Influence of loss of posterior occlusal support on Stress Hormone and Immunoglobulin in Saliva

本研究的目的是阐明后牙合支持丧失和可摘局部义齿(RPD)修复支持对人体应激和免疫系统的影响。为了模拟不合适的义齿，我们量化了不同厚度的托板放置在覆盖腭部粘膜的试验性亚克力托板(EXP托板)下所引起的不适程度。接下来，21名单侧或双侧磨牙缺失的患者(Eichner B2-B4，C1)参与了这项研究。他们接受了3名牙医的义齿治疗。唾液采集的阶段是在第一次就诊和随后每次就诊时的治疗前。所有人都填写了状态-特质焦虑量表。用棉花卷(唾液)收集他们的唾液样本。用酶联免疫吸附试验试剂盒检测皮质醇、α-淀粉酶和免疫球蛋白A。对数据进行重复测量的单因素方差分析。使用试验板的皮质醇浓度和唾液α-淀粉酶活性显著高于不使用试验板的(p&lt；0.01)。免疫球蛋白随实验时间的延长而增大。钢板组优于无钢板组，差异无统计学意义。感到焦虑的受试者往往会增加唾液中α-淀粉酶的活性水平。当患者接受义齿修复并满意时，唾液皮质醇、α-淀粉酶和免疫球蛋白A的浓度较其他修复义齿时显著降低。目前的数据表明，丧失后牙合支持是压力的一个因素，义齿修复治疗应该减轻压力。然而，由于这些结果可能涉及许多其他因素(个人特征、他们的生活方式等)，因此需要一个新的实验模型来进行分析。

The purpose of this study is to elucidated influences of loss of posterior occlusal support and restored support by removable partial dentures (RPD) on stress and immune system in human.First, nineteen healthy subjects were included in this study. We quantified the degree of discomfort induced by plates of different thicknesses placed under an experimental acrylic plate (exp-plate) covering the palatal mucosa in an attempt to model ill-fitting dentures.Next, Twenty-one patients whose unilateral or bilateral molar teeth were missing (Eichner B2-B4, C1) were participated in this study. They were treated their denture by 3 dentists. The stages of saliva collection were just before treatment at first visit, and at each subsequent visit. All of them filled out the State-Trait Anxiety Inventory.A cotton roll (salivette) was to collect their saliva sample. Cortisol, α-amylase and immunoglobulin A were measured by ELISA kit. The data were analyzed using an ANOVA with repeated measures.The concentrations of cortisol and salivary α-amylase activity were significantly greater with exp-plate than without exp-plate (p<0.01). The immunoglobulin was greater with exp. plate than without exp-plate, which was not shown statistic significant. Subjects who feel anxious tend to increase their salivary α-amylase activity levels. These results suggest that the pain and discomfort from an ill-fitting denture can be the source of stress.When the patients were provided the RPD and satisfied with their RPD, the concentration of salivary cortisol, α-amylase and immunoglobulin A decreased significantly compare with those at the other visits.The present data suggest that loss of posterior occlusal support was a factor for a source of stress and that treatment of RPD should reduce the stress. However, as these results might involve many other factors (individual characteristics, their life style, etc.), a new experimental model should be required for the analysis.