ANALYSIS OF SALIVARY CORTISOL LEVELS IN PATIENTS AT DIFFERENT STAGES OF ORTHODONTIC TREATMENT WITH FIXED APPLIANCE SYSTEMS AND VARYING LEVELS OF TRAIT ANXIETY
DOI:
https://doi.org/10.11603/2311-9624.2026.2.16431Keywords:
dentistry, orthodontic patients, fixed orthodontic treatment, psycho-emotional state, anxiety, cortisol, statistical patternsAbstract
One of the most common and effective modern approaches is treatment with fixed orthodontic appliances; however, certain stages of such treatment are accompanied by a pronounced pain syndrome. The stages of orthodontic therapy also induce a marked general adaptive stress response, reflected in increased cortisol activity. At the same time, direct tooth movement is not always associated with significant changes in biochemical markers of pain and stress, which highlights the need for further research to clarify the diagnostic value of salivary biomarkers in predicting individual patient responses to orthodontic treatment.
Objective. To analyze the relationship between cortisol concentration in oral fluid and the level of personal anxiety in patients undergoing different stages of orthodontic treatment with fixed appliances.
Materials and Methods. The study included 60 patients treated at the LLC “University Dental Clinic” in Uzhhorod (27 males – 45 % and 33 females – 55 %) who were undergoing orthodontic treatment with fixed appliances (bracket systems). The level of personal and reactive anxiety was assessed using the Spielberger Anxiety Scale adapted by L. Khanin. In all patients, salivary cortisol levels were measured at 1, 7, and 30 days after appliance placement using an enzyme-linked immunosorbent assay (ELISA).
Results. A high level of personal anxiety predominated among the examined patients, observed in 63.3 % (38 individuals). Comparative analysis between gender groups demonstrated a statistically significantly higher prevalence of high personal anxiety in females compared to males (75.8 % and 48.2 %, respectively; p < 0.05). Significant differences in salivary cortisol levels were found over time in all patients, namely an increase at day 7 followed by a further increase at day 30 compared to day 1 after bracket placement (P < 0.05), both in the overall sample and in female (P < 0.05) and male (P < 0.05) groups. Differences in salivary cortisol levels between female and male groups were observed at all time points.
Conclusions. The study of salivary biomarkers represents a promising direction in predictive dentistry. High anxiety serves as a marker of increased salivary cortisol levels in patients undergoing orthodontic treatment with fixed appliances. Female sex is a predictor of increased salivary cortisol levels during orthodontic treatment with fixed appliances.
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