SynthesisJournal of clinical periodontology2025
The Influence of Psychological Stress and Stress-Related Disorders in the Treatment Outcome of Periodontitis: A Systematic Review and Meta-Analysis.
Synthesis in Journal of clinical periodontology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Influence of Psychological Stress and Stress-Related Disorders in the Treatment Outcome of Periodontitis: A Systematic Review and Meta-Analysis.Journal of clinical periodontology · 2025Pooled it
- Salivary Cortisone as a Potential Alternative to Cortisol in Periodontitis Severity Assessment.International journal of molecular sciences · 2026Article
- The oral-gut-brain axis: how periodontitis influence depression.Frontiers in microbiology · 2026Review
- Alcohol intake patterns, stress exposures and oral health in treatment seeking individuals with alcohol use disorder.Frontiers in oral health · 2026Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveIn humans 16 years and above with periodontitis (Population), how do psychological stress and stress-related disorders (PSRD; Exposure) compared to those without PSRD (Comparison) affect clinical attachment level (CAL) upon periodontitis treatment (Outcome), as observed in experimental studies or descriptive pre-post studies (Study design)?
methodsFive major databases were searched for pre-post studies, descriptive cohort and quasi-experimental or randomised controlled trials (RCTs). For meta-analysis, mean differences in CAL and bleeding on probing (BOP) were pooled with random-effects models. Risk of bias, study quality and certainty of evidence were assessed.
resultsThirteen studies (eight prospective, two retrospective, two quasi-experimental and one pilot RCT) with 1610 participants were identified. PSRD (measured as stress in nine studies, depression in three studies and anxiety in one study) showed a negative influence on periodontitis treatment (steps 1 + 2: eight studies, steps 1 + 2 + 3 or 4: four studies, step 4: one study) outcomes. Meta-analysis of steps 1 + 2 treatment results revealed that patients with PSRD (exposure: stress)-compared to those without-had smaller reductions in CAL (three studies; n = 170; weighted mean difference (WMD) = 0.78 mm; p = 0.01) and probing pocket depth (PPD; three studies; n = 170; WMD = 1.02 mm; p = 0.04) following periodontitis treatment in studies.
conclusionPSRD adversely affected periodontitis treatment outcomes, particularly concerning CAL and PPD, even though our confidence in the effect estimate is limited in the case of CAL and very low in the case of PPD. This conclusion, based on small treatment cohorts and quasi-experimental studies following steps 1 + 2 of periodontitis treatment over a 3-6-month period, warrants validation through rigorously designed studies.
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