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

本研究旨在探讨可摘局部义齿（RPD）缺失后牙合支持和修复后支持对人体应激和免疫系统的影响。首先，本研究纳入19名健康受试者。我们量化了在覆盖腭黏膜的实验性丙烯酸板（expi -plate）下放置不同厚度的钢板所引起的不适程度，试图模拟不合适的义齿。接下来，21例单侧或双侧臼齿（Eichner B2-B4, C1）缺失的患者参与了本研究。他们接受了3位牙医的义齿治疗。唾液收集的阶段是在治疗前的第一次就诊，以及在随后的每次就诊。他们都填写了状态-特质焦虑量表。用棉签（唾液棒）收集他们的唾液样本。采用ELISA试剂盒检测皮质醇、α-淀粉酶、免疫球蛋白A含量。使用重复测量的方差分析分析数据。皮质醇浓度和唾液α-淀粉酶活性显著高于未加exp板的大鼠（p<0.01）。免疫球蛋白的表达明显高于对照组，但差异无统计学意义。感到焦虑的受试者往往会增加唾液α-淀粉酶的活性水平。这些结果表明，不合适的假牙带来的疼痛和不适可能是压力的来源。患者在接受RPD治疗后，其唾液皮质醇、α-淀粉酶和免疫球蛋白A的浓度较其他时间明显下降。目前的数据表明，后牙合支持的丧失是压力来源的一个因素，治疗RPD应该减少压力。然而，由于这些结果可能涉及许多其他因素（个体特征，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.