PURPOSE: Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. METHODS: Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. RESULTS: A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). CONCLUSIONS: Subjects with a high SCL and depression may show an increased risk for CP.
Chronic Periodontitis ; Depression ; Depressive Disorder ; Hemorrhage ; Hydrocortisone ; Odds Ratio ; Surveys and Questionnaires ; Saliva ; Stress, Physiological ; Tooth Mobility

  The main objective of the present study was to determine the in situ biomechanical behaviour of skin in response to the use of three muds manufactured with a hyperosmotic Spring “Hervederos de Cofrentes” water, Valencia, Spain. The impact of the osmotic muds on the biomechanical behaviour of human skin, its pH, blood flow, barrier function and dermal density was quantified in healthy volunteers using several non-invasive approaches. Materials and Method: This study was designed to assess the skin response to daily use for 10 and 20 days on volar forearms of 33 healthy volunteers aged between 18 and 40 years (23.3 ± 4.4) when applied 3 extemporaneous peloides with 0 (P0), 30 (P3) and 60 (P6) days of maturation.   Peloids daily placed on volar forearm on panellist and variables were determined at baseline before starting treatment (day 0), and 10 and 20 days after the start of treatment. Day zero values are considered normal skin pattern.   After a descriptive statistical analysis (mean and standard deviation), a paired Student’s t-test was used to compare data. The level of significance was set at p<0.05. Results and Conclusions: Our results also suggest a direct relationship between the actions of the muds used and the following changes in the in vivo characteristics of human skin.   P3 peloid gradually decreases blood flow (p<0.05) whitout affetation TEWL and there is a general increase in pH with the implementation of treatment. Increases skin firmness (p<0, 05) and elasticity (p<0.05).   All peloids P0, P3 and P6 had an increase in dermal density (p<0.05), and was recorded reaching significance after 10 days of treatment and increased resistance towards repeated suction (reduced fatigue) after 10 days of treatment too, rising gradually up to 20 days was observed (p<0.05).   As an overall conclusion, our findings indicate that the skin treatment proposed, P3 peloid mainly, decrease blood flow without modifying the barrier function of the skin, does not change TEWL, and clearly improves its biomechanical properties, improving skin density, skin firmness, increasing the elasticity and decreasing the fatigue of the skin, up minimally modifying the pH.   All these circumstances make it very compatible with scaly process type psoriasis, atopic dermatitis, ichthyosis or cutaneous process that curse with an increase in skin cell turn-over.