Evaluation of salivary stress markers and inflammatory cytokine levels in peri-implantitis patients

Abstract

Background and objective: Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar data for peri-implantitis. The aim of this study was to determine the relationship between interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)α inflammatory cytokines and the psychological stress-related markers, glucocorticoid receptor-α (GRα), and salivary α-amylase (sAA) gene expression levels in saliva samples obtained from healthy implants and peri-implantitis patients.

Materials and methods: The study included a total of 50 systemically healthy subjects. Peri-implant clinical parameters were recorded and psychological stress level was evaluated with the hospital anxiety and depression scale (HAD) and state-trait anxiety inventory (STAI) questionnaire forms. Following the evaluations, the patients were divided into 4 groups according their stress and clinical status (Ia, Ib, IIa, IIb). IL-1β, IL-6, IL-10, IFNα, GRα, sAA gene expression levels in the saliva samples were quantified by quantitative polymerase chain reaction (qPCR).

Results: In the group of peri-implantitis who had a high score in stress level assessment scales, significantly higher IL-1β, IL-6, sAA expression levels were observed (p < 0.001). The IL-10 gene expression levels were lower in the groups with a high score in the stress level assessment scales (p < 0.001). GRα gene was expressed at lower levels in the group of peri-implantitis who had a high score in stress level assessment scales but the difference was not statistically significant (p = 0.065).

Conclusion: The study findings suggest that psychological stress may increase the inflammation associated with peri-implantitis by affecting cytokine expression levels.

Clinical relevance: To prevent peri-implantitis or reduce its prevalence, it could be beneficial to evaluate stress levels and identify individuals experiencing stress.

Keywords: Biomarkers; Peri-implantitis; Psychological stress; Saliva.

Fig. 1

mRNA expression levels of IL-1β, IL-6, IL-10, IFNα, α-amylase, GRα in saliva samples of healthy and peri-implantitis patient groups. Expression levels were relative to housekeeping gene β-actine. (***) p < 0.001 represents the significant difference