Evaluation of Salivary Cortisol Levels and Periodontal Inflammation during Fixed Orthodontic Treatment: A Prospective Clinical Study
DOI:
https://doi.org/10.48165/ajm.2026.9.01.48Keywords:
Salivary cortisol, Orthodontic treatment, Periodontal inflammationAbstract
Background: Orthodontic treatment is associated with both physical and psychological stress, which may influence periodontal health through inflammatory changes. Salivary cortisol is considered a reliable biomarker for evaluating stress responses during orthodontic therapy. Aim: To evaluate salivary cortisol levels and their association with periodontal inflammation during fixed orthodontic treatment. Materials and Methods: This prospective clinical study was conducted among 30 patients undergoing fixed orthodontic treatment. Periodontal parameters including Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were assessed at baseline, 24 hours after appliance activation, and one month after treatment initiation. Unstimulated saliva samples were collected at each interval and analyzed for salivary cortisol levels using Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analysis was performed to evaluate changes in cortisol levels and periodontal parameters and their correlation. Results: An increase in salivary cortisol levels and periodontal inflammatory parameters was observed following orthodontic appliance activation, particularly during the initial phase of treatment. A positive correlation was noted between elevated cortisol levels and periodontal inflammation. Conclusion: Fixed orthodontic treatment may induce transient stress-related increases in salivary cortisol levels, which may be associated with mild periodontal inflammatory changes. Assessment of stress biomarkers alongside periodontal monitoring may aid in improving orthodontic treatment outcomes.
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