Abstract
Background
The aim of this study was to evaluate the influence of psychological stress on non‐surgical periodontal treatment (SRP) outcomes in severe chronic periodontitis (stage 3/4 generalized periodontitis) patients at 6 months in the French population.
Methods
Patients diagnosed with severe generalized chronic periodontitis (periodontitis stage 3/4) were included in this study. At baseline, psychological status was evaluated by self‐administered questionnaire (Depression Anxiety Stress Scale 42 (DASS‐42) and Toulouse coping scale (TSC)). Plasma levels of cortisol and chromogranin‐A were determined. Patients were then managed by oral hygiene instructions, scaling and root planing of sites with PPD>3mm and followed at 3 and 6 months. Quantitative and qualitative variables were described and interactions were determined by linear and logistic regressions.
Results
Seventy‐one patients were included in this study and 54 were followed up to 6 months. An average PPD reduction of 0.73+/‐0.11mm and decrease of diseased sites (PPD>3mm) were measured at 6 months illustrating SRP efficacy. Multivariable analysis showed that increased DASS‐stress score was associated to worsened SRP outcomes in terms of BOP (OR = 1.02, p <0.05) and mean PPD (p <0.05) reduction. An increase of DASS‐depression score negatively influenced PPD>5mm (OR = 1.06, p <0.05), PPD>7mm (OR = 1.17, p <0.01), CAL>5mm (OR = 1.03, p <0.05) and CAL>7mm (OR = 1.07, p <0.05) reduction. Negative coping strategies were also associated with worsened SRP outcomes.
Conclusions
Patients with increased stress, anxiety and depression scores as well as those exhibiting negative coping strategies demonstrate worsened SRP outcomes. DASS‐42 and TSC were useful to determine psychological status and their use could be incorporated to assess treatment prognosis.
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https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.20-0105?af=R
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