Abstract
<jats:p>Stress-induced disorders, including chronic psycho-emotional stress and post-traumatic stress disorder, are considered important contributors to the development of systemic metabolic, neuroendocrine, and immune-inflammatory disturbances. Over recent years, substantial evidence has accumulated demonstrating a close relationship between stress-associated conditions and oral pathology, particularly inflammatory and destructive periodontal diseases. The aim of this review was to summarize current knowledge regarding the role of systemic and local biochemical mechanisms in the development of oral pathology under conditions of stress-induced disorders. A systematic analysis of contemporary literature sources indexed in PubMed, Scopus, Web of Science, and the Cochrane Library was performed. This review summarizes current data regarding the involvement of the hypothalamic-pituitary-adrenal axis, systemic inflammation, oxidative-nitrosative stress, and redox-sensitive NF-κB and Nrf2 signaling pathways in the development of inflammatory and destructive changes in periodontal tissues. Chronic stress has been shown to be associated with excessive generation of reactive oxygen and nitrogen species, activation of inducible nitric oxide synthase, peroxynitrite accumulation, impairment of antioxidant defense systems, and extracellular matrix degradation mediated by matrix metalloproteinases. Particular attention was paid to the role of neuroimmune interactions, imbalance of the RANK/RANKL/OPG system, and osteoimmune mechanisms in the progression of alveolar bone resorption. The reviewed data indicate that oral pathology associated with stress-induced disorders results from the complex integration between systemic neuroendocrine disturbances and local tissue mechanisms. Promising directions for future research include the investigation of redox-sensitive signaling systems and the development of effective pathogenetically targeted approaches for correction of stress-associated periodontal tissue injury.</jats:p>