Mental health disorders, particularly depression and anxiety, affect a significant number of the global population. Several pathophysiological pathways for these disorders have been identified, including the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and the immune system. In addition, life events, environmental factors, and lifestyle affect the onset, progression, and recurrence of mental health disorders. These may all overlap with periodontal and/or peri-implant disease. Mental health disorders are associated with more severe periodontal disease and, in some cases, poorer healing outcomes to nonsurgical periodontal therapy. They can result in behavior modification, such as poor oral hygiene practices, tobacco smoking, and alcohol abuse, which are also risk factors for periodontal disease and, therefore, may have a contributory effect. Stress has immunomodulatory effects regulating immune cell numbers and function, as well as proinflammatory cytokine production. Stress markers such as cortisol and catecholamines may modulate periodontal bacterial growth and the expression of virulence factors. Stress and some mental health disorders are accompanied by a low-grade chronic inflammation that may be involved in their relationship with periodontal disease and vice versa. Although the gut microbiome interacting with the central nervous system (gut-brain axis) is thought to play a significant role in mental illness, less is understood about the role of the oral microbiome. The evidence for mental health disorders on implant outcomes is lacking, but may mainly be through behaviourial changes. Through lack of compliance withoral hygiene and maintenance visits, peri-implant health can be affected. Increased smoking and risk of periodontal disease may also affect implant outcomes. Selective serotonin reuptake inhibitors have been linked with higher implant failure. They have an anabolic effect on bone, reducing turnover, which could account for the increased loss.

中文翻译：

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心理健康与牙周和种植体周围疾病

精神健康障碍，尤其是抑郁症和焦虑症，影响着全球大量人口。已经确定了这些疾病的几种病理生理途径，包括下丘脑-垂体-肾上腺轴、自主神经系统和免疫系统。此外，生活事件、环境因素和生活方式会影响心理健康障碍的发生、进展和复发。这些都可能与牙周和/或种植体周围疾病重叠。精神健康障碍与更严重的牙周病有关，在某些情况下，非手术牙周治疗的愈合效果较差。它们会导致行为改变，例如不良的口腔卫生习惯、吸烟和酗酒，这些也是牙周病的危险因素，因此，可能有促进作用。压力具有调节免疫细胞数量和功能以及促炎细胞因子产生的免疫调节作用。应激标记物如皮质醇和儿茶酚胺可调节牙周细菌的生长和毒力因子的表达。压力和一些精神健康障碍伴随着低度慢性炎症，这可能与它们与牙周病的关系有关，反之亦然。尽管与中枢神经系统（肠-脑轴）相互作用的肠道微生物组被认为在精神疾病中起着重要作用，但人们对口腔微生物组的作用知之甚少。精神健康障碍对植入结果的影响证据不足，但可能主要是通过行为改变。由于不遵守口腔卫生和维护检查，种植体周围的健康可能会受到影响。吸烟增加和牙周病风险增加也可能影响种植体结果。选择性血清素再摄取抑制剂与较高的植入失败率有关。它们对骨骼有合成代谢作用，减少周转，这可能是损失增加的原因。