Abstract
The null hypothesis was that there is no difference in whole salivary cortisol levels (CL) and peri-implant health status among adults with and without a diagnosis of mental health disorders (MHD). The aim was to assess whole salivary CL and peri-implant health status among adults with and without MHD. The inclusion criteria were: (a) adults with at least one dental implant in function for at least one year; (b) adults with and without a diagnosis of MHD. Patients were divided into two-groups: (a) patients with depression (test-group); and (b) patients without MHD (control-group). Information on duration and treatment of depression and implant-related parameters were recorded. Periodontal parameters (plaque and gingival indices [PI and GI], probing depth (PD), clinical attachment loss [CAL] and marginal bone loss [MBL]) were measured. Peri-implant modified plaque and gingival indices (mPI and mGI), PD and crestal bone loss (CBL) were also recorded. Whole salivary cortisol levels were assessed in unstimulated whole saliva. Group comparisons were done and level of significance was set at P < 5%. Sixty-five individuals (33 and 32 in the test and control-groups, respectively) were included. Peri-implant mPI (P < 0.01), mGI (P < 0.01), PD (P < 0.01) and mesial (P < 0.01) and distal (P < 0.01) CBL were higher in the test than control group. Scores of full -mouth PI (P < 0.01), GI (P < 0.01), PD (P < 0.01), CAL (P < 0.01) and mesial (P < 0.01) and distal (P < 0.01) MBL were higher in the test than the control group. Unstimulated whole salivary flow rate was higher in the control than in the test group (P < 0.01). Whole salivary CL were higher in the test than in the control group (P < 0.01). There was a correlation between periodontal and peri-implant PD and whole salivary CL (P < 0.05) in the test group. Patients with MHD are more prone to peri-implant diseases compared to healthy individuals, with inadequate oral hygiene maintenance being the main contributing factor in the former group. Patients with MHD are more prone to periodontal and peri-implant diseases; and poor routine oral hygiene maintenance plays a critical role in this regard.