An observational study in Periodontitis, Bruxism and Perceived Stress, sponsored by Postgraduate Institute of Dental Sciences Rohtak. Not yet recruiting at 1 site in India. Open to participants aged 30 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-06-02.
Sponsored by Postgraduate Institute of Dental Sciences Rohtak · Observational
The present study aims to evaluate psychological resilience as a modifier of the relationship between perceived stress and periodontal status among bruxers. Given that both stress and inflammation share common neuroendocrine and immunological pathways, resilience may play a crucial role in buffering stress-induced periodontal breakdown. Understanding this relationship could shift periodontal management toward a biopsychosocial model, integrating psychological assessment and resilience enhancement with conventional non-surgical therapy. Such insights could help design personalized periodontal care strategies addressing both biological and psychological determinants of disease progression.
Periodontitis has been defined by the 2018 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions as "a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth supporting apparatus". The disease represents one of the most prevalent chronic conditions globally and is a leading cause of tooth loss in adults. The pathogenesis involves a complex interplay between microbial challenge, host immune-inflammatory responses, and modifying environmental, systemic and psychosocial factors. Although bacterial biofilm is a necessary etiological factor, it is the host response that determines disease progression or stability. Among several modifying influences, psychosocial stress has gained increasing attention in periodontal research. Chronic stress leads to sustained activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary system, resulted in elevated cortisol and cathecholamine. These neuroendocrine mediators exert profound effects on immune regulation, enhancing pro-inflammatory cytokine production, impairing neutrophil function, and delaying wound healing. In the periodontium, such dysregulation may potentiate tissue breakdown by amplifying inflammatory cascades and reducing reparative capacity.
Several studies have demonstrated a positive association between perceived psychosocial stress and periodontal disease severity, including increased probing depth, attachment loss, and bleeding on probing. Furthermore, stress can indirectly influence oral health through behavioral pathways such as poor oral hygiene, smoking, bruxism, and altered diet. Despite this, not all individuals exposed to similar stress levels exhibit equivalent periodontal destruction, indicating the presence of psychological moderators that buffer or modify stress effects.
One such factor is psychological resilience, defined as "a measure of stress-coping ability and a personal quality that enables one to thrive in the face of adversity".It reflects an individual's ability to maintain or regain mental health and functional stability despite adversity. Resilience is shaped by cognitive, emotional, and social components that promote adaptive coping and self-regulation. High resilience has been linked to better immune regulation, lower inflammatory markers such as C-Reactive protein and Interleukin-6, and faster recover from stress induced physiological changes.
Moreover, behavioural factors such as stress related parafunctional activity bruxism, characterized by repetitive jaw-muscle activity involving clenching or grinding of teeth and/or bracing or thrusting of the mandible. The excessive and repetitive forces associated with bruxism may exert traumatic effects on tooth supporting structures and are considered an important cofactor in the progression of periodontal breakdown.
Emerging evidence in behavioral medicine suggests that resilience can moderate the relationship between perceived stress and health outcomes, attenuating the physiological and behavioral impacts of chronic stress. In dentistry, however, this construct remains underexplored. No study have assessed how resilience interacts with stress to influence periodontal status among bruxers. Given that both stress and inflammation share common neuroendocrine and immunological pathways, resilience may play a crucial role in buffering stress-induced periodontal breakdown in bruxers.
Understanding this relationship could shift periodontal management toward a biopsychological model, integrating psychological assessment and resilience enhancement with conventional non-surgical therapy. Therefore, the present study aims to evaluate psychological resilience as a modifier of the relationship between perceived stress and periodontal status among bruxers. Such insights could help designed personalized periodontal care strategies addressing both biological and psychological determinants of disease progression.
1,231 studies on the registry are indexed under Periodontitis; 295 are open to participants now.
This study's planned enrollment of 75 is below the median of 90 across 372 observational studies indexed under Periodontitis.
Browse Periodontitis studies →Postgraduate Institute of Dental Sciences Rohtak is the lead sponsor of 213 studies on the registry; 72 are open to participants now.
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The study population will be drawn from patients reporting to the outpatient clinic of department of Periodontics at PGIDS, Rohtak on the basis of strict inclusion and exclusion criteria
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Autoimmune disease
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Corticosteroids (steroids)
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients aged 30-50 years with probable bruxism based on self report and clinical examination using Bruxscreen questionnaire. Participants underwent assessment of perceived stress using the perceived stress scale, pyschological resilience using Connor-Davidson Resilience scale, and periodontal health status via pocket probing depth, clinical attachment level, bleeding on probing, gingival index and plaque index.
Other: Resilience assessment
Psychological resilience and perceived stress was assessed using questionaires
Psychological Resilience
Participants will complete validated questionnaire using Connor-Davidson Resilience Scale (CD-RISC-10) to assess psychological resilience. 10 Items using 5-point Likert scale from 0 = not true at all to 4 = true nearly all the time. Minimum score:0, maximum score: 40. Higher score indicates greater psychological resilience.
Time frame: Baseline
Perceives Stress Scale
Perceived stress scale will be assessed using perceived stress scale-10 item version questionnaire. 10 items using 5 point Likert scale 0= never to 4= very often. Minimum score: 0, maximum score: 40. Higher score indicate greater perceived stress.
Time frame: baseline
Plan to share: No
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Start is estimated for Jun 2026; primary completion for Dec 2026, 6 months later.
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