Effect and mechanisms of ozone therapy on temporomandibular disorders

• Grant number: 22/01111-0
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2023
• End date: November 30, 2025
• Field of knowledge: Biological Sciences - Physiology - General Physiology
• Principal Investigator: Claudia Herrera Tambeli
• Grantee: Claudia Herrera Tambeli
• Host Institution: Instituto de Biologia (IB). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Associated researchers: Carlos Amilcar Parada
• Associated research grant(s): 24/08771-0 - IASP 2024 Congress on Pain, AR.EXT
• Associated scholarship(s): 24/14954-0 - Effect of ozone therapy on M1 and M2 macrophage polarization, BP.TT

Abstract

Temporomandibular disorders (TMDs) correspond to a group of frequently painful disorders that involve the temporomandibular joint (TMJ), masticatory muscles, and associated structures. TMJ pain (arthralgia) results primarily from acute trauma, internal derangement, or arthritis, and is commonly associated with acute or chronic inflammation. The search for new effective and safer therapies is of great relevance for the treatment of these painful conditions. Ozone therapy has aroused interest in the treatment of pain, including that associated with TMDs. Ozone (O3) is a highly water-soluble inorganic molecule made up of three oxygen molecules. However, little is known about its effect and action mechanisms in TMJ arthralgia. Therefore, this translational research project will aim to evaluate the effect of ozone therapy on pain and TMJ inflammatory response and some potentially involved mechanisms, such as macrophage polarization and the participation of the opioid system. Part of the study will be carried out in humans and part in an animal model. The study in humans will be randomized, double-blind, and controlled. In this study, it will be verified whether the oxygen-ozone mixture: reduces TMJ arthralgia (spontaneous pain assessed by the visual analog scale and mechanical pain threshold assessed by the algometer); increases the maximum mouth opening measured in mm by a caliper; modulates the inflammatory process (TMJ synovial fluid will be collected before and 15 days after TMJ applications to investigate whether ozone therapy reduces the pro-inflammatory cytokines TNF alfa, IL-1beta and IL-8, increases the anti-inflammatory cytokines IL -10 and TGF alpha and whether it improves the quality of life of patients (assessed by the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-bref). The animal study will evaluate the effect of the oxygen-ozone mixture on the nociceptive and inflammatory response of the TMJ of rats induced by the administration of sodium monoiodoacetate (MIA) in the TMJ through behavioral analysis and expression of inflammatory cytokines. In addition, some mechanisms potentially involved in the analgesic and anti-inflammatory action of ozone therapy will be investigated, such as the participation of the opioid system and macrophage polarization. (AU)