Cortisol level as a biomarker of the body's stress state in conditions of periodontitis

Abstract

Introduction. Periodontitis is a common oral disease accompanied by chronic inflammation and destruction of the supporting tissues of the tooth. Microbiological factors, genetic predisposition and hormonal background play an important role in its development. Cortisol, as a marker of the stress response, affects the immune system and inflammatory processes in the periodontium. Determining its level in oral fluid helps monitor the activity of inflammation, which is important for early diagnosis and optimization of treatment of periodontitis of the II–III degree.The purpose. To assess the dynamics of cortisol levels in the oral fluid of patients with stage II-III periodontitis and to establish the relationship between changes in this hormone and clinical indicators of the state of periodontal tissues.Materials and methods. The research methods included clinical examination (assessment of the condition of the oral cavity using the Plaque Index and Gingival Index hygiene indices), radiological method (analysis of the condition of the alveolar bone), probing (measurement of periodontal pockets), biochemical analysis (determination of cortisol levels in oral fluid by ELISA method, reagents of Hema LLC) and statistical analysis (data processing in Statistica and Excel 2019 using descriptive statistics and correlation analysis methods).Research results. The selection of patients was carried out in compliance with the principle of anonymity on the basis of the university dental clinic of the State Higher Educational Institution "UzhNU" and included 31 people aged 25–60 years with diagnosed periodontitis of the II-III degree. For comparison, a control group of 12 people of the same age range without signs of periodontal pathology was formed. All participants underwent a study of the level of cortisol in the oral fluid with subsequent analysis of the obtained indicators. In the control group, the average cortisol values were 1.41 nmol/l, while in patients with acute periodontitis of the II degree – 6.15–5.12 nmol/l. In the chronic course of periodontitis of the II degree, the cortisol level varied within 3.35–4.17 nmol/l, while in the chronic course of periodontitis of the III degree the indicators were 2.35–2.56 nmol/l. The results obtained indicate a significant increase in cortisol levels in patients with inflammatory periodontal diseases compared to control values, which may indicate the role of stress factors in the pathogenesis of periodontitis.Conclusions. The study showed that patients with stage II-III periodontitis have significantly higher levels of cortisol in their oral fluid, indicating a systemic stress response. A correlation was found between cortisol levels and clinical signs of periodontitis, confirming its effect on inflammation. Cortisol dynamics can serve as a biomarker for diagnosing and monitoring the disease. Elevated cortisol emphasizes the role of stress in pathogenesis, which requires a comprehensive approach to treatment.