Periodontal nitric oxide pathway alteration due to precompetition anxiety in handball players

Psychologic and physical stress is known to be related with periodontal disorders. The objective of this study is to investigate salivary and gingival crevicular fluid (GCF) nitric oxide (NO) metabolism and its association with the periodontal reaction to precompetition anxiety in competitive athletes.

A total of 18 elite male handball players participated in this study. The anxiety level of participants was determined by using a competitive state anxiety inventory-2 (CSAI-2). Periodontal clinical measurements, saliva, and GCF samples were obtained before the application of the CSAI-2 during the half-season break and just before the league championship match. NO-level, arginase, and NO synthase (NOS) activities were analyzed in saliva samples; NO and basic fibroblast growth factor (FGF-b) levels were analyzed in GCF samples.

The CSAI-2 was significantly different between the two evaluation time points. GCF NO and FGF-b levels increased before the championship match, whereas saliva levels did not change. The plaque index and gingival index (GI) increased at the evaluation just before the championship match. The difference in the GI was statistically significant.

The competitive stress of athletes may lead to a gingival/periodontal disturbance accompanied by an altered NO metabolism in saliva and GCF.