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The psychobiological links between chronic stress-related diseases, periodontal/peri-implant diseases, and wound healing

Journal

PERIODONTOLOGY 2000
Volume 87, Issue 1, Pages 94-106

Publisher

WILEY
DOI: 10.1111/prd.12381

Keywords

interleukins; peri-implant diseases; peri-implantitis; periodontitis; psychologic stress; salivary cortisol; serum cortisol

Funding

  1. NIH [R01DE025225, K99DE029756]

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Chronic stress is linked to periodontal diseases and may worsen oral tissue conditions. Through further research trials and improved data collection methods, it is discovered that chronic stress and related diseases may have significant impacts on the progression of periodontal/peri-implant diseases and treatment outcomes.
Chronic stress is a relevant disease to periodontal practice, encompassing 25%-28% of the US population (American Psychological Association 2015). While it is well established that chronic psychologic stress can have significant deleterious systemic effects, only in recent decades have we begun to explore the biochemical, microbial, and physiologic impacts of chronic stress diseases on oral tissues. Currently, chronic stress is classified as a risk indicator for periodontal disease. However, as the evidence in this field matures with additional clinically controlled trials, more homogeneous data collection methods, and a better grasp of the biologic underpinnings of stress-mediated dysbiosis, emerging evidence suggests that chronic stress and related diseases (depression, anxiety) may be significant contributing factors in periodontal/peri-implant disease progression and inconsistent wound healing following periodontal-related therapeutics. Ideal solutions for these patients include classification of the disease process and de-escalation of chronic stress conditions through coping strategies. This paper also summarizes periodontal/implant-related therapeutic approaches to ensure predictable results for this specific patient subpopulation.

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