The Influence of Anxiety on Gingival Inflammation, Attachment Level and Inflammatory Markers in GCF from Subjects with Periodontal Disease

During the past decade psychological stress has been associated with an increased risk for periodontal disease (Kurer et al, 1995; Linden et al, 1996; Croucher et al, 1997; Deinzer et al, 1998; Genco et al, 1999; Hugosson et al, 2002; Pistorius et al, 2002; Vettore et al, 2003). While the mechanism for a possible association is poorly understood and has not yet been securely established, several mechanisms of action have been suggested. One possibility is an over-production of pro-inflammatory mediators in the local inflammatory lesions (Genco et al, 1998). Pro-inflammatory mediators such as prostaglandin E2 (PGE2), interleukin 1β (IL-1β) and tumor necrosis factor (TNFα) have been associated with an increased risk of periodontal disease (Hart and Kornman, 1997). PGE2, has been implicated both in bone loss and in loss of attachment (Offenbacher The Influence of Anxiety on Gingival Inflammation, Attachment Level and Inflammatory Markers in GCF from Subjects with Periodontal Disease