Prospective Evaluation of Estrogen-Associated Temporomandibular Disorders and the Efficacy of Different Intra-Articular Therapies

Background: Emerging evidence suggests a potential association between estrogen levels and temporomandibular disorders (TMDs), though the clinical implications remain poorly understood. This study examines this relationship in a defined patient population. Objective: To characterize TMD presentations in patients with elevated estrogen levels, compare treatment efficacy across therapeutic modalities, and identify predictors of treatment response. Methods: A prospective analysis was conducted on 35 female TMD patients (mean age 30.2±6.5 years) divided into three treatment groups: Group 1 (n=6) received corticosteroid injections, Group 2 (n=19) underwent a stepped protocol including autologous blood therapy, and Group 3 (n=10) with comorbid rheumatoid arthritis received PRF therapy. Clinical parameters, including pain characteristics, joint findings, and treatment outcomes, were systematically evaluated. Results: All groups' samples demonstrated high estrogen hormone levels in laboratory tests; in clinical examinations, all participants reported chronic pain (100%), with frequent trigger points (80%) and crepitus (65%). Group 2 exhibited superior outcomes (100% success) compared to Groups 1 (83.3%) and 3 (80%), with autologous blood therapy showing a statistically significant advantage (p<0.05). Refractory cases were associated with more advanced degenerative changes. Conclusion: These findings support an association between elevated estrogen and specific TMD phenotypes, while demonstrating the therapeutic potential of biologic interventions. The results suggest hormonal factors may influence TMD progression and treatment response, warranting further investigation into targeted management strategies.