{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:44:27Z","timestamp":1787582667514,"version":"build-2736575974"},"reference-count":74,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"XIV Call for aid for the Development of Research Projects FUAX-Santander 2022","award":["1,014,007"],"award-info":[{"award-number":["1,014,007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Temporomandibular disorders or dysfunction (TMDs) encompass a range of complex conditions that impact the temporomandibular joint (TMJ), chewing muscles, teeth, and\/or their supporting tissues. Stress is one of the most associated factors studied as a TMD predictor. The aim is to figure out the influence of stress on TMJ status and salivary cortisol in university students during and before exams. Materials and Methods: The study was non-experimental, employing a longitudinal, analytical, observational cohort design. The study population consisted of students enrolled in the physiotherapy degree program at the Alfonso X El Sabio University (Madrid, Spain). Data were collected during two distinct academic periods: the first period was characterized by low academic stress and no exams, and the second period coincided with the high academic stress of final course exams. The collected results included sociodemographic data, assessment of TMJ status (Fonseca Index), evaluation of muscle evaluation (masseter, upper trapezius, and sternocleidomastoid) using a MOXY Monitor (muscle oxygenation) and Neurotrac\u00ae (surface EMG, sEMG), assessment of perceived stress (PSS-14), and measurement of salivary cortisol (enzyme immunoassay with Elisa). The statistical analysis was conducted with a confidence level of 95% (p \u2264 0.05) and asymptotic or bilateral significance. Results: 70 students were analyzed during two different measurement periods. According to the Fonseca Index, initially, 37.14% of the analyzed students showed mild TMDs, 17.14% moderate TMDs, and 45.72% showed no TMDs. In general terms, stress increased with age and is related to female sex, maximum mouth opening decreased with age, oxygen saturation decreased with age and academic stress, and myoglobin concentration was related to age. Furthermore, muscle contraction decreased during higher academic stress and increased with age. For women, age was a risk factor for suffering from TMDs, and stress worsened the transition from having TMDs to having no TMDs in both sexes. Conclusions: Academic stress influences TMJ status and muscle outcomes such as oxygen saturation, myoglobin concentration, and muscle contraction, although more research is needed.<\/jats:p>","DOI":"10.3390\/medicina60060952","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T10:43:42Z","timestamp":1717757022000},"page":"952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Analysis of the Effect of Exams on Perceived Stress and Temporomandibular Joint Status in Physiotherapy Students: A Pilot Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Marta Macarena","family":"Paz-Cort\u00e9s","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Alfonso X El Sabio University, 28691 Villanueva de la Ca\u00f1ada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0489-2256","authenticated-orcid":false,"given":"Andrea","family":"Mart\u00edn-Vacas","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Alfonso X El Sabio University, 28691 Villanueva de la Ca\u00f1ada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9511-4507","authenticated-orcid":false,"given":"Pedro Antonio","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Villanueva de la Ca\u00f1ada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5060-799X","authenticated-orcid":false,"given":"Manuel","family":"Rozal\u00e9n","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Villanueva de la Ca\u00f1ada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Alvaredo","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Villanueva de la Ca\u00f1ada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/08869634.2016.1162950","article-title":"Analysis of the morphometric characteristics of the cervical spine and its association with the development of temporomandibular disorders","volume":"35","author":"Flores","year":"2017","journal-title":"Cranio"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1177\/0022034516653922","article-title":"The evolution of TMD diagnosis: Past, present, future","volume":"95","author":"Ohrbach","year":"2016","journal-title":"J. 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