Background: Stress is playing a major role as an aetiologic factor in the initiation of many systemic diseases. Similarly, it is also thought to be an aetiologic factor in the progression of periodontal diseases.
Aim: The production of free radical species is associated with various inflammatory diseases and also during stressful conditions. Hence, an effort in the present study is done to correlate psychosocial stress and periodontitis using serum MDA as an oxidative stress biomarker.
Materials and Methods: A current cross-sectional study included 201 individuals between 20 to 60 years of age. A periodontal examination included Probing Pocket Depth, CAL, Plaque Index, and Gingival Index. According to CAL individuals were divided into four groups i.e. healthy, slight (CAL = 1-2 mm), moderate (CAL = 3-4 mm) and severe (CAL = ≥5 mm) periodontitis. Psychosocial stress of the individuals was evaluated using occupational stress index. Serum MDA level was evaluated using spectrochromatometer.
Results: Patients with stress demonstrated increased levels of MDA along with a higher loss of attachment.
Conclusion: The results revealed statistically significant association between psychosocial stress and periodontitis indicating psychosocial stress as a risk factor for developing periodontitis.
Keywords: Free radicals, malondialdehyde, oxidative biomarker, periodontitis, psychosocial stress.
Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1-6.
Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev. 2001;14:727-52.
Dhabhar FS. A hassle a day may keep the pathogens away: the fight-or-flight stress response and the augmentation of immune function. Integr Comp Biol. 2009;49(3):215-36.
Löe H. The gingival index, the plaque index and the retention index systems. The J Periodontol. 1967;38(6P2):610-6.
Srivastava AK, Singh AP. Manual of the occupational stress index. Varanasi, UP: Manovaigyanik Parikcchan Sansthan;1981.
Bhutia Y, Ghosh A, Sherpa ML, Pal R, Mohanta PK. Serum malondialdehyde level: Surrogate stress marker in the Sikkimesediabetics. J Nat Sci Biol Med. 2011;(1):107-12.
Johnson NW, Griffiths GS, Wilton JM, Maiden MF, Curtis MA, Gillett IR, Wilson DT, Sterne JA. Detection of high-risk groups and individuals for periodontal diseases: Evidence for the existence of high-risk groups and individuals and approaches to their detection. J Clin Periodontol. 1988;15(5):276-82.
Genco RJ. Current view of risk factors for periodontal diseases. J Periodontol. 1996;67(10s):1041-9.
Moss ME, Beck JD, Kaplan BH, Offenbacher S, Weintraub JA, Koch GG, et al. Exploratory case‐control analysis of psychosocial factors and adult periodontitis. J Periodontol. 1996;67:1060-9.
Irwin M, Patterson T, Smith TL, Caldwell C, Brown SA, Gillin JC, et al. Reduction of immune function in life stress and depression. Biol Psychiatry. 1990;27(1):22-30.
Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 2000. 1997;14(1):216-48.
Monteiro da Silva AM, Oakley DA, Newman HN, Nohl FS, Lloyd HM. Psychosocial factors and adult onset rapidly progressive periodontitis. J Clin Periodontol. 1996;23:789-94.
Breivik T, Thrane PS, Murison R, Gjermo P. Emotional stress effects on immunity, gingivitis and periodontitis. Eur J Oral Sci. 1996;104(4):327-34.
Maes M, Yirmyia R, Noraberg J, Brene S, Hibbeln J, Perini G, et al. The inflammatory & neurodegenerative (I&ND) hypothesis of depression: leads for future research and new drug developments in depression. Metab Brain Dis. 2009;24(1):27-53.
Del Rio D, Stewart AJ, Pellegrini N. A review of recent studies on malondialdehyde as toxic molecule and biological marker of oxidative stress. Nutr Metab Cardiovasc Dis. 2005;15(4):316-28.
Hugoson A, Ljungquist B, Breivik T. The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age. J Clin Periodontol. 2002;29(3):247-53.
Wimmer G, Janda M, Wieselmann-Penkner K, Jakse N, Polansky R, Pertl C. Coping with stress: its influence on periodontal disease. J Periodontol. 2002;73(11):1343-51.
Croucher R, Marcenes WS, Torres MC, Hughes F, Sheiham A. The relationship between life-events and periodontitis A case-control study. J Clin Periodontol. 1997;24(1):39-43.
Deinzer R, Förster P, Fuck L, Herforth A, Stiller-Winkler R, Idel H. Increase of crevicular interleukin 1b under academic stress at experimental gingivitis sites and at sites of perfect oral hygiene. J Clin Periodontol. 1999;26(1):1-8.
Kurer JR, Watts TL, Weinman J, Gower DB. Psychological mood of regular dental attenders in relation to oral hygiene behaviour and gingival health. J Clin Periodontol. 1995;22(1):52-5.
Khanzode SD, Dakhale GN, Khanzode SS, Saoji A, Palasodkar R. Oxidative damage and major depression: the potential antioxidant action of selective serotonin re-uptake inhibitors. Redox Rep. 2003;8(6):365-70.
Vettore MV, Leão AT, Monteiro Da Silva AM, Quintanilha RS, Lamarca GA. The relationship of stress and anxiety with chronic periodontitis. J Clin Periodontol. 2003;30(5):394-402.
Almerich-Silla JM, Pastor S, Serrano F, Puig-Silla M, Dasí F. Oxidative stress parameters in saliva and its association with periodontal disease and types of bacteria. Dis Markers. 2015;2015:653537.
Halliwell B, Whiteman M. Measuring reactive species and oxidative damage in vivo and in cell culture: how should you do it and what do the results mean? Br J Pharmacol. 2004;142(2):231-55.
Celec P, Hodosy J, Celecová V, Vodrážka J, Červenka T, Halčák L, et al. Salivary thiobarbituric acid reacting substances and malondialdehyde–their relationship to reported smoking and to periodontal status described by the papillary bleeding index. DisMarkers. 2005;21(3):133-7.
Mashayekhi F, Aghahoseini F, Rezaie A, Zamani MJ, Khorasani R, Abdollahi M. Alteration of cyclic nucleotides levels and oxidative stress in saliva of human subjects with periodontitis. J Contemp Dent Pract. 2005;6(4):46-53.
Maxwell SR, Dietrich T, Chapple IL. Prediction of serum total antioxidant activity from the concentration of individual serum antioxidants. Clinic Chim Acta. 2006 Oct;372(1-2):188-94.