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Khalid S, Kearney M, McReynolds DE. Can social adversity alter the epigenome, trigger oral disease, and affect future generations? Ir J Med Sci 2024:10.1007/s11845-024-03697-3. [PMID: 38740675 DOI: 10.1007/s11845-024-03697-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/27/2024] [Indexed: 05/16/2024]
Abstract
The nature versus nurture debate has intrigued scientific circles for decades. Although extensive research has established a clear relationship between genetics and disease development, recent evidence has highlighted the insufficiency of attributing adverse health outcomes to genetic factors alone. In fact, it has been suggested that environmental influences, such as socioeconomic position (SEP), may play a much larger role in the development of disease than previously thought, with extensive research suggesting that low SEP is associated with adverse health conditions. In relation to oral health, a higher prevalence of caries (tooth decay) exists among those of low SEP. Although little is known about the biological mechanisms underlying this relationship, epigenetic modifications resulting from environmental influences have been suggested to play an important role. This review explores the intersection of health inequalities and epigenetics, the role of early-life social adversity and its long-term epigenetic impacts, and how those living within the lower hierarchies of the socioeconomic pyramid are indeed at higher risk of developing diseases, particularly in relation to oral health. A deeper understanding of these mechanisms could lead to the development of targeted interventions for individuals of low SEP to improve oral health or identify those who are at higher risk of developing oral disease.
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Affiliation(s)
- Sakr Khalid
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Michaela Kearney
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - David E McReynolds
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland.
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Wang R, Kogler L, Derntl B. Sex differences in cortisol levels in depression: A systematic review and meta-analysis. Front Neuroendocrinol 2024; 72:101118. [PMID: 38176541 DOI: 10.1016/j.yfrne.2023.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/11/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.
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Affiliation(s)
- Rui Wang
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany.
| | - Lydia Kogler
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany; LEAD Graduate School and Research Network, University of Tübingen, Germany
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Klomp T, Jahr H, Abdelbary MMH, Conrads G. Evaluation of hydrocortisone as a strain-dependent growth-regulator of Porphyromonasgingivalis. Anaerobe 2023; 80:102698. [PMID: 36681234 DOI: 10.1016/j.anaerobe.2023.102698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Porphyromonas gingivalis is an oral key pathogen and known to be very diverse in geno- and phenotypes. It is a fastidious bacterium with low O2-tolerance and 3-7 days of incubation are necessary. With growing interest in the field of microbial endocrinology we explored the potential growth-stimulating effect of hydrocortisone (HC, synonym cortisol) on P. gingivalis cultures. MATERIAL AND METHODS Six different P. gingivalis strains were pre-incubated in supplemented Brain-Heart-Infusion broth under appropriate conditions for 24 h, diluted and transferred into microplates. A newly developed and semi-automated spectrophotometric measurement in triplicate, applying a SpectraMax i3x microplate reader at an optical density of 600 nm, was conducted to test growth differences between test group (exposed to a supplement of either 1.25, 2.5, 5, 10, or 20 μg/ml of hydrocortisone) and control group over 48 h of anaerobic incubation (O2 ≤ 1%). Furthermore, strains were also incubated on HC-supplemented blood agar to test for a possible growth-stimulating effect on solid media. RESULTS HC significantly stimulated the lag-phase growth of four out of six P. gingivalis strains. Our data suggest a concentration-dependent growth stimulatory effect of HC between 2.5 and 5 μg/ml, while below 1.25 μg/ml and above 10 μg/ml HC either did not stimulate or inhibited growth. CONCLUSIONS HC could reduce the incubation time when isolating P. gingivalis from clinical samples and could boost low biomass cultivations especially during their lag-phase. The growth-modulating effect might be via modulation of virulence factors/quorum sensing gene expression or by reactive oxygen species(ROS)-capturing during early stages of bacterial growth. Further experiments are necessary to explain the mechanism behind our observations.
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Affiliation(s)
- Tim Klomp
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany; Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany
| | - Holger Jahr
- Department of Anatomy and Cell Biology, Uniklinik RWTH Aachen and Institute of Structural Mechanics and Lightweight Design, RWTH Aachen University, Aachen, Germany
| | - Mohamed M H Abdelbary
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany.
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Neupane SP, Virtej A, Myhren LE, Bull VH. Biomarkers common for inflammatory periodontal disease and depression: A systematic review. Brain Behav Immun Health 2022; 21:100450. [PMID: 35330865 DOI: 10.1016/j.bbih.2022.100450] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Dysregulated immune response arising in the periphery can induce depressive symptoms through neuroimmune interactions. Inflammatory oral pathology can be a potent inducer of chronic neuroimmune response relevant to depression. We aimed to synthesize available evidence for the association between inflammatory periodontal diseases (IPD) and major depression (MD) in relation to a broad range of biomarkers. Methods Medline, Embase, PsycInfo, Cochrane Library, Web of Science and Scopus databases were searched from inception until January 27, 2022. Search terms included subject headings and synonyms for inflammatory periodontal disease and depression. Studies that reported data on both depression and inflammatory periodontal disease as categories along with measurement of a biomarker were considered. Two reviewers independently selected the articles for inclusion, extracted data and assessed the quality of each study. The protocol for this study was registered with PROSPERO, CRD42021215524. Results Twenty-eight studies were included in the final review-eleven cross-sectional studies, seven case-control studies, and six prospective cohort studies conducted in humans; the remaining four were experimental animal studies. Eighteen studies including all animal studies reported a positive association between depression and periodontal disease; one study reported a negative association and another nine studies found no such associations. Twenty studies reported mixed associations between IPD and biomarkers (i.e, salivary, serum, urine or gingival crevicular fluid cortisol, C reactive protein, cytokines, etc.). Biomarkers related to depression were gingival crevicular fluid cortisol, interleukin 6 (IL-6), Il-1β, immunoglobulin G against Bacterioides forsythus; root canal lipopolysaccharides; blood IL-6, IL-1β, cortisol, advanced oxidation protein products, nitric oxide metabolites, lipid hydroperoxides and trapping antioxidant parameter; whereas five studies found no associations between depression and a biomarker. Although animal studies showed interaction of immune, inflammatory and neurotrophic biomarkers in the relationship between depression and periodontal disease, human studies showed mixed findings. In most studies, there were risks of bias due to the sample selection and assessment protocol. Study heterogeneity and limited number of comparable studies reporting on shared biomarkers precluded a meta-analysis. Conclusion Immune-inflammatory contribution to depression was evident in the context of inflammatory periodontal diseases, but whether biomarkers mediate the associations between IPD and MD needs to be tested through methodologically rigorous studies aiming specifically at this hypothesis.
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Li Q, Zhao Y, Deng D, Yang J, Chen Y, Liu J, Zhang M, Andrukhov O. Aggravating Effects of Psychological Stress on Ligature-Induced Periodontitis via the Involvement of Local Oxidative Damage and NF-κB Activation. Mediators Inflamm 2022; 2022:1-11. [PMID: 35221795 PMCID: PMC8866020 DOI: 10.1155/2022/6447056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/16/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Periodontitis is the leading cause of tooth loss in adults, and psychological factors play an important role in the development of periodontitis. To elucidate the adverse effects of psychological stress on the inflammatory process and redox status of periodontitis tissue, fifty male Sprague-Dawley rats were divided into the control, experimental periodontitis, psychological stress, experimental periodontitis plus psychological stress, and experimental periodontitis plus psychological stress plus fluoxetine groups. Chronic unpredictable mild stress (CUMS) was used to establish psychological stress, and silk ligature was used to induce experimental periodontitis. Four weeks later, stressed rats showed altered behaviour, serum hormone levels, and sucrose preference. More obvious alveolar bone loss and attachment loss and higher protein expressions of inflammatory cytokines were observed in the experimental periodontitis plus psychological stress group. The combination of CUMS and periodontitis had synergistic effects on increasing hypoxia-inducible factor-1α (HIF-1α) protein expression and reactive oxygen species (ROS) and malondialdehyde (MDA) contents and decreasing antioxidant enzyme activities compared with those in the stress or periodontitis groups. Moreover, psychological stress further increased p-IκBα and p-NF-κB p65 protein levels and decreased IκBα protein levels in periodontitis rats. Fluoxetine administration alleviated the adverse effects of psychological stress on the progression of periodontitis in rats. These results hint us that psychological stress could aggravate inflammation in periodontitis tissues, which may be partly due to local worsening of oxidative damage and further activation of the nuclear factor kappa-B (NF-κB) signalling pathway.
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Petit C, Anadon-Rosinach V, Tuzin N, Davideau JL, Huck O. Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study. Int J Environ Res Public Health 2021; 18:9394. [PMID: 34501984 DOI: 10.3390/ijerph18179394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 01/10/2023]
Abstract
Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools.
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Moharrami M, Perez A, Mohebbi SZ, Bassir SH, Amin M. Oral health status of individuals with obsessive-compulsive disorder considering oral hygiene habits. Spec Care Dentist 2021; 42:41-48. [PMID: 34288027 DOI: 10.1111/scd.12632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 01/22/2023]
Abstract
AIMS This study aimed to evaluate the oral health status of individuals with obsessive-compulsive disorder (OCD). METHODS Ninety-two participants, aged 18 years and older from which 46 had OCD symptoms, were included in this comparative cross-sectional study. Data on age, sex, smoking habit, educational level, and potential mediators including brushing frequency (BF) and brushing duration (BD) were collected. Clinical examinations determined outcome measures including decayed-missing-filled teeth (DMFT), presence of root caries (PoRC), gingival recession (GR), plaque index (PI), and papillary bleeding index (PBI). Pathway analysis was used for data analysis. RESULTS Individuals with OCD had significantly lower DMFT (p < .01), higher BF (p = .01), and lower PI (p = .01); however, there were no significant differences regarding BD, GR, PBI, and PoRC (p > .05). While BD did not have a mediating role, BF mediated the effect of OCD on DMFT (B = -0.31, CI = -0.60 to -0.06) and PI (B = -0.15, CI = -0.36 to -0.03). Males had less PI (B = -1.03, CI = -1.81 to -0.24) and PBI (B = -1.14, CI = -2.09 to 0.20) than females. Except for OCD and sex, other predictors were not significant. CONCLUSIONS Individuals with OCD had lower caries experience and similar gingival health compared to controls. Part of the impact of OCD was mediated through brushing habits.
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Affiliation(s)
| | - Arnaldo Perez
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Simin Zahra Mohebbi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Bassir
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Maryam Amin
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Aziz J, Rahman MT, Vaithilingam RD. Dysregulation of metallothionein and zinc aggravates periodontal diseases. J Trace Elem Med Biol 2021; 66:126754. [PMID: 33831799 DOI: 10.1016/j.jtemb.2021.126754] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 03/29/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Periodontitis (PD) is a multifaceted inflammatory disease connected to bacterial infection that results in the destruction of tooth supporting structures and eventually tooth loss. Given their involvement in infection and inflammation, both metallothionein (MT) and zinc (Zn) might play vital roles in the development and progression of PD. More specifically, both MT and Zn are heavily involved in regulating immune functions, controlling bacterial infection, balancing inflammatory responses, and reducing oxidative stress, all of which are associated with the pathogenesis of PD. OBJECTIVE This review paper will explore the physiological functions of MT and Zn and hypothesise how dysregulation could negatively affect periodontal health, leading to PD. FINDINGS Bacterial lipopolysaccharide (LPS) derived from periodontal pathogens, namely P. gingivalis initiates the acute phase response, thus upregulating the expression of MT which leads to the subsequent deficiency of Zn, a hallmark of periodontal disease. This deficiency leads to ineffective NETosis, increases the permeability of the gingival epithelium, and disrupts the humoral immune response, collectively contributing to PD. In addition, the presence of LPS in Zn deficient conditions favours M1 macrophage polarisation and maturation of dendritic cells, and also inhibits the anti-inflammatory activity of regulatory T cells. Collectively, these observations could theoretically give rise to the chronic inflammation seen in PD. CONCLUSION A disrupted MT and Zn homeostasis is expected to exert an adverse impact on periodontal health and contribute to the development and progression of PD.
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Affiliation(s)
- Jazli Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia; Dept. of Oral & Craniofacial Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | | | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
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Al-Zawawi AS, Bukhari IA, Bello-Correa FO, Sheikh SA, Albaijan R, Vohra F. Influence of root debridement with adjunct photodynamic therapy on periodontal parameters and gingival crevicular fluid cortisol levels among patients with and without type-2 diabetes mellitus. Photodiagnosis Photodyn Ther 2020; 32:102076. [PMID: 33152543 DOI: 10.1016/j.pdpdt.2020.102076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the present study was to assess the influence of scaling and root planing (SRP) with adjunct antimicrobial photodynamic therapy (aPDT) on periodontal parameters and gingival crevicular fluid (GCF) cortisol levels in type-2 diabetic and non-diabetic patients with periodontitis. METHODS One hundred and twenty-eight patients with periodontitis (64 with and 64 without type-2 diabetes mellitus, respectively) were included. In the test- and control-groups, patients underwent SRP with and without aPDT, respectivey. In both groups, plaque and gingival indices (PI and GI), probing depth (PD), clinical attachment loss (CAL), marginal bone loss (MBL) and GCF volume and cortisol levels were assessed at baseline and three and six-months after SRP with or without aPDT. The aPDT was performed at baseline using methylene blue and photobiomodulation. The Kruskall-Wallis test was used to assess data normality; and group-comparisons were done. P-values, which were below 0.01 indicated statistical significance. RESULTS Sixty-four type-2 diabetic patients with and 64 non-diabetic patients with periodontitis were included. All individuals had Stage-III/Grade-C periodontitis. Among patients with type-2 diabetes mellitus (DM), there was no statistically significant difference in hemoblobin A1c, PI, GI, PD, CAL and MBL at baseline and at 3- and 6-months intervals. Amongst diabetic patietns, there was no difference in the GCF volume and cortisol levels in the test- and control-groups at all time intervals. In non-diabetic patients, there was a significqnt reductionin GCF volume and cortisol levels when SRP was done with aPDT than when SRP was carried out as the sole treatment strategy CONCLUSION: Among non-diabetic patients, SRP with aPDT helps reduce periodontal inflammation and GCF cortisol levels for up to 6-months; however poorly-controlled DM compromises the beneficial effects of this treatment strategy.
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Affiliation(s)
- Abeer S Al-Zawawi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ishfaq A Bukhari
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fernanda O Bello-Correa
- Department of Dentistry, Life Sciecnes Institute, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Saeed A Sheikh
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Develioglu H, Korkmaz S, Dundar S, Schlagenhauf U. Investigation of the levels of different salivary stress markers in chronic periodontitis patients. J Oral Biol Craniofac Res 2020; 10:514-8. [PMID: 32874881 DOI: 10.1016/j.jobcr.2020.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND AIM In this study, we aimed to determine the salivary levels of cortisol, α-amylase, β-endorphin, and chromogranin (CgA) in saliva and to investigate their relationship with periodontitis. METHODS Thirty-seven female and 43 male periodontitis patients who presented to the Periodontology Department of the XXX University Faculty of Dentistry participated in the study. The individuals were divided into three groups: mild, moderate, or severe chronic periodontitis. Plaque index (PI), gingival index (GI), clinical attachment loss (CAL), and probing depth (PD) measurements were recorded for all the participants. All participants underwent the State-Trait Anxiety Inventory test (STAI 1 and 2). Between 09:00 and 11:00 a.m., saliva samples from the participants were collected into tubes within an average of five minutes. RESULTS Higher cortisol measurements were detected in the saliva samples of participants with severe chronic periodontitis than in those who had mild chronic periodontitis (P < 0.05). There were statistically significant age differences among patients with mild-moderate, moderate-severe, and mild chronic periodontitis, the severity of the disease increasing with age (P < 0.05). There was also a positive correlation between STAI 1 stress scores and cortisol levels. Similarly, there was a positive correlation between CAL and cortisol levels (P < 0.05). However, a significant difference was found among groups only in terms of salivary cortisol levels (P < 0.05). CONCLUSION Within the limitations of this study, there was found to be a relationship between saliva cortisol levels and periodontitis and between salivary cortisol levels and stress.
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Simpson CA, Adler C, du Plessis MR, Landau ER, Dashper SG, Reynolds EC, Schwartz OS, Simmons JG. Oral microbiome composition, but not diversity, is associated with adolescent anxiety and depression symptoms. Physiol Behav 2020; 226:113126. [PMID: 32777312 DOI: 10.1016/j.physbeh.2020.113126] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/07/2020] [Accepted: 08/04/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Depression and anxiety are highly prevalent disorders, whose significant burden is compounded by the presence of oral disease. Mental health disorders and oral health may be associated via changes to the oral microbiome, involving increased pro-inflammatory communication and cortisol in saliva. The present study provides the first culture-independent investigation of the oral microbiome considering depression and anxiety symptoms in adolescence, a critical age where these conditions begin to emerge and co-occur. It also investigates whether inflammation and cortisol moderate these relationships. METHODS Participants (N = 66) aged 14-18 years (69.70% female) self-reported oral health, depression and anxiety symptoms, and collected saliva samples across two days. Saliva was assayed for cortisol and C-reactive protein (CRP), and used for 16S rRNA gene sequencing to estimate the oral microbiome. Multivariate statistical analyses examined associations. RESULTS Overall diversity of the oral microbiome did not differ between adolescents by anxiety or depression grouping (low versus high symptoms), and was not associated with symptom measures. Depression and anxiety symptoms were instead associated with differential abundance of specific bacterial taxa, including Spirochaetaceae, Actinomyces, Treponema, Fusobacterium and Leptotrichia spp. Several host mood-microbial relationships were moderated by proposed mechanisms, including salivary cortisol and CRP. CONCLUSIONS Oral microbiome composition, but not diversity, was associated with adolescent anxiety and depression symptoms. Longitudinal studies considering these associations would improve mechanistic understanding. This research indicates that adolescence remains an essential developmental period to identify early targets for intervention.
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Affiliation(s)
- Carra A Simpson
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne and Melbourne Health, VIC, Australia.
| | - Christina Adler
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Mieke R du Plessis
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, South Africa
| | - Elizabeth R Landau
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne and Melbourne Health, VIC, Australia
| | - Stuart G Dashper
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, VIC, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, VIC, Australia
| | - Orli S Schwartz
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, VIC, Australia
| | - Julian G Simmons
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne and Melbourne Health, VIC, Australia
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Pedraz-Petrozzi B, Neumann E, Sammer G. Pro-inflammatory markers and fatigue in patients with depression: A case-control study. Sci Rep 2020; 10:9494. [PMID: 32528052 PMCID: PMC7289841 DOI: 10.1038/s41598-020-66532-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/20/2020] [Indexed: 11/20/2022] Open
Abstract
The aim of this work was to investigate differences between depressed subjects (PG) and non-depressed healthy control participants (HCG) with regard to fatigue dimensions and inflammation. For this purpose, 43 participants in the PG and 51 participants in the HCG were included in the study. IL-6, IL-1β, TNF-α, IFN-γ, and CRP were assessed in venous blood samples. Fatigue and depression were assessed using the FIS-D and BDI-FS questionnaires. Main results showed higher BDI-FS values in PG. Moreover, PG showed mean differences for fatigue dimensions when compared to the HCG. For the pro-inflammatory markers, a moderate group effect was found between PG and HCG which was mainly caused by IL-6. Correlations between TNF-α and BDI-FS, TNF-α and cognitive fatigue, TNF-α and psychosocial fatigue were found within the PG. In the HCG, correlations were found between IL-6, TNF-α and somatic fatigue, as well as IL-6 and cognitive fatigue. Significant correlations were found between the psychological variables in both groups. All results were controlled for the confounding variables gender, age, BMI and multiple comparisons. These results suggest the presence of inflammation in both depression and fatigue. However, each correlates with different pro-inflammatory parameters, suggesting a biological heterogeneity.
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Affiliation(s)
- Bruno Pedraz-Petrozzi
- Cognitive Neurosciences at the Center for Psychiatry and Psychotherapy, Justus-Liebig University, Giessen, Hessen, Germany.
| | - Elena Neumann
- Internal Medicine and Rheumatology, Campus Kerckhoff, Justus-Liebig University, Bad Nauheim, Hessen, Germany
| | - Gebhard Sammer
- Cognitive Neurosciences at the Center for Psychiatry and Psychotherapy, Justus-Liebig University, Giessen, Hessen, Germany
- Faculty of Psychology and Sports Science, Justus-Liebig University, Giessen, Hessen, Germany
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Tiznobaik A, Taheri S, Torkzaban P, Ghaleiha A, Soltanian AR, Omrani R, Shirinzad M. Relationship between dental plaque formation and salivary cortisol level in pregnant women. Eur Oral Res 2019; 53:62-66. [PMID: 31309195 PMCID: PMC6614692 DOI: 10.26650/eor.20192484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/17/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose: Understanding how increased level of salivary cortisol contributes to the
development of dental biofilm during pregnancy can help inthe prevention of
dental caries and periodontal diseases. This study aims to evaluate the relationship
between salivary cortisol level and dental biofilm formation in pregnant women. Patients and methods: This descriptive-analytic study was conducted in Hamadan, Iran in 2011. Forty
consecutive pregnant women with no history of abortion, stillbirth, or any known
physical or psychological disorders at weeks 25 and 33 of gestation were included.
Salivary samples were collected for measurement of cortisol levels by Enzyme
Linked Immunoabsorbent Assay (ELISA) method. The amount and extension of
dental biofilms were determined by using a disclosing agent. Data were analyzed
using descriptive and analytical statistics in SPSS version 16. Results: The mean levels of salivary cortisol at weeks 25 and 33 of gestation were respectively,
2.45 ± 1.56 μg/dl and 5.24 ± 4.07 μg/dl which demonstrates a significant difference
(P<0.001). Evaluation of dental biofilm at two time intervals revealed a significant
increase in amount of dental biofilm at week 33 of gestational period (34.65 ± 10.9%
vs. 42.45 ± 12.35%, P<0.001). Elevated levels of dental biofilm were significantly
correlated with salivary cortisol levels at week 33 (r=0.494, P=0.001),however, it was
not significant at week 25 of gestation (r=0.148, P=0.361). Conclusion: The findings suggested that increased levels of salivary cortisol can predict dental
biofilm formation and accumulation in pregnant women in the last weeks of gestation.
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Affiliation(s)
- Azita Tiznobaik
- Department of Reproductive Health, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran.Iran.,Department of Midwifery, Maternity and Child Care Research Center, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan.Iran
| | - Safoura Taheri
- Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam.Iran
| | - Parviz Torkzaban
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan.Iran
| | - Ali Ghaleiha
- Research center for Behavioral disorders and substance abuse, Hamadan University of Medical Sciences, Hamadan.Iran
| | - Ali Reza Soltanian
- Modeling of non-communicable diseases research center, school of public health, Hamadan University of Medical science, Hamadan.Iran
| | - Reza Omrani
- Department of Restorative Dentistry, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan.Iran
| | - Mehdi Shirinzad
- Department of Restorative Dentistry, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan.Iran
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Abstract
The present literature review on periodontal complications in aging focuses on the diagnosis, etiology and development of periodontal complications as a complete entity. In addition, the review also focuses on some of the common systemic diseases that either may further add to periodontal complications or, as result of anti-inflammatory treatment, limit the expression of periodontal disease. There is no evidence to suggest that clinical methods to provide periodontal therapies have been developed especially for older individuals. There is evidence that aging can be associated with periodontally healthy conditions through life and with a high level of tooth retention and function. Periodontal complications that are difficult to manage are usually associated with concurrent medical diseases and complications, or with socio-economic factors that limit the ability to provide dental care for the aging population. Currently, some systemic medical conditions are managed with anti-inflammatory medications with positive effects, while slowing the progression and expression of chronic periodontitis. The lack of data from clinical studies on how to manage periodontal complications in aging is obvious.
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Affiliation(s)
- Goesta Rutger Persson
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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15
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Karami E, Naghsh N, Mogharehabed A, Yaghini J. Comparative evaluation of the cortisol level of unstimulated saliva in patients with and without chronic periodontitis. Dent Res J (Isfahan) 2019. [DOI: 10.4103/1735-3327.270786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Østergaard L, Jørgensen MB, Knudsen GM. Low on energy? An energy supply-demand perspective on stress and depression. Neurosci Biobehav Rev 2018; 94:248-270. [DOI: 10.1016/j.neubiorev.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
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Affiliation(s)
- Wael Sabbah
- Division of Population and Patient Health; Dental Institute; King's College London; London UK
| | - Noha Gomaa
- Faculty of Dentistry; University of Toronto; Toronto ON Canada
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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 Dis 2018; 25:250-257. [PMID: 30187981 DOI: 10.1111/odi.12973] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/02/2018] [Accepted: 09/02/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The purpose of this prospective study was to investigate the effect of nonsurgical periodontal treatment (PT) on anxiety/depression scale scores and on gingival crevicular fluid (GCF) cortisol (COR) and dehydroepiandrosterone (DHEA) levels. METHODS Fifty-five participants with generalized chronic periodontitis (GCP group, n: 21), with localized chronic periodontitis (LCP group, n: 19) and with gingivitis or healthy (control group, n: 15) subjects were treated and followed up for 6 months. Clinical periodontal parameters include plaque index, gingival index, bleeding on probing, probing depth and attachment level; psychosocial measurements include Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI 1-2) psychometric instruments; hormone levels in GCF including COR and DHEA were evaluated. RESULTS All clinical parameters were significantly decreased (except attachment loss) after PT (p < 0.05). No significant differences were observed between the two groups for STAI-1-2 and BDI scores, either at baseline or at 6 months (p > 0.05). COR levels were statistically lower following PT in GCP and LCP groups when compared to the baseline levels (p < 0.05). DHEA values at baseline and 6 months did not show significant differences. CONCLUSION Within the limits of the study, decreased GCF COR and unchanged GCF DHEA levels were determined in nonsurgically treated patients regardless of the extent and severity of periodontitis.
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Affiliation(s)
- Omer Cakmak
- Department of Periodontology, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Banu Arzu Alkan
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Ebru Saatci
- Department of Biology, Faculty of Science, Erciyes University, Kayseri, Turkey
| | - Zekeriya Tasdemir
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Cademartori MG, Gastal MT, Nascimento GG, Demarco FF, Corrêa MB. Is depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis. Clin Oral Investig 2018; 22:2685-2702. [PMID: 30191327 DOI: 10.1007/s00784-018-2611-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/23/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To systematically review the literature in order to investigate association between depression and oral diseases. MATERIAL AND METHODS Electronic searches were performed in five databases. Studies testing associations between depression and oral diseases as either exposure or outcome were included. Oral disease variable included any tooth loss or edentulism, periodontal disease, and dental caries. RESULTS A total of 2504 articles were identified in the electronic database search. Sixteen studies were included in this systematic review being 14 included in the meta-analyses. Eleven studies considered oral health as outcome, whereas three studies considered depression as an outcome variable. Depression was associated to dental caries, tooth loss, and edentulism. Pooled estimates showed that depression increased the odds of dental caries (OR 1.27; 95% CI 1.13-1.44), tooth loss (OR 1.31; 95% CI 1.24-1.37), and edentulism (OR 1.17; 95% CI 1.02-1.34), respectively. When the oral diseases were tested as independent variable and depression as outcome, associations with both edentulism (OR 1.28; 95% CI 1.06-1.55) and periodontal disease (HR 1.73; 95% CI 1.58-1.89) were found. CONCLUSIONS The results of our systematic review and meta-analyses show a positive association between depression and oral diseases, specifically dental caries, tooth loss, and edentulism, in adults and elders. More longitudinal studies are required to test causal and temporal relationship between depression and oral health status. CLINICAL RELEVANCE Mental and oral health are among the main disabilities worldwide. This article helps to understand more about the relationship between both conditions, highlighting the importance for both clinicians and policy makers of considering individual's psychological status in management of oral health.
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Affiliation(s)
| | - Márcia Torres Gastal
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil
| | | | - Flavio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil
| | - Marcos Britto Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil.
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Botelho J, Machado V, Mascarenhas P, Rua J, Alves R, Cavacas MA, Delgado A, João Mendes J. Stress, salivary cortisol and periodontitis: A systematic review and meta-analysis of observational studies. Arch Oral Biol 2018; 96:58-65. [PMID: 30189327 DOI: 10.1016/j.archoralbio.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/21/2018] [Accepted: 08/27/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This meta-analysis aims to systematically assess whether periodontitis has a meaningful effect on salivary cortisol, reflecting changes on free blood cortisol levels. DESIGN The Cochrane Handbook and the PRISMA statement were used as reporting guidelines. The MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases were searched until September 2017 to identify eligible studies, screened by seven independent authors and verified by an eighth. Studies comparing salivary cortisol level of periodontitis cases to controls were included. Data were extracted using a predefined table and since all papers were non-randomized clinical trials they were appraised using Downs and Black tool. DerSimonian random effects meta-analysis was performed using OpenMetaAnalyst. RESULTS Six cross-sectional studies were included, with 258 participants with chronic periodontitis and 72 with aggressive periodontitis, in a total of 573 participants. Overall results showed that aggressive periodontitis patients have, on average, 53% higher salivary cortisol levels than healthy controls 1.53 (1.11-2.12). Meta-regression exploring the relationship among salivary cortisol levels and periodontal measures, i.e., periodontitis severity, showed a global neutral effect, although this result requires future confirmation due to the low power of the model. CONCLUSION Observational studies results suggest that subjects with aggressive periodontitis have higher salivary cortisol levels than healthy ones or patients with chronic periodontitis. Such salivary cortisol response difference may have a negative impact on the periodontium, contributing to worse the burden of aggressive periodontitis disease. In the future, wide and well-designed longitudinal studies should be carried out in order to extensively confirm this possible effect, considering the complex nature of periodontitis and its many confounders factors that may contribute to this outcome.
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Do KY, Lee KS. Relationship between Problematic Internet Use, Sleep Problems, and Oral Health in Korean Adolescents: A National Survey. Int J Environ Res Public Health 2018; 15:E1870. [PMID: 30158492 DOI: 10.3390/ijerph15091870] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/25/2018] [Accepted: 08/20/2018] [Indexed: 12/22/2022]
Abstract
We examined the relationship between Problematic Internet Use (PIU), sleep (sleep satisfaction, sleep duration), and experience of oral disease symptoms in Korean adolescents by gender. This cross-sectional study utilized the 6th (2010) Korean Youth Risk Behavior Web-based Survey. Participants comprised 74,980 students from 400 middle schools and 400 high schools nationwide. Among these, 73,238 students from 799 schools (38,391 boys, 34,847 girls, aged 13–18 years) were included in the analysis (inclusion rate = 97.7%). Multiple logistic regression and analysis of moment structures (AMOS) analyses were performed to identify meaningful relationships between the three factors. The “high risk group” of problematic internet usage had increased experience of oral disease symptoms (boys: adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI) = 1.63–2.28, girls: AOR = 1.98, 95% CI = 1.50–2.63) compared to the general group. Boys who used the Internet for “5–6 h” had a higher risk of oral disease symptoms compared to those who used it for “less than 1 h” (OR = 1.24, 95% CI = 1.01–1.53); however, this difference was not significant in Models II and III. For girls, the risk of 5–6 h of use (Model I: OR = 1.69, 95% CI = 1.40–2.04) was higher than that of the boys. In addition, the difference was significant in Models II and III for girl students who used the Internet for 5–6 h. In subgroup analysis, the high-risk group had a higher odds ratio for mild symptoms of bad breath to severe symptoms such as sore and bleeding gums. In addition, in the path analysis, PIU affected sleep and indirectly affected oral health. Direct and indirect causal relationships between the three factors were confirmed. Therefore, it is important to recognize that PIU can have a detrimental effect on mental, physical, and oral health.
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Yarkac FU, Gokturk O, Demir O. Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis. Clin Oral Investig 2021; 25:1677-84. [PMID: 30066030 DOI: 10.1007/s00784-018-2569-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis. MATERIALS AND METHODS This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay. RESULTS The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups. CONCLUSIONS Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings. CLINICAL RELEVANCE Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.
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Abstract
Introduction: Periodontal diseases are caused by pathogenic microorganisms that induce increases in of local and systemic proinflammatory cytokines, resulting in periodontal damage. The onset and evolution of periodontal diseases are influenced by many local and systemic risk factors. Educational objective: In this article, we aim to review the results of the research on the impact of chronic stress on the occurrence, development, and response to periodontal disease treatments and on the pathophysiological mechanisms of periodontal disease. Conclusion: Chronic stress has a negative impact on the occurrence, development, and response to the treatment of periodontal disease via indirect actions on the periodontium. This can result from behavioral changes caused by stress (poor dental hygiene, smoking, etc.) and a direct neuroimmunoendocrinological action related to the consequences (particularly immunological) of the secretion of certain chemicals (e.g., cortisol) induced by the activation of the hypothalamus and the autonomic nervous system in response to stress. These factors necessitate multidisciplinary management (e.g., physician, oral surgeon, and psychologist) of patients to identify subjects with chronic stress and to employ countermeasures to decrease the impact of stress on the periodontium.
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D'Avila OP, Wendland E, Hilgert JB, Padilha DMP, Hugo FN. Association between Root Caries and Depressive Symptoms among Elders in Carlos Barbosa, RS, Brazil. Braz Dent J 2018; 28:234-240. [PMID: 28492755 DOI: 10.1590/0103-6440201700933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/23/2017] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to evaluate the association between depressive symptoms and root caries among independent-living older persons. All community-dwelling older adults (not hospitalized and not bedridden) living in Carlos Barbosa, RS, Brazil, were invited to participate, and 785 completed the study protocol (standardized questionnaire assessing socio-demographic information and health behavior, Geriatric Depression Scale [GDS] - brief version, and oral examination [DMFT-Root index, Visible Plaque Index and stimulated salivary flow]). Out of them, 390 participants with at least one natural tooth were included in the present analysis. The outcome of interest was the ratio between the number of decayed roots and the number of roots at risk. The association between independent variables (depression and socioeconomic aspects) and the outcome was assessed using negative binomial regression models. RESULTS The final, fully adjusted model revealed that age (β=0.03, p=0.001), female sex (β=-0.23, p=0.08), living in a rural area (β=0.25, p=0.008), tooth brushing frequency (β=0.43, p=0.025) and stimulated salivary flow (β=-0.012, p<0.0001) were significantly associated with the presence of root caries. In addition, the interaction between male sex and the presence of depression symptoms (β=-0.99, p=0.012) was also independently and significantly associated with root caries. The interaction between male sex and depression symptoms was associated with root caries, suggesting that psychological mechanisms may be involved indirectly in the development of root caries in older adults.
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Affiliation(s)
- Otávio Pereira D'Avila
- Research Center for Social and Preventive Dentistry, Dental School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eliana Wendland
- Department of Public Health, UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Research Center for Social and Preventive Dentistry, Dental School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Dalva Maria Pereira Padilha
- Research Center for Social and Preventive Dentistry, Dental School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Research Center for Social and Preventive Dentistry, Dental School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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La Fratta I, Tatangelo R, Campagna G, Rizzuto A, Franceschelli S, Ferrone A, Patruno A, Speranza L, De Lutiis MA, Felaco M, Grilli A, Pesce M. The plasmatic and salivary levels of IL-1β, IL-18 and IL-6 are associated to emotional difference during stress in young male. Sci Rep 2018; 8:3031. [PMID: 29445205 PMCID: PMC5813044 DOI: 10.1038/s41598-018-21474-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/04/2018] [Indexed: 12/14/2022] Open
Abstract
Saliva collection is considered a non-invasive method to detect inflammatory markers in response to emotional states within natural social contexts. Numerous studies have prompted an important role of cytokines in modulating distinct aspects of social and emotional behavior. The aim of this study was to investigate the reliability of plasma and saliva as investigative tools for measure some inflammatory marker levels (CRP, IL-1β, IL-18, and IL-6). At the same time, the relationships between these markers and emotional states in response to a socio-cognitive stress (Academic Exam, AE), were considered. It was demonstrated that the plasma and saliva concentrations of all immune-mediators analyzed were significantly related across the socio-cognitive stress. In addition, when there was a close correlation to AE, the anger state, the IL-1β, the IL-18 salivary and plasmatic concentrations were significantly higher, while they decreased during the AE. On the other hand, the anxiety state and the IL-6 levels significantly increased throughout the AE. The IL-1β and IL-6 were positively associated to the anger and the anxiety state, respectively. In conclusion, our data highlight that different immune markers are similarly detectable in plasma and saliva during socio-cognitive stress. Also, they could be related to different emotional responses.
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Affiliation(s)
- I La Fratta
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - R Tatangelo
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - G Campagna
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - A Rizzuto
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - S Franceschelli
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - A Ferrone
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - A Patruno
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - L Speranza
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - M A De Lutiis
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - M Felaco
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - A Grilli
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy
| | - M Pesce
- Medicine and Health Science School, Via dei Vestini, 31-66100, Chieti, Italy.
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Muniz FWMG, Melo IM, Rösing CK, de Andrade GM, Martins RS, Moreira MMSM, Carvalho RDS. Use of antidepressive agents as a possibility in the management of periodontal diseases: A systematic review of experimental studies. ACTA ACUST UNITED AC 2017; 9. [PMID: 28862386 DOI: 10.1111/jicd.12291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/01/2017] [Indexed: 11/30/2022]
Abstract
Antidepressant agents have anti-inflammatory functions that could be interesting as adjuvants in periodontal therapy. The aim of the present study was to analyze the effect of antidepressive drugs in the management of periodontal disease. The MEDLINE, Scopus, Embase, LILACS, and SciELO databases were searched. To be included, the studies had to be experimental studies; randomized, controlled; double-blinded; or blinded studies. A total of 565 articles were initially searched, of which five were selected for the systematic review. All studies used rats, and three different drugs were evaluated: tianeptine, venlafaxine, and fluoxetine. Two of these studies evaluated the effect of antidepressive agents in rats submitted to both ligature-induced periodontitis and depression models, showing that depressive rats had greater alveolar bone loss (ABL). Only the venlafaxine study was not able to find any significant ABL reduction in the group that used this antidepressive drug. The other four studies showed statistically-significant differences, favoring the group with the antidepressant agent. Treatments that are able to modulate the brain-neuroendocrine-immune system could be used as an adjuvant to periodontal disease management. However, studies on humans and animals are scarce, limiting the conclusion of a positive effect in the present systematic review.
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Affiliation(s)
| | - Iracema Matos Melo
- Department of Periodontology, Federal University of Ceará, Sobral, Brazil
| | | | - Geanne Matos de Andrade
- Department of Physiology and Pharmacology, Medicine School, Federal University of Ceará, Fortaleza, Brazil
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Dumitrescu AL. Depression and Inflammatory Periodontal Disease Considerations-An Interdisciplinary Approach. Front Psychol 2016; 7:347. [PMID: 27047405 PMCID: PMC4804721 DOI: 10.3389/fpsyg.2016.00347] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/25/2016] [Indexed: 12/18/2022] Open
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Araújo MM, Martins CC, Costa LCM, Cota LOM, Faria RLAM, Cunha FA, Costa FO. Association between depression and periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2016; 43:216-28. [DOI: 10.1111/jcpe.12510] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Milena Moreira Araújo
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Carolina Castro Martins
- Department of Pediatric Dentistry and Orthodontics; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Lidiane Cristina Machado Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | | | - Fabiano Araújo Cunha
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
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Solis ACDO, Marques AH, Dominguez WV, Prado EBDA, Pannuti CM, Lotufo RFM, Lotufo-Neto F. Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines. Brain Behav Immun 2016; 53:49-53. [PMID: 26616397 DOI: 10.1016/j.bbi.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/20/2015] [Accepted: 11/21/2015] [Indexed: 02/07/2023] Open
Abstract
An imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (± 3 years) with a healthy control (n=36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1β (IL-1β), and interferon-γ (INF-γ) production in whole blood culture (WBC) and IL-6 and IL-1β levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1β (unstimulated) as well as GCF IL-1β were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann-Whitney, p=0.002, 0.0075, ANCOVA, p=0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r=0.07, p=0.67), and between the levels of circulating IL-1β and the IL-1β level in the CGF (r=-0.08, p=0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r=0. 02, p=0.91) or between the circulating IL-1β and GCF IL-1β (r=0.13, p=0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.
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Affiliation(s)
- Ana Cristina de Oliveira Solis
- Department of Stomatology, Division of Periodontics, University of São Paulo, São Paulo, Brazil; Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
| | | | | | | | - Cláudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, University of São Paulo, São Paulo, Brazil.
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Gomaa N, Glogauer M, Tenenbaum H, Siddiqi A, Quiñonez C. Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. PLoS One 2016; 11:e0146218. [PMID: 26751953 DOI: 10.1371/journal.pone.0146218] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 11/09/2015] [Indexed: 11/01/2022] Open
Abstract
Oral diseases constitute a major worldwide public health problem, with their burden concentrating in socially disadvantaged and less affluent groups of the population, resulting in significant oral health inequalities. Biomedical and behavioural approaches have proven relatively ineffective in reducing these inequalities, and have potentially increased the health gap between social groups. Some suggest this stems from a lack of understanding of how the social and psychosocial contexts in which behavioural and biological changes occur influence oral disease. To unravel the pathways through which social factors affect oral health outcomes, a better understanding is thus needed of how the social 'gets under the skin,' or becomes embodied, to alter the biological. In this paper, we present the current knowledge on the interplay between social and biological factors in oral disease. We first provide an overview of the process of embodiment in chronic disease and then evaluate the evidence on embodiment in oral disease by reviewing published studies in this area. Results show that, in periodontal disease, income, education and perceived stress are correlated with elevated levels of stress hormones, disrupted immune biomarkers and increased allostatic load. Similarly, socioeconomic position and increased financial stress are related to increased stress hormones and cariogenic bacterial counts in dental caries. Based on these results, we propose a dynamic model depicting social-biological interactions that illustrates potential interdependencies between social and biological factors that lead to poor oral health. This work and the proposed model may aid in developing a better understanding of the causes of oral health inequalities and implicate the importance of addressing the social determinants of oral health in innovating public health interventions.
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Kumar A, Kardkal A, Debnath S, Lakshminarayan J. Association of periodontal health indicators and major depressive disorder in hospital outpatients. J Indian Soc Periodontol 2015; 19:507-11. [PMID: 26644715 PMCID: PMC4645535 DOI: 10.4103/0972-124x.167161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Major depressive disorder (MDD) has been associated with changes in behavioral, neurophysiological, and neuroendocrinological factors and thought to be one of the leading causes of disability worldwide. There are various evidences that depression and periodontitis may also be related. Aim: The aim was to evaluate the association between MDD and periodontitis in a convenience sample of hospital outpatients. Materials and Methods: Sixty individuals (30 subjects with MDD and 30 subjects without MDD) of age 26–67 years were included in the study. Depression was assessed by means of structured clinical interview for diagnostic and statistical manual of mental disorders. The periodontal clinical examination included the number of missing teeth, plaque index, gingival index (GI), probing pocket depth, and clinical attachment level (CAL). Results: Mean number of missing teeth per patient was 1.14 (±1.2 standard deviation [SD]) in the control group and 2.58 (±1.64 SD) in case group (P < 0.001). The amount of plaque was significantly higher in cases compared with control (P = 0.001). The patients had an average GI of 1.82 (±0.65 SD) compared to 1.14 (±0.81 SD) for the controls (P < 0.001). Mean probing depth and CAL were 4.67 (±0.8 SD) mm and 4.96 (±0.2 SD) mm in the case group and 2.6 (±2.2 SD) mm and 2.7 (±0.43 SD) mm in the control group, respectively (P < 0.05). Conclusion: Our study confirms the significant association between depression and periodontitis and depression can be considered one of the important risk factors for periodontal diseases.
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Affiliation(s)
- Amit Kumar
- Department of Periodontology, Navodaya Dental College, Raichur, Karnataka India
| | - Asif Kardkal
- Department of Periodontology, Navodaya Dental College, Raichur, Karnataka India
| | - Surangama Debnath
- Department of Periodontology, Navodaya Dental College, Raichur, Karnataka India
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Warren KR, Postolache TT, Groer ME, Pinjari O, Kelly DL, Reynolds MA. Role of chronic stress and depression in periodontal diseases. Periodontol 2000 2015; 64:127-38. [PMID: 24320960 PMCID: PMC7167640 DOI: 10.1111/prd.12036] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2013] [Indexed: 12/15/2022]
Abstract
An extensive body of experimental and clinical evidence documents the negative impact of chronic psychological stress and depression on the immune system and health. Chronic stress and depression can result in general dysregulation of the immune system, of both cellular and humoral pathways, which may contribute to pathogenic infection and concomitant periodontal tissue destruction. In general, the evidence is consistent with the hypothesis that stress can modify the host defense and progression of periodontal infections in patients susceptible to periodontitis. However, substantial evidence also indicates that these conditions can mediate risk for disease, including periodontitis, through changes in health-related behaviors, such as oral hygiene, smoking and diet. The unequivocal interpretation of studies has also been hampered, in part, by issues related to conceptualization of stress and depression, as well as commonly associated comorbidities, such as diabetes, that can modify the onset and progression of periodontal disease. In addition, stress and depression appear to fall into a spectrum, ranging from mild to severe, involving a complex interaction of genetic background, coping strategies and environment. Differences in the conceptualization of stress and depression are probably important in assessing associations with other biologic and clinical measures. Future studies are necessary to clarify the complex interactions of chronic stress and depression in periodontal diseases.
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Yang SE, Park YG, Han K, Min J, Kim S. Association between dental pain and depression in Korean adults using the Korean National Health and Nutrition Examination Survey. J Oral Rehabil 2015; 43:51-8. [DOI: 10.1111/joor.12343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S. E. Yang
- Department of Conservative Dentistry; Seoul St. Mary's Dental Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Y. G. Park
- Department of Biostatistics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - K. Han
- Department of Biostatistics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J.A. Min
- Department of Psychiatry; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - S.Y. Kim
- Department of Conservative Dentistry; Seoul St. Mary's Dental Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
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Mizutani S, Ekuni D, Tomofuji T, Irie K, Azuma T, Iwasaki Y, Morita M. Structural equation modeling to assess gender differences in the relationship between psychological symptoms and dental visits after dental check-ups for university students. Acta Odontol Scand 2015; 73:368-74. [PMID: 25330163 DOI: 10.3109/00016357.2014.968870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Some studies have shown a relationship between psychological symptoms and oral health behaviors. However, it is unknown whether gender differences affect the relationship between psychological symptoms and oral health behaviors. In addition, gender differences in the relationship between dental anxiety and dental visits for treatment or regular check-up are unclear. The objective of the present study was to explain the relationships among gender differences, psychological symptoms, oral health behaviors, dental anxiety and 'expectation of dental visit', evaluated as 'dental visits when treatments are recommended' in university students. MATERIALS AND METHODS A total of 607 students (311 males, 296 females) aged 18-38 years old were examined. The information was collected via questionnaire regarding gender, psychological symptoms and oral health behaviors. Psychological symptoms were assessed using the Hopkins Symptom Checklist. Structural equation modeling was used to test pathways from these factors to 'expectation of dental visit'. Multiple-group modeling was also conducted to test for gender differences. RESULTS Psychological symptoms were related to low expectation of dental visit in females, but there was no such relationship in males. Oral health behaviors were related to expectation of dental visit in both genders. CONCLUSIONS Psychological symptoms were directly related to expectation of dental visit in females and oral health behaviors were related to expectation of dental visit in both genders. To promote dental visits after dental check-ups at school, it might be necessary to improve oral health behaviors in both genders and to evaluate psychological symptoms, especially in females.
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Affiliation(s)
- Shinsuke Mizutani
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
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Breivik T, Gundersen Y, Murison R, Turner JD, Muller CP, Gjermo P, Opstad K. Maternal Deprivation of Lewis Rat Pups Increases the Severity of Experi-mental Periodontitis in Adulthood. Open Dent J 2015; 9:65-78. [PMID: 25713634 PMCID: PMC4333617 DOI: 10.2174/1874210601509010065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/24/2014] [Accepted: 12/11/2014] [Indexed: 11/30/2022] Open
Abstract
Background and Objective: Early life adverse events may influence susceptibility/resistance to chronic inflammatory diseases later in life by permanently dysregulating brain-controlled immune-regulatory systems. We have investigated the impact of infant-mother separation during early postnatal life on the severity of experimental periodontitis, as well as systemic stress and immune responses, in adulthood. Material and Methods: Pups of periodontitis resistant Lewis rats were separated from their mothers for 3 h daily during postnatal days 2-14 (termed maternal deprivation; MD), separated for 15 min daily during the same time period (termed handling; HD), or left undisturbed. As adults, their behaviour was tested in a novel stressful situation, and ligature-induced periodontitis applied for 21 days. Two h before sacrifice all rats were exposed to a gram-negative bacterial lipopolysaccharide (LPS) challenge to induce a robust immune and stress response. Results: Compared to undisturbed controls, MD rats developed significantly more periodontal bone loss as adults, whereas HD rats showed a tendency to less disease. MD and HD rats exhibited depression-like behaviour in a novel open field test, while MD rats showed higher glucocorticoid receptor (Gr) expression in the hippocampus, and HD rats had altered methylation of genes involved in the expression of hippocampal Gr. LPS provoked a significantly lower increase in circulating levels of the cytokine TGF-1β in MD and HD rats, but there were no significant differences in levels of the stress hormone corticosterone. Conclusion: Stressful environmental exposures in very early life may alter immune responses in a manner that influences susceptibility/resistance to periodontitis.
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Affiliation(s)
- Torbjørn Breivik
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Norway ; Norwegian Defence Research Establishment, Division for Protection, Kjeller, Norway
| | - Yngvar Gundersen
- Norwegian Defence Research Establishment, Division for Protection, Kjeller, Norway
| | - Robert Murison
- Department of Biology and Medical Psychology, Faculty of Psychology, University of Bergen, Norway
| | - Jonathan D Turner
- Institute of Immunology, CRP- Santé/Laboratoire National de Sante, 20A Rue Auguste Lumière, L-1950, Luxembourg
| | - Claude P Muller
- Institute of Immunology, CRP- Santé/Laboratoire National de Sante, 20A Rue Auguste Lumière, L-1950, Luxembourg
| | - Per Gjermo
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Norway
| | - Kristian Opstad
- Norwegian Defence Research Establishment, Division for Protection, Kjeller, Norway
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Abstract
Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: "periodontal disease," "periodontitis," "risk factors," and "causal." This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors.
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Cakmak O, Alkan BA, Ozsoy S, Sen A, Abdulrezzak U. Association of gingival crevicular fluid cortisol/dehydroepiandrosterone levels with periodontal status. J Periodontol 2014; 85:e287-94. [PMID: 24669848 DOI: 10.1902/jop.2014.130787] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress-related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. METHODS One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme-linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non-periodontitis; group 2, localized CP; and group 3, generalized CP. RESULTS There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non-periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). CONCLUSIONS Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.
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Affiliation(s)
- Omer Cakmak
- Department of Periodontology, Faculty of Dentistry, Kocatepe University, Afyonkarahisar, Turkey
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Laudisio A, Milaneschi Y, Bandinelli S, Gemma A, Ferrucci L, Incalzi RA. Chewing problems are associated with depression in the elderly: results from the InCHIANTI study. Int J Geriatr Psychiatry 2014; 29:236-44. [PMID: 23852611 PMCID: PMC6329002 DOI: 10.1002/gps.3995] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 05/23/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Depression is increasingly recognized in older populations and associated with undernutrition, disability, and increased mortality. Chewing problems (CPs) share with depression these associations. The aim of the study was to evaluate the association, if any, between CPs and depression in older subjects. METHODS We assessed 927 participants aged 65 years and older, derived from the 'InCHIANTI' study. Mood was evaluated using the CES-D scale and defined depressed by a CES-D score ≥20. CPs were self-reported. Logistic regression was performed to assess the adjusted association between depression and CPs. The adjusted model was analyzed after stratifying for use of complete, partial dentures and edentulism. RESULTS Chewing problems were reported by 293/927 (31.6%) participants. Depression was present in 188/927(20.3%) participants. In multivariable logistic regression, CPs were associated with depression (OR = 1.81, 95% CI = 1.26-2.58; p = 0.001). No significant association was found among subjects who used complete dentures (OR = 1.12, 95% CI = 0.80-1.58, p = 0.515). Up to 27.8% of prevalent depression might be attributed to CPs. CONCLUSIONS Chewing problems are associated with depression in elderly population. Use of complete dentures hinder this association. Older depressed subjects should be screened for the presence of CPs; further studies are needed to evaluate the impact of early detection and correction of CPs on the development of depression.
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Affiliation(s)
- Alice Laudisio
- Area di Geriatria, Campus Bio-Medico University, Rome, Italy
| | - Yuri Milaneschi
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.,Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Stefania Bandinelli
- Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy
| | - Antonella Gemma
- UOS Accesso e Presa in Carico Assistenziale, Azienda Sanitaria Locale Roma E, Rome, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
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Ilday NO, Celik N, Dilsiz A, Alp HH, Aydin T, Seven N, Kiziltunç A. The effects of silorane composites on levels of cytokines and periodontal parameters. Contemp Clin Dent 2014; 4:437-42. [PMID: 24403785 PMCID: PMC3883320 DOI: 10.4103/0976-237x.123021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aims: The purpose of this pilot study was to determine the effects of silorane composites on gingival crevicular fluid (GCF) levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and IL-8, GCF volume and clinical periodontal parameters in patients with silorane composite restorations before and after restorative treatment. Materials and Methods: A total of 20 systemically healthy non-smokers, 12 female and 8 male (age range: 24-46 years), presenting with 25 instances of primary dentine caries with subgingival margins were selected for this study. Approval was obtained from the university ethics committee and treatment plans were approved by the patients. GCF samples were obtained with periopaper strips from relevant teeth for IL-6, IL-8 and TNF-α measurements. Each sample was stored at − 80°C and analyzed using the enzyme-linked immunosorbent assay (ELISA) kits. Cavities were prepared according to the common principles for adhesive restorations and restored with a silorane adhesive system (Silorane System Adhesive (3M ESPE) and silorane composite (Filtek Silorane, 3M ESPE). Cytokine levels were reassessed 2 weeks after restorative treatment. Data were analyzed using the independent t-test at a significance level of α =0.05. Associations between parameters were analyzed using Pearson correlation analysis. Results: A significant increase in gingival index (GI) and plaque index (PI) were observed after 15 days (P < 0.05). GCF volume, IL-6, IL-8 and TNF-α levels exhibited significant differences before and after restorative treatment (P < 0.05). There were strong positive correlations among parameters except for PI/GCF volume and GI/GCF volume. Conclusion: Within the limitations of this investigation, silorane composites may have some negative effects on cytokine levels, clinical parameters and GCF volume.
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Affiliation(s)
- Nurcan Ozakar Ilday
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Neslihan Celik
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Hamit Hamit Alp
- Department of Biochemistry, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Tuba Aydin
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Nilgun Seven
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Ahmet Kiziltunç
- Department of Biochemistry, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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Cunningham LL, Novak MJ, Madsen M, Abadi B, Ebersole JL. A bidirectional relationship of oral-systemic responses: observations of systemic host responses in patients after full-mouth extractions. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:435-44. [PMID: 24630161 DOI: 10.1016/j.oooo.2013.11.502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/18/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This investigation tested the hypothesis that systemic inflammatory responses would be attenuated by minimizing the oral microbial burden in patients with moderate to severe periodontitis. STUDY DESIGN Patients (n = 73) scheduled for full-mouth extractions were categorized as case type I/II (gingivitis/mild periodontitis) or case type III/IV (moderate/severe periodontitis). Serum levels of acute phase proteins (APPs) and immunoglobulin G (IgG) antibody were assessed at baseline and through 1 year after extraction. RESULTS At baseline, the levels of multiple APPs (e.g., fibrinogen, C-reactive protein) and antibodies to periodontal pathogens were significantly higher with case type III/IV vs I/II. These differences were sustained 12 months after extractions for most APPs. CONCLUSIONS The results demonstrated that removal of disease by full-mouth extraction of teeth altered the overall burden of challenge to the host. Continued elevation in various APPs in the III/IV group suggested a potential underlying constitutive difference in systemic response characteristics of this population.
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Affiliation(s)
- L L Cunningham
- Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, Lexington, KY, USA; Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
| | - M J Novak
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - M Madsen
- Department of Oral and Maxillofacial Surgery, University of Louisville School of Dentistry, Louisville, KY, USA
| | - B Abadi
- Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - J L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Akcalı A, Huck O, Buduneli N, Davideau JL, Köse T, Tenenbaum H. Exposure of Porphyromonas gingivalis to cortisol increases bacterial growth. Arch Oral Biol 2014; 59:30-4. [DOI: 10.1016/j.archoralbio.2013.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 09/08/2013] [Accepted: 09/12/2013] [Indexed: 01/29/2023]
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Park SJ, Ko KD, Shin SI, Ha YJ, Kim GY, Kim HA. Association of oral health behaviors and status with depression: results from the Korean National Health and Nutrition Examination Survey, 2010. J Public Health Dent 2013; 74:127-38. [DOI: 10.1111/jphd.12036] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Se Jin Park
- Department of Public Health; Graduate School, Catholic University of Korea; Seoul Korea
- Department of Mental Health Research; Seoul National Hospital; Seoul Korea
| | - Ki Dong Ko
- Department of Family Medicine; Seoul National University Hospital; Seoul Korea
| | - Seung-Il Shin
- Department of Periodontology; School of Dentistry, Kyung Hee University; Seoul Korea
| | - Yu Jeong Ha
- Department of Mental Health Research; Seoul National Hospital; Seoul Korea
| | - Gy Young Kim
- Department of Dentistry; Ajou University Hospital; Suwon Gyeonggi-do Korea
| | - Hyoung Ah Kim
- Department of Preventive Medicine; Catholic University of Korea; Seoul Korea
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Abstract
OBJECTIVE Many researchers and health care providers have noticed male vulnerability in infant health, mother-infant interactions, and some infant cognitive development, especially among very low birth weight (VLBW) preterm infants. However, factors beyond gender that could explain these observed differences have not been clear. The purpose of this article is to review the literature on the subject and to introduce a conceptual framework relating these factors. DISCUSSION According to gender-difference theories, prenatal exposure to high levels of testosterone may influence infant health and mother-infant interactions by negatively affecting infant cognitive/motor/language development. We constructed a conceptual framework based on the associations among biological (perinatal testosterone), stress-related (perinatal and maternal cortisol), and developmental (infant cognitive/motor/language skills) factors. If research establishes these biological, environmental, and developmental associations in mother-VLBW preterm pairs, the results will highlight the importance of addressing gender differences in nursing research and encourage the development of nursing interventions designed to reduce stress among mothers of VLBW preterm infants, particularly male infants. CONCLUSION From a psychobiosocial perspective, combining biophysiological factors such as perinatal testosterone and cortisol with socioenvironmental factors such as the quality of mother-infant interactions and infant temperament may provide a broader view of gender differences in infant health and development.
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Affiliation(s)
- June Cho
- 1School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Solis ACO, Marques AH, Pannuti CM, Lotufo RFM, Lotufo-Neto F. Evaluation of periodontitis in hospital outpatients with major depressive disorder. J Periodontal Res 2013; 49:77-84. [PMID: 23586804 DOI: 10.1111/jre.12082] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Major depressive disorder (MDD) has been associated with alterations in the neuroendocrine system and immune function and may be associated with an increased susceptibility to cardiovascular disease, cancer and autoimmune/inflammatory disease. This study was conducted to investigate the relationship between periodontitis and MDD in a convenience sample of hospital outpatients. MATERIAL AND METHODS The sample consisted of 72 physically healthy subjects (36 outpatients with MDD and 36 age-matched controls [± 3 years]). Patients with bipolar disorder, eating disorders and psychotic disorders were excluded. Probing pocket depth and clinical attachment level were recorded at six sites per tooth. Depression was assessed by means of Structured Clinical Interview for DSM-IV. RESULTS Extent of clinical attachment level and probing pocket depth were not different between controls and subjects with depression for the following thresholds: ≥ 3 mm (Mann-Whitney, p = 0.927 and 0.756); ≥ 4 mm (Mann-Whitney, p = 0.656 and 0.373); ≥ 5 mm (Mann-Whitney, p = 0.518 and 0.870);, and ≥ 6 mm (Mann-Whitney, p = 0.994 and 0.879). Depression parameters were not associated with clinical attachment level ≥ 5 mm in this sample. Smoking was associated with loss of attachment ≥ 5 mm in the multivariable logistic regression model (odds ratio = 6.99, 95% confidence interval = 2.00-24.43). CONCLUSIONS In this sample, periodontal clinical parameters were not different between patients with MDD and control subjects. There was no association between depression and periodontitis.
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Affiliation(s)
- A C O Solis
- Department of Stomatology, Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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46
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Jaremka LM, Lindgren ME, Kiecolt-Glaser JK. Synergistic relationships among stress, depression, and troubled relationships: insights from psychoneuroimmunology. Depress Anxiety 2013; 30:288-96. [PMID: 23412999 PMCID: PMC3816362 DOI: 10.1002/da.22078] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 01/07/2013] [Accepted: 01/21/2013] [Indexed: 02/06/2023] Open
Abstract
Stress and depression consistently elevate inflammation and are often experienced simultaneously, which is exemplified by people in troubled relationships. Troubled relationships also elevate inflammation, which may be partially explained by their ability to engender high levels of stress and depression. People who are stressed, depressed, or in troubled relationships are also at greater risk for health problems than their less distressed counterparts. Inflammation, a risk factor for a variety of age-related diseases including cardiovascular disease, Type II diabetes, metabolic syndrome, and frailty, may be one key mechanistic pathway linking distress to poor health. Obesity may further broaden the health implications of stress and depression; people who are stressed or depressed are often overweight, and adipose tissue is a major source of proinflammatory cytokines. Stress, depression, and troubled relationships may have synergistic inflammatory effects: loneliness, subclinical depression, and major depression enhance inflammatory responses to an acute stressful event. The relationship between distress and inflammation is bidirectional; depression enhances inflammation and inflammation promotes depression. Interesting questions emerge from this literature. For instance, some stressors may be more potent than others and thus may be more strongly linked to inflammation. In addition, it is possible that psychological and interpersonal resources may buffer the negative inflammatory effects of stress. Understanding the links among stress, depression, troubled relationships, and inflammation is an exciting area of research that may provide mechanistic insight into the links between distress and poor health.
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Affiliation(s)
- Lisa M. Jaremka
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Monica E. Lindgren
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,Department of Psychiatry, The Ohio State University College of Medicine
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47
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Abstract
Stress is an equated response to constant adverse stimuli. At one point or another everybody suffers from stress. Stress is compatible with good health, being necessary to cope with the challenges of everyday life. Problems start when the stress response is inappropriate to the intensity of the challenge. Psychological stress can down regulate the cellular immune response. Communication between the central nervous system and the immune system occurs via a complex network of bidirectional signals linking the nervous, endocrine, and immune systems. Stress disrupts the homeostasis of this network, which in turn, alters immune function. Direct association between periodontal disease and stress remains to be proven, which is partly due to lack of an adequate animal models and difficulty to quantifying the amount and duration of stress and also there are many factors influencing the incidence and severity of periodontal disease. Nevertheless, more recent studies indicate that psychosocial stress represents a risk indicator for periodontal disease and should be addressed before and during treatment. This paper discusses how stress may modulate host response to bacteria and influence the course and progression of periodontal disease.
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Affiliation(s)
- Sachin Goyal
- Department of Periodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Garima Gupta
- Department of Orthodontics and Dentofacial Orthopaedics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Betsy Thomas
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - K M Bhat
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - G S Bhat
- Department of Periodontics, PDS Division, College of Dentistry, University of Dammam, Saudi Arabia
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48
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Preeja C, Ambili R, Nisha KJ, Seba A, Archana V. Unveiling the role of stress in periodontal etiopathogenesis: an evidence-based review. ACTA ACUST UNITED AC 2012; 4:78-83. [PMID: 23073923 DOI: 10.1111/jicd.12000] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 07/24/2012] [Indexed: 11/30/2022]
Abstract
Periodontal disease is a multifactorial disease affecting the supporting tissues of the teeth, resulting in progressive attachment loss and bone loss. Periodontal disease is influenced by various systemic, environmental, and psychologic factors that have the potential to alter periodontal tissues and host immune response, resulting in more severe periodontal destruction. Several studies have documented the relationship between psychosocial stress and chronic forms of periodontal disease. Stress impairs periodontal health through changes in behavior and complex interactions among the nervous, endocrine, and immune systems. The influence of stress on periodontal disease is affected by the emotional coping skills of the individual. Psychologic stress and depression may also influence the outcome of periodontal therapy. Stressful life events and coping skills are factors to consider in the risk of periodontal disease destruction and the potential for successful periodontal therapy. Therefore psychosocial stress is considered as an important risk factor for periodontal disease, and emotional stress in periodontitis patients should be diagnosed and treatment should be administered for the proper management and successful outcome of periodontal disease.
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Affiliation(s)
- C Preeja
- Department of Periodontics, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.
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49
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Abstract
OBJECTIVES Studies on hypothalamus-pituitary-adrenal (HPA) axis activity in stress-related exhaustion and burnout have revealed incongruent results, and few longitudinal studies on clinical populations have been performed. This study was designed to investigate differences in HPA axis activity between patients with stress-related exhaustion and healthy controls and to investigate longitudinal changes in HPA axis activity in the patient group as they entered a multimodal treatment programme. DESIGN HPA axis activity was assessed through the cortisol awakening response (CAR). Salivary cortisol was sampled at awakening and after 15 min. Follow-up measurements were performed in the patient group after 3, 6, 12 and 18 months. SETTING An outpatient clinic specialising in stress-related illness. PARTICIPANTS Patients with clinically diagnosed stress-related exhaustion (n=162) and healthy controls (n=79). PRIMARY AND SECONDARY OUTCOME MEASURES The primary measure was CAR measured as the difference between the two salivary cortisol samples. Changes in CAR during follow-up were related to changes in symptoms of burnout, depression and anxiety. RESULTS Patients showed similar CAR as the controls and their CAR did not change significantly during treatment. No association was found between CAR and symptom development during treatment. CONCLUSIONS The authors conclude that CAR does not seem to discriminate clinically defined patients with exhaustion from healthy controls and it appears not to change during treatment. CAR, measured as salivary cortisol, at awakening and after 15 min, is thus not a valid marker for stress-related exhaustion.
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Affiliation(s)
- Anna Sjörs
- The Institute of Stress Medicine, Gothenburg, Sweden
- Rehabilitation Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Thomas Ljung
- County Council of Jämtland, R&D-unit, Östersund, Sweden
- Mid Sweden University, IHV, Östersund, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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50
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Modéer T, Blomberg C, Wondimu B, Lindberg TY, Marcus C. Association between obesity and periodontal risk indicators in adolescents. ACTA ACUST UNITED AC 2011; 6:e264-70. [DOI: 10.3109/17477166.2010.495779] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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