Background: The aim of the present study was to investigate the importance of stress for the development of periodontitis by comparing oral health status, proinflammatory markers, and cortisol in gingival crevicular fluid (GCF) and saliva in patients with stress‐related mental depression and controls.Methods: The participants consisted of 43 women with stress‐related depression and exhaustion (Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM‐IV]), with a mean age of 42.0 (±9.3 SD) years, and 29 controls, with a mean age of 54.5 (±2.9 SD) years. Clinical examination included the assessment of dental plaque, gingival inflammation (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of teeth. GCF was collected with an intracrevicular washing technique from four sites in each subject. Interleukin (IL)‐1β, IL‐6, and matrix metalloproteinase‐9 were determined with enzyme‐linked immunosorbent assay and cortisol with radioimmunoassay (¹²⁵I RIA). Analysis of covariance (one‐way covariance analyses) was used to remove the influence of age and smoking.Results: The amount of plaque was significantly higher in patients compared to controls (P <0.003). The patients had an average GI of 1.53 (±0.13 SD) compared to 0.89 (±0.10 SD) for the controls (P <0.001). The levels of cortisol in GCF was significantly higher in patients than in controls, 3.46 nmol/l (±3.25 SD) and 0.30 nmol/l (±0.25 SD), respectively (P <0.001), whereas cortisol in saliva did not differ between groups. The levels of IL‐6 in GCF were significantly higher in the patients than in controls (P <0.05).Conclusion: Women with stress‐related depression and exhaustion had more plaque accumulation, GI, and increased levels of IL‐6 and cortisol in GCF compared to normal controls, suggesting that depression might affect immune function, which could lead to impaired periodontal health.

Background: The aim of the present study was to evaluate the adjunctive effect of the local application of a hyaluronan gel to scaling and root planing in the treatment of chronic periodontitis.Methods: Twelve patients with chronic periodontitis were recruited to participate in a study with a split‐mouth design and provided informed consent. Plaque formation and bleeding on probing were evaluated pretreatment (baseline) and at 1, 4, and 12 weeks post‐treatment. Probing depths and attachment levels were evaluated at baseline and at 12 weeks. The patients received full‐mouth scaling and root planing. A hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the paired t test, repeated‐measures analysis of variance (Wilks lambda), and a non‐parametric Wilcoxon signed‐rank test.Results: A significant reduction in bleeding on probing scores and probing depths was observed in both groups at 12 weeks (P <0.05). Significantly lower bleeding on probing scores were observed in the hyaluronan group compared to control at 12 weeks (P <0.05). Mean probing depth reductions between baseline and 12 weeks were 1.0 ± 0.3 mm and 0.8 ± 0.2 mm for the hyaluronan and control groups, respectively. The difference between the groups was statistically significant (P <0.05).Conclusion: The local application of hyaluronan gel in conjunction with scaling and root planing may have a beneficial effect on periodontal health in patients with chronic periodontitis.

The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.