Chronic stress is a relevant disease to periodontal practice, encompassing 25%-28% of the US population (American Psychological Association 2015). While it is well established that chronic psychologic stress can have significant deleterious systemic effects, only in recent decades have we begun to explore the biochemical, microbial, and physiologic impacts of chronic stress diseases on oral tissues. Currently, chronic stress is classified as a “risk indicator” for periodontal disease. However, as the evidence in this field matures with additional clinically controlled trials, more homogeneous data collection methods, and a better grasp of the biologic underpinnings of stress-mediated dysbiosis, emerging evidence suggests that chronic stress and related diseases (depression, anxiety) may be significant contributing factors in periodontal/peri-implant disease progression and inconsistent wound healing following periodontal-related therapeutics. Ideal solutions for these patients include classification of the disease process and de-escalation of chronic stress conditions through coping strategies. This paper also summarizes periodontal/implant-related therapeutic approaches to ensure predictable results for this specific patient subpopulation.

中文翻译：

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慢性压力相关疾病、牙周/种植体周围疾病和伤口愈合之间的心理生物学联系


慢性压力是一种与牙周治疗相关的疾病，覆盖了 25%-28% 的美国人口（美国心理学会 2015）。虽然众所周知，慢性心理压力可能会产生显着的有害全身影响，但直到最近几十年，我们才开始探索慢性压力疾病对口腔组织的生化、微生物和生理影响。目前，慢性压力被列为牙周病的“风险指标”。然而，随着该领域的证据随着更多的临床对照试验、更同质的数据收集方法以及对压力介导的生态失调的生物学基础的更好掌握而成熟，新的证据表明慢性压力和相关疾病（抑郁、焦虑）可能是牙周/种植体周围疾病进展和牙周相关治疗后伤口愈合不一致的重要因素。这些患者的理想解决方案包括对疾病过程进行分类，并通过应对策略缓解慢性压力状况。本文还总结了牙周/种植体相关的治疗方法，以确保该特定患者亚群的可预测结果。