title: Estimation and comparison of serum cortisol levels in periodontally diseased patients and periodontally healthy individuals: A clinical-biochemical study.
abstract: BACKGROUND
  Psychological conditions, particularly psychosocial stress have been implicated as risk indicators of periodontal disease. Stress increases cortisol production from the adrenal cortex by stimulating an increase in the release of ACTH from the pituitary gland. Increased cortisol production suppresses the immune response and increases the potential of periodontal tissue destruction.
  
  
  OBJECTIVE
  The aim of the present study was to estimate and compare the serum cortisol levels in periodontally diseased patients and periodontally healthy individuals.
  
  
  METHODS
  Total of 45 subjects were recruited for this study and were categorized into three groups. Group I - Comprised of aggressive periodontitis patients (n = 15), Group II - Chronic periodontitis patients (n = 15), and Group III - Healthy controls (n = 15). Serum samples were collected from each of the groups and cortisol levels were determined using cortisol immunoassay kit. Clinical examination covered probing depth, gingival index (GI), gingival recession, plaque index, and clinical attachment level. The statistical analysis was done using nonparameteric t-test and Spearman's rank correlation coefficient.
  
  
  RESULTS
  With respect to cortisol, the levels were higher in Group-I compared to the other groups. On comparison of mean cortisol levels among the groups, the values were statistically significant between Group-I and Group-III. Group-I showed a significant negative correlation between cortisol levels and GI.
  
  
  CONCLUSIONS
  Within the limits of the study serum cortisol levels was higher in the chronic periodontitis group compared to the other groups. Positive correlation was found between the cortisol levels and other clinical parameters except for the GI.
authors.affiliation: Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, India.
authors.forename: G
authors.initials: G
authors.lastname: Rohini
authors.affiliation: Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, India.
authors.forename: S
authors.initials: S
authors.lastname: Kalaivani
authors.affiliation: Consultant Periodontist and Implantologist, Delhi, India.
authors.forename: Vipin
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Consultant Oral and Maxillofacial surgeon, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: S A
authors.initials: SA
authors.lastname: Rajasekar
authors.affiliation: Department of Periodontics, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Jaishree
authors.initials: J
authors.lastname: Tuckaram
authors.affiliation: Department of Conservative Dentistry and Endodontics, Rama Dental College, Kanpur, Uttar Pradesh, India.
authors.forename: Vinisha
authors.initials: V
authors.lastname: Pandey
keywords: Cortisol; periodontal disease; stress