IL1B and adrenal gland hyperfunction: They considered that periodontitis leads to the release of proinflammatory cytokines such as interleukin (IL)-1β, IL-6, and tumor necrosis factor into systemic circulation, and that psychological stress in patients with periodontitis promotes disturbances in the hypothalamic–pituitary–adrenal (HPA) axis and related hypercortisolism.