Evaluation of Stress and Salivary Neuropeptides in Periodontal Health and Disease Kiran Joseph Fernandez, Snophia Rani Suresh, Uma Sudhakar, Navina Ravindran, Archana Balakrishnan, S. Catherine Jean Journal of Interdisciplinary Dentistry, 2026 Background: Neuropeptides have been identified as pivotal regulators of periodontal inflammation. The primary objective of this study is to investigate the salivary and serum levels of substance P (SP), vasoactive intestinal peptide (VIP), and cortisol, aiming to elucidate their relationship with periodontal health and disease. In addition, it aims to explore the potential associations between these biomarkers, stress factors, and clinical periodontal parameters. Materials and Methods: A total of 90 individuals were recruited as a part of this study and categorized into Group I: healthy periodontium, Group II: nonsmokers with periodontitis, and Group III: smokers with periodontitis. The clinical parameters evaluated were gingival index, plaque index, probing pocket depth, and clinical attachment loss. Perceived Stress Scale (PSS) was evaluated by validated questionnaires. Serum and salivary expression of SP, VIP, and cortisol levels were estimated all the groups. Neuropeptides were estimated with enzyme-linked immunosorbent assay procedure, and the cortisol was estimated using electrochemiluminescent method. Results: Salivary SP and salivary and serum VIP levels were comparatively high in the generalized periodontitis with smokers (Group III) than in the generalized periodontitis (Group II) and healthy periodontium (Group I) groups, and the difference was statistically significant ( P = 0.001). Salivary cortisol levels and PSS scores were comparatively high in the generalized periodontitis with smokers (Group III) than in the generalized periodontitis (Group II) and healthy periodontium (Group I) groups, and the difference was statistically significant. Conclusion: Neuropeptides SP and VIP are modulated in periodontal disease. Smoking and stress may influence neurogenic inflammation in periodontitis by enhancing the local peptidergic innervation within the periodontium.
Monocyte-to-High-density Lipoprotein Cholesterol Ratio as a Novel Inflammatory Marker in Periodontal Disease: A Pilot Study T Sivasankari, Ebenezer Mani, Parthiban Saketharaman, TA Lalitha, Archana Balakrishnan, R Kadhiresan Journal of Contemporary Dental Practice, 2022 AIM The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) has currently been proposed as an indicator of inflammation. The aim of the present study was to assess the relationship between the monocyte-to-high-density lipoprotein cholesterol ratio and periodontal health and disease. MATERIALS AND METHODS A total of 90 patients were selected for the study - 30 healthy patients (group I) and 60 periodontitis patients (groups II and III). All the patients were subjected to blood sampling and serum malondialdehyde (MDA), high-density lipoprotein cholesterol (HDL) levels and monocyte counts were estimated. RESULTS Monocyte-to-high-density lipoprotein cholesterol ratio was 80.64 ± 28.71 for patients with moderate periodontitis (group II), 95.14 ± 53.21 in severe periodontitis (group III), and 14.28 ± 16.05 for the healthy patients. Monocyte-to-high-density lipoprotein cholesterol ratio values were found to be statistically significantly higher than the control group (p < 0.001). Monocyte-to-high-density lipoprotein cholesterol ratio also showed significantly positive correlation with the severity of periodontitis. CONCLUSION Malondialdehyde and MHR are increased in periodontal disease and correlate with severity of the periodontal disease. CLINICAL SIGNIFICANCE Monocyte-to-high-density lipoprotein cholesterol ratio is a novel, readily available inflammatory and oxidative stress marker in patients with periodontitis and can be useful to evaluate periodontitis and disease severity.
