"given":"Sara","family":"Zi\u0119ba","sequence":"additional","affiliation":[{"name":"Independent Researcher, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-0951","authenticated-orcid":false,"given":"Anna","family":"Zalewska","sequence":"additional","affiliation":[{"name":"Restorative Dentistry Department, Medical University of Bialystok, M. Sk\u0142odowskiej-Curie 24A Street, 15-276 Bialystok, Poland"},{"name":"Independent Laboratory of Experimental Dentistry, Medical University of Bialystok, M. Sk\u0142odowskiej-Curie 24A Street, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Greene, C., Manfredini, D., and Ohrbach, R. (2023). Creating patients: How technology and measurement approaches are misused in diagnosis and convert healthy individuals into TMD patients. Front. 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