Stresin cerrahi olmayan periodontal tedavi üzerine etkisi

Year 2020, Volume: 45 Issue: 3, 1182 - 1190, 30.09.2020

Mustafa Özcan , Gönen Özcan

https://doi.org/10.17826/cumj.745326

Cited By: 2

Abstract

Amaç: Bu çalışmanın amacı stresin cerrahi olmayan periodontal tedavi (COPT) sonuçları üzerine etkisini değerlendirmektir.

Yöntem: Çalışmaya 40 yetişkin kronik periodontitis hastası dahil edildi. Klinik periodontal parametreler kaydedildi ve diş eti oluğu sıvısı (DOS) inflamatuar biyobelirteçleri (IL-1 beta, IL-6 ve IL-10) ve tükürük stres biyobelirteçleri (kromogranin-A, kortizol ve a-amilaz) toplandı. Hastaların stres derecesi ölçülerek kategorize edildi. Tüm klinik ve biyolojik parametreler COPT'den önce ve sonra 1. ayda kaydedildi.

Bulgular: Stresli hasta grubunda, klinik parametreler ve tükürük stres belirteç düzeyleri yüksek bulundu (p <0.05). İki grup arasında inflamatuar belirteçlerden IL-1 beta düzeylerinde istatistiksel olarak anlamlı bir fark tespit edildi (p <0.001). Tedavi sonrası klinik parametreler ve IL-1 beta düzeylerindeki değişim stressiz hastalarda anlamlı derece yüksek olarak tespit edildi (p <0.05).

Sonuç: Psikososyal stresin, kronik periodontitis hastalarında cerrahi olmayan periodontal tedaviye verilen yanıtı olumsuz etkilediği tespit edilmiştir. Periodontal hastalığa sahip bireylere psikoloijik destek sağlanarak yeni tedavi protokolleri oluşturulabilir.

Keywords

stres, biyobelirteç, inflamasyon, cerrahi olmayan periodontal tedavi

Supporting Institution

Gazi Üniversitesi Bilimsel Araştırma Projeleri Birimi

Project Number

03/2012-16

Effects of psychosocial stress on non-surgical periodontal treatment

Abstract

Purpose: The aim of this study was to evaluate the effects of psychocial stress on the outcome of non-surgical periodontal treatment (NPT).
Materials and Methods: Forty participants with chronic periodontitis were treated. Clinical parameters were recorded and inflammatory markers (IL-1b, IL-6 and IL-10) were analyzed from gingival crevicular fluid. Stress markers (chromogranin-A, cortisol, a-amylase) were measured from saliva. The patients were categorized as ‘stressed’ or ‘unstressed according to their stress status. All clinical and biological parameters were recorded before and at 1-month after NPT.
Results: All the clinical parameters and salivary stress marker levels were significantly higher in the stressed group. Among the inflammatory markers, only IL-1 level was significantly different between groups. The effects of stress was statistically significant for the clinical and biological parameters, with poorer response to treatment in the stressed group.
Conclusion: Patients under psychosocial stress had a poorer outcome following non-surgical periodontal treatment. New treatment protocols can be created by providing psychological support to individuals with periodontal disease. 

Keywords

stress, biomarkers, Nonsurgical Periodontal Debridement, Inflammation

Project Number

03/2012-16

References

• 1. Genco RJ. Host responses in periodontal diseases: current concepts. J Periodontol 1992;63(4 Suppl):338-55.
• 2. Burt B. Position paper: epidemiology of periodontal diseases. J Periodontol 2005;76(8):1406-19.
• 3. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4(1):1-6.
• 4. Breivik T, Opstad PK, Gjermo P, Thrane PS. Effects of hypothalamic-pituitary-adrenal axis reactivity on periodontal tissue destruction in rats. Eur J Oral Sci 2000;108(2):115-22.
• 5. Genco RJ, Ho AW, Kopman J, Grossi SG, Dunford RG, Tedesco LA. Models to evaluate the role of stress in periodontal disease. Ann Periodontol 1998;3(1):288-302.
• 6. Vettore MV, Leao AT, Monteiro Da Silva AM, Quintanilha RS, Lamarca GA. The relationship of stress and anxiety with chronic periodontitis. J Clin Periodontol 2003;30(5):394-402.
• 7. Linden GJ, Mullally BH, Freeman R. Stress and the progression of periodontal disease. J Clin Periodontol 1996;23(7):675-80.
• 8. Breivik T, Thrane PS, Murison R, Gjermo P. Emotional stress effects on immunity, gingivitis and periodontitis. Eur J Oral Sci 1996;104(4 ( Pt 1)):327-34.
• 9. Bozovic D, Racic M, Ivkovic N. Salivary cortisol levels as a biological marker of stress reaction. Med Arh 2013;67(5):374-7.
• 10. Obayashi K. Salivary mental stress proteins. Clin Chim Acta 2013;425:196-201.
• 11. Warren KR, Postolache TT, Groer ME, Pinjari O, Kelly DL, Reynolds MA. Role of chronic stress and depression in periodontal diseases. Periodontol 2000 2014;64(1):127-38.
• 12. Monteiro da Silva AM, Newman HN, Oakley DA, O'Leary R. Psychosocial factors, dental plaque levels and smoking in periodontitis patients. J Clin Periodontol 1998;25(6):517-23.
• 13. da Silva AM, Newman HN, Oakley DA. Psychosocial factors in inflammatory periodontal diseases. A review. J Clin Periodontol 1995;22(7):516-26.
• ,14. Kirschbaum C, Hellhammer D. Salivary cortisol in psychoneuroendocrine research: recent developments and. Psychoneuroendocrinology 1994;19(4):313-33.
• 15. Seiffert K, Hosoi J, Torii H, Ozawa H, Ding W, Campton K, Wagner JA, Granstein RD. Catecholamines inhibit the antigen-presenting capability of epidermal Langerhans cells. J Immunol 2002;168(12):6128-35.
• 16. Hamaguchi T, Fukudo S, Kanazawa M, Tomiie T, Shimizu K, Oyama M, Sakurai K. Changes in salivary physiological stress markers induced by muscle stretching in patients with irritable bowel syndrome. Biopsychosoc Med 2008;2:20.
• 17. Nater UM, Rohleder N. Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology 2009;34(4):486-96.
• 18. Axtelius B, Söderfeldt B, Nilsson A, Edwardsson S, Attström R. Therapy‐resistant periodontitis. Psychosocial characteristics. Journal of clinical periodontology 1998;25(6):482-91.
• 19. Bakri I, Douglas CWI, Rawlinson A. The effects of stress on periodontal treatment: a longitudinal investigation using clinical and biological markers. Journal of clinical periodontology 2013;40(10):955-61.
• 20. Armitage GC. Development of a classification system for periodontal diseases and conditions. Annals of periodontology 1999;4(1):1-6.
• 21. Rudin HJ, Overdiek HF, Rateitschak KH. Correlation between sulcus fluid rate and clinical and histological inflammation of the marginal gingiva. Helv Odontol Acta 1970;14(1):21-6.
• 22. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361-70.
• 23. Aydemir Ö GT, Küey L, Kültür S. Hastane ankisyete ve depresyon ölçeği Türkçe formunun geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi 1997;8(4):280-7.
• 24. Spielberger CD GR, Lushene RE. Manual for the State-Trait Anxiety, Inventory. California: Consulting Psychologist’s Press PA, 1970 s13-23.
• 25. Öner N, Lecompte, A. Süreksiz Durumluk/Sürekli Kaygı Envanteri El Kitabı. İstanbul, Boğaziçi Üniversitesi Yayınlar, 1985.
• 26. Cobb CM. Non‐surgical pocket therapy: Mechanical. Annals of periodontology 1996;1(1):443-90.
• 27. Liu J, Zhao J, Li C, Yu N, Zhang D, Pan Y. Clinical and microbiologic effect of nonsurgical periodontal therapy on patients with chronic or aggressive periodontitis. Quintessence Int 2013;44(8):575-83.
• 28. Yadav N, Lamba A, Thakur A, Faraz F, Tandon S, Pahwa P. Effect of periodontal therapy on lactoferrin levels in gingival crevicular fluid. Aust Dent J 2014.
• 29. Castro GD, Oppermann RV, Haas AN, Winter R, Alchieri JC. Association between psychosocial factors and periodontitis: a case-control study. J Clin Periodontol 2006;33(2):109-14.
• 30. Croucher R, Marcenes WS, Torres MC, Hughes F, Sheiham A. The relationship between life-events and periodontitis. A case-control study. J Clin Periodontol 1997;24(1):39-43.
• 31. Seymour GJ, Gemmell E, Reinhardt RA, Eastcott J, Taubman MA. Immunopathogenesis of chronic inflammatory periodontal disease: cellular and molecular mechanisms. J Periodontal Res 1993;28(6 Pt 2):478-86.
• 32. Paik IH, Toh, K. Y., Lee, C., Kim, J. J. &, Lee SJ: Psychological stress may induce increased humoral and decreased cellular immunity. Behavioral Medicine 2000;26:139–41.
• 33. Turnbull AV, Rivier CL. Regulation of the hypothalamic-pituitary-adrenal axis by cytokines: actions and mechanisms of action. Physiol Rev 1999;79(1):1-71.
• 34. de Lima Oliveira AP, de Faveri M, Gursky LC, Mestnik MJ, Feres M, Haffajee AD, Socransky SS, Teles RP. Effects of periodontal therapy on GCF cytokines in generalized aggressive periodontitis subjects. J Clin Periodontol 2012;39(3):295-302.
• 35. Reis C, AV DAC, Guimaraes JT, Tuna D, Braga AC, Pacheco JJ, Arosa FA, Salazar F, Cardoso EM. Clinical improvement following therapy for periodontitis: Association with a decrease in IL-1 and IL-6. Exp Ther Med 2014;8(1):323-27.
• 36. Nayak SU, Nayak DG, Uppoor AS, Pai KK. Evaluation of cortisol levels in gingival crevicular fluid and saliva in anxious and non-anxious patients with chronic periodontitis. Dent Res J (Isfahan) 2013;10(4):474-81.
• 37. Cakmak O, Alkan BA, Saatci E, Tasdemir Z. The effect of nonsurgical periodontal treatment on gingival crevicular fluid stress hormone levels: A prospective study. Oral diseases 2019;25(1):250-57.
• 38. Khalfa S, Bella SD, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci 2003;999:374-6.
• 39. Vedhara K, Miles J, Bennett P, Plummer S, Tallon D, Brooks E, et al. J An investigation into the relationship between salivary cortisol, stress, anxiety and depression. Biol Psychol 2003;62(2):89-96.
• 40. Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, cortisol, and periodontitis in a population aged 50 years and over. J Dent Res 2006;85(4):324-8.
• 41. Rai B, Kaur J, Anand SC, Jacobs R. Salivary stress markers, stress, and periodontitis: a pilot study. J Periodontol 2011;82(2):287-92.
• 42. Cohen S, Williamson GM. Stress and infectious disease in humans. Psychol Bull 1991;109(1):5-24.
• 43. McClelland DC, Floor E, Davidson RJ, Saron C. Stressed power motivation, sympathetic activation, immune function, and illness. J Human Stress 1980;6(2):11-9.