The impact of stress on periodontal disease

Author(s)

Daiane Cristina Peruzzo

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2008-01-25

Examining board members

Getulio da Rocha Nogueira Filho; Giuseppe Alexandre Romito; Élcio Marcantonio Junior; Gláucia Maria Bovi Ambrosano; Marcio Zaffalon Casati

• Advisor: Getulio da Rocha Nogueira Filho; Francisco Humberto Nociti Junior

Abstract

Animal and epidemiological studies have suggested that stress may modify the establishment and progression of periodontal disease (PD). However, data regarding the effect of stress and the mechanisms involved in PD are limited. The aim of this study was: i) to review systematically the literature about the influence of chronic stress (CS) on PD ii) to evaluate the impact of CS, induced in rats, in the progression of PD and regulation of genes related to the disease progression, as well as the variations of stress biomarkers (cathecolamines e corticoesterone); iii) to evaluate the feasibility of the use of metyrapone (MT) as an experimental model to inhibit glucocorticoid (GC) production and, therefore, as a method to determine the effect of CS on periodontal tissues. A systematic literature search was performed and the data of the studies were independently extracted and evaluated by two reviewers. The animal studies were carried out on male Wistar rats assigned to 3 groups with 20 animals each: control, PD induced by ligature; PD associated with CS (restraint stress and isolation, 12 h/day) and PD + CS + MT administration (3 daily doses, 50mg/Kg). After 30 days, all animals were sacrificed. Blood samples were obtained and the concentrations of corticosterone and catecholamines measured as biomarkers of CS, marginal tissues around ligated and non-ligated teeth were harvested and gene expression assessed by qPCR (quantitative Polymerase Chain Reaction) and the jaws were removed and fixed to histometrically determine the interradicular bone loss (IBL). Data analysis demonstrated that: i) the majority of the studies showed a positive outcome between CS and PD; ii) the stress biomarkers may locally modulate PD by an increase of the local ratio of pro-inflammatory and pro-resorptive genes, thus favoring tissue destruction; and, iii) MT administration resulted in an important lowering effect of GC systemic levels, however, it could be observed that MT administration modified the expression of important factors which modulate PD, and consequently reflected the IBL. Within the limits of this study, it may be speculated that CS has a significant relationship with PD and the local increase in pro-inflammatory and pro-resorptive factors can be the mechanisms involved in disease progression. Moreover, MT administration is able to lower systemic levels of GC, however, it modulates the expression of factors related to periodontitis progression, resulting in IBL (AU)