Evaluating the Clinico-biochemical Association between Stress and Chronic Periodontitis by Estimation of Serum Cortisol and Serum Chromogranin A Levels

Introduction: Periodontitis is a persistent diseased condition of the oral tissues that manifests as loss of attachment. Alterations in immune, neural, endocrinal and behavioural systems caused by stressful life events may impair periodontal health. Using serum stress markers, this study was designed to investigate the link between periodontal infection and psychoneuroimmunologic variables.Materials and Methods: Four hundred systemically healthy patients in the age group of 20-60 years were selected and segregated into two groups, namely healthy periodontium group (200 subjects) and chronic periodontitis group (200 subjects) after recording plaque index, probing depth, gingival index and clinical attachment loss. The analysis of stress levels using the Social Readjustment Rating Scale and lifestyle evaluation using the Health Practice Index was done. Serum cortisol and serum chromogranin A (CgA) levels were recorded. Descriptive statistics and unpaired t-tests for comparing the differences in the parameters and Pearson's correlation test for establishing the correlation between serum markers with clinical variables and stress levels were done. Multivariate analysis of covariance analysis was done to find the linear relation of periodontal and serum parameters (dependent variables) with psychological stress and lifestyle patterns (independent variables).Results: A poorer lifestyle and higher stress magnitude were more allied to worsened periodontal condition (P <= 0.05). Significantly higher (P <= 0.05) concentrations of serum cortisol and serum CgA levels were observed in the chronic periodontitis group.Conclusion: Stress shall be regarded as a probable risk factor for periodontal infection, and it should be catered to attain benefits in patients with inexplicable periodontal disease.