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. Author manuscript; available in PMC: 2021 Jan 1.
Published in final edited form as: Clin Oral Investig. 2019 Nov 1;24(1):1–12. doi: 10.1007/s00784-019-03089-3

Figure 2:

Figure 2:

Adrenergic control of bone remodeling in the progression of periodontal disease is complex and guided by many local and systemic factors. Stress-related disorders function through a two-fold process to affect bone mass and remodeling: 1) hypothalamic/adrenal cortex/cortisol signaling axis and 2) Direct adrenergic nerve signaling, which collectively affects immune capacity, alters inflammatory signaling, and disrupts the bone remodeling balance.