Comparative Evaluation of Salivary Cortisol Levels and Peripheral Blood Neutrophil Functions in Chronic Periodontitis Patients with and without Stress – A Case Control Study

Abstract

Background and aim: Development of chronic periodontitis (CP) is related to the presence of periopathogenic bacteria and several other conditions including stress. In the successful management of chronic periodontitis, early detection of psychological stress plays a crucial role. Salivary cortisol is found to be associated with stress, however not many published evidence exists suggesting the association of stress and salivary cortisol levels in chronic periodontitis. Hence, this study was carried out with the aim to assess salivary cortisol levels and neutrophil functions in chronic periodontitis patients with and without stress. Materials and methods: Cortisol levels were determined using ELISA method from saliva samples collected, analysis of neutrophil functions such as chemotaxis, phagocytosis and intracellular killing was done using nitro blue tetrazolium (NBT) assay, and stress was assessed using Derogatis Stress Profile scale in 60 participants. Study participants were categorized into two groups based on their periodontal condition, Group I: Healthy control (n=30) and Group II: Chronic periodontitis (CP) (n=30) with a probing depth of ≥ 4mm and Clinical attachment loss (CAL) AL >1mm. Results: The difference in mean stress score of the chronic periodontitis group (0.52 ± 0.12) and healthy control group (0.46 ± 0.08) was statistically significant (P < 0.05). Salivary cortisol levels in the healthy (7.77 ± 5.48) and chronic periodontitis (8.77 ± 8.75) groups did not differ significantly. Neutrophil functions defects in the CP group (32.70 ± 12.15) and healthy group (20.33 ± 10.17) differed in a statistically significant manner. Conclusion: Statistically significant differences were observed in the stress levels, salivary cortisol levels and neutrophil functions between healthy and CP subjects with and without stress, thus demonstrating a possible link between CP and stress.