Clinical, Instrumental, And Biochemical Assessment of Osteoarthritis and Arthritis in Women of Reproductive Age: The Role of Electronic Axiography In Personalized Treatment Abstract

Abstract

The aim of this study was to improve the diagnostic accuracy and treatment efficacy of temporomandibular joint (TMJ) dysfunction in women of reproductive age through the integration of instrumental biomarkers of mandibular movement and systemic biochemical parameters. A clinical and functional assessment was performed using electronic axiography (HCN parameters, Bennett angle, ISS, and displacement angles), occlusal analysis, and cephalometry. Morphological verification was based on cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). In addition, systemic markers of stress-related metabolic alterations were investigated, including sodium (Na), calcium (Ca), total protein, glucose, ATP, histamine, adrenaline, cortisol, parathyroid hormone (PTH), and vitamin D. The findings showed that, in most patients, the pain phenotype was predominantly associated with myogenic mechanisms, whereas confirmed structural changes in the joint accounted for a limited proportion of cases. Electronic axiography demonstrated high diagnostic value in identifying movement patterns associated with the stage of the chronic process and helped reduce the risk of overdiagnosing intra-articular pathology when symptom-based classification systems were used in isolation. The biochemical profile reflected the ‘stress signature’ of the pain syndrome and enhanced the prognostic value of the functional and morphological findings. Based on the integration of clinical, axiographic, cephalometric, and biochemical parameters, a practice-oriented stage-based stratification system was proposed, directly linking disease stages to clinical management decisions. Implementation of a standardized algorithm (clinical assessment → axiography → imaging when indicated → biomarker panel) improves treatment targeting, facilitates patient adaptation, and reduces the frequency of unnecessary interventions.

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