Comparison of Salivary Stress Biomarkers in Patients with and without Periodontal Diseases: A Cross-sectional Study.

PURPOSE: This study aimed to evaluate the salivary concentrations of cortisol (Cort), chromogranin A (CgA), and alpha-amylase (sAA) in periodontally healthy individuals and individuals with periodontal disease, and to investigate their association with perceived psychological stress, as measured by the Perceived Stress Scale (PSS). MATERIALS AND METHODS: The study included 400 participants aged ≥18 years (117 healthy participants, 140 with gingivitis, and 143 with periodontitis). Unstimulated salivary samples were collected from 90 participants systematically randomized from the 400 enrolled in this study. Subsequently, psychological stress was assessed using the PSS, and periodontal parameters were recorded. The ELISA test was used to measure salivary levels of Cort, CgA, and sAA. RESULTS: The means of salivary cortisol concentrations were 33.54 (± 3.77 ng/ml) in controls, 65.89 (± 16.41 ng/ml) and 47.06 (± 4.55 ng/ml) in the gingivitis and periodontitis groups, respectively. Mean CgA concentrations were 724.75 (± 90.70 pg/ml) in controls, 1133.47 (± 302.49 pg/ml) in gingivitis, and 1526.30 (± 433.81 pg/ml) in periodontitis. Additionally, the mean of sAA levels was 24.40 (± 6.91 ng/ml) in the control group, 31.44 (± 3.91 ng/ml) and 34.13 (± 5.64 ng/ml) in the gingivitis and periodontitis groups, respectively. PSS scores were considerably higher in individuals with periodontal disease than in healthy controls. CONCLUSION: Salivary levels of Cort, CgA, and sAA were elevated in individuals with periodontal disease compared to healthy controls. These biomarkers may serve as supportive indicators in the assessment of periodontal disease. However, further studies are required to validate these findings.