Salivary glutamate and substance P response to ear acupuncture in healthy and temporomandibular disorders myalgia subjects: a pilot study

Emanuela Serritella; Hajer  Jasim; Bijar  Ghafouri; Carlo  Di Paolo; Malin  Ernberg

doi:10.59987/ads/2026.2.417-424

Vol. 17 No. 2 (2026)

DOI: 10.59987/ads/2026.2.417-424

Articles

2026-06-30

Salivary glutamate and substance P response to ear acupuncture in healthy and temporomandibular disorders myalgia subjects: a pilot study

Emanuela Serritella, Hajer Jasim, Bijar Ghafouri, Carlo Di Paolo, Malin Ernberg

Keywords: temporo-mandibular disorders, TMJ, pain, acupuncture, auriculotherapy, saliva, biomarker, glutamate, substance P

Abstract

Aim

Auricular acupuncture (AA) treats pain-related temporomandibular disorders (TMD). Studies have suggested gene and protein expression variations after acupuncture; however, the salivary protein response to AA in subjects with and without TMD has not been investigated. This study aimed to analyze salivary glutamate and substance P (SP) responses to AA in healthy and TMD myalgia subjects and to explore the effectiveness of AA on this type of pain.

Methods

This study included 30 healthy participants and 10 patients with myalgia caused by TMD. Healthy participants were randomly assigned to one of the following three groups (10 subjects per group): real AA, sham AA, or no treatment. Patients with TMD underwent actual AA treatment. Stimulated whole saliva was collected to analyze glutamate and SP levels before (T0) and 1 week after (T1) the intervention. Current, average, and worst pain intensities were assessed using 0–10 numeric rating scale (NRS).

Results

Two-way repeated-measures ANOVA did not reveal significant differences between groups or time points for glutamate or SP levels (p > 0.05). There were no differences in background variables between the groups (p > 0.05), but the characteristic pain intensity differed significantly between the patients and healthy subjects (p < 0.001). The pain intensity of the NRS in the TMD group decreased significantly after the AA
administration (p < 0.01).

Conclusion

There was no difference in salivary glutamate and SP across levels after the one-week intervention in any group, despite a decrease in pain intensity in TMD patients.

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Authors

Emanuela Serritella - Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden - Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy

Hajer Jasim - Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden - Department of Orofacial Pain and Jaw Function, Eastman Institute, Folktandvården AB, Stockholm, Sweden

Bijar Ghafouri - Pain and Rehabilitation Center and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden

Carlo Di Paolo - Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy

Malin Ernberg - Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden

License

This work is licensed under a Creative Commons Attribution 4.0 International License.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, provided appropriate credit is given to the original author(s) and source, a link to the license is provided, and any changes made are indicated.

https://creativecommons.org/licenses/by/4.0/

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How to Cite

Serritella, E., Jasim, H. ., Ghafouri, B. ., Di Paolo, C. ., & Ernberg, M. . (2026). Salivary glutamate and substance P response to ear acupuncture in healthy and temporomandibular disorders myalgia subjects: a pilot study . Annali Di Stomatologia, 17(2), 417–424. https://doi.org/10.59987/ads/2026.2.417-424

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