Psychological Status’ Influence on Non-surgical Treatment of Chronic Periodontitis

Objectives: Stress, depression, anxiety have been described as having potential influence on periodontal treatment outcomes. However, it seems difficult for the clinician to clearly evaluate patient’s psychological status and the impact of such psychological traits on non-surgical periodontal treatment outcomes in severe chronic periodontitis patients. The aim of this prospective cohort study was to evaluate the impact of psychological parameters on treatment outcomes at 6 months.
Methods: 50 patients diagnosed with severe chronic periodontitis were included in this study. All patients were healthy and did not take any medications during the follow-up. Non-surgical periodontal treatment was performed at baseline and evaluation of psychological parameters using different questionnaires (DASS-42 ; BDI ; STAI ; coping strategies) has been performed at baseline, 3 and 6 months. Plasma levels of cortisol and chromogranin A were also evaluated. Furthermore, the coping strategies developed by the patient in relation with stressful events seems also to influence therpaeutic outcomes.
Results: Non-surgical periodontal treatment improved periodontal parameters at 3 and 6 months (PD, CAL, BOP, PI). Interestingly, levels of anxiety and depression evaluated by DASS-42, BDI STAY questionnaires were associated with reduced periodontal treatment outcomes regarding PPD reduction at 6 months. (Posterior probability of a strictly negative time-variable interaction was greater than 99%. OR were calculated for dichotomous outcomes and 95 % credibility intervals were estimated from the posterior distribution). Periodontal treatment outcomes were also influenced by plasma levels of cortisol and chromogranin-A.
Conclusions: Psychological status of patients seems to influence negatively periodontal treatment outcomes. However, the evaluation of psychological status by the clinician remains difficult. The use of specific biological markers in combination with questionnaires may be interesting to quantify the impact of this risk factor on periodontal treatment outcomes.