{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:52:37Z","timestamp":1788022357087,"version":"build-2784847793"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic\u2013pituitary\u2013adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p &lt; 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support.<\/jats:p>","DOI":"10.3390\/dj13060230","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T12:15:43Z","timestamp":1747916143000},"page":"230","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stomatognathic Dysfunction and Neuropsychological Imbalance: Associations with Salivary Cortisol, EMG Activity, and Emotional Distress"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2643-761X","authenticated-orcid":false,"given":"Ioana","family":"Scrobota","sequence":"first","affiliation":[{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 10 1st Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7701-2307","authenticated-orcid":false,"given":"Liliana","family":"Sachelarie","sequence":"additional","affiliation":[{"name":"Department of Preclinical Discipline, Faculty of Medicine, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8981-1958","authenticated-orcid":false,"given":"Timea Claudia","family":"Ghitea","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8412-104X","authenticated-orcid":false,"given":"Georgiana Ioana","family":"Potra Cicalau","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 10 1st Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Alexandra","family":"Cristea","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 10 1st Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pelea","family":"Diana","sequence":"additional","affiliation":[{"name":"Preclinics Department, Faculty of Medicine and Pharmacy, University of Oradea, 10 1st Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0533-1396","authenticated-orcid":false,"given":"Petra","family":"Saitos","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 10 1st Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7645-5904","authenticated-orcid":false,"given":"Alexandra","family":"Vlad","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3803-9405","authenticated-orcid":false,"given":"Loredana Liliana","family":"Hurjui","sequence":"additional","affiliation":[{"name":"Morpho-Functional Sciences II Department, Faculty of Medicine, Discipline of Physiology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, 16 Universitatii Str., 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/joor.12955","article-title":"Distribution of Temporomandibular Disorders among Sleep Bruxers and Non-Bruxers\u2014A Polysomnographic Study","volume":"47","author":"Wieckiewicz","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"613","DOI":"10.17219\/dmp\/185249","article-title":"Movement disorders of the stomatognathic system: A blind spot between dentistry and medicine","volume":"61","author":"Yoshida","year":"2024","journal-title":"Dent. Med. 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