Exploring the periodontal disease—ischemic stroke link

Sen, Souvik; Mascari, Rachel

doi:10.1002/jper.20-0138

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Prior studies have reported an association between PD and ECAS as well as aortic arch atherosclerosis [16, 18]. However, limited data to date support the PD-ICAS link [30]. To our knowledge, this may be one of the first studies to report an association between PD measured as specific PD stages and ICAS-driven ischemic stroke.…”

Section: Discussionmentioning

confidence: 59%

Association of Dental Infections with Intracranial Atherosclerotic Stenosis

Sen¹,

Meyer²,

Mascari³

et al. 2023

Cerebrovasc Dis

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Introduction: Periodontal disease (PD) and dental caries are oral infections leading to tooth loss that are associated with atherosclerosis and cerebrovascular disease. We assessed the hypothesis that PD and caries are associated with asymptomatic intracranial atherosclerosis (ICAS) in the Atherosclerosis Risk in Communities (ARIC) study. Methods: Full-mouth clinical periodontal measurements (7-indices) collected at 6 sites per tooth from 6155 subjects from the Dental Atherosclerosis Risk in Communities Study (DARIC) without prior stroke were used to differentiate seven periodontal disease stages (PPC-I to VII) and dental caries on coronal dental surface (DS) and dental root surface (DRS). All participants who had a previous brain MRI were eligible for imaging. A stratified subset underwent 3D time-of-flight MR angiogram and 3D high isotropic resolution black blood MRI. ICAS was graded according to the criteria established by the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial. We evaluated the relationship between PD stage and dental caries with asymptomatic ICAS, graded as no ICAS, <50% ICAS, and ≥50% ICAS. Results: Among dentate subjects who underwent vascular imaging, 801 (70%) had no ICAS, 232 (20%) had <50% ICAS, and 112 (10%) had ≥50% ICAS. Compared to participants without gum disease (PPC-I), participants with mild-moderate tooth loss (PPC-VI), severe tooth loss (PPC-VII), and severe PD (PPC-IV) had higher odds of having <50% ICAS. Participants with extensive gingivitis (PPC- V) had significantly higher odds of having ≥50% ICAS. The association remained significant after adjusting for confounding variables: age, gender, race, hypertension, diabetes, dyslipidemia, 3-level education, and smoking status. There was no association between dental caries (DS and DRS) and ICAS <50% and ≥50%. Conclusion: We report significant associations between mild-moderate tooth loss, severe tooth loss and severe PD with <50% ICAS as well as an association between gingivitis and ≥50% ICAS. We did not find an association between dental caries and ICAS.

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Section: Discussionmentioning

confidence: 59%

Association of Dental Infections with Intracranial Atherosclerotic Stenosis

Sen¹,

Meyer²,

Mascari³

et al. 2023

Cerebrovasc Dis

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“…This report opens the prelude to studying the relationship between periodontitis and ischemic stroke. Over the past 30 years, several case-control studies, cross-sectional studies, and cohort studies have confirmed this association ( 8 – 12 ). A 15-year follow-up community cohort study of 10,362 stroke-free participants found an independent association between periodontal disease and stroke risk, and that regular oral periodontal care reduced the risk of stroke ( 13 ).…”

Section: Introductionmentioning

confidence: 82%

The oral microbiome of patients with ischemic stroke predicts their severity and prognosis

et al. 2023

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Background and objectivesStroke is a common group of cerebrovascular diseases that can lead to brain damage or death. Several studies have shown a close link between oral health and stroke. However, the oral microbiome profiling of ischemic stroke (IS) and its potential clinical implication are unclear. This study aimed to describe the oral microbiota composition of IS, the high risk of IS, and healthy individuals and to profile the relationship between microbiota and IS prognosis.MethodsThis observational study recruited three groups: IS, high-risk IS (HRIS), and healthy control (HC) individuals. Clinical data and saliva were collected from participants. The modified Rankin scale score after 90 days was used to assess the prognosis of stroke. Extracted DNA from saliva and performed 16S ribosomal ribonucleic acid (rRNA) gene amplicon sequencing. Sequence data were analyzed using QIIME2 and R packages to evaluate the association between the oral microbiome and stroke.ResultsA total of 146 subjects were enrolled in this study according to the inclusion criteria. Compared with HC, HRIS and IS demonstrated a progressive increase trend in Chao1, observed species richness, and Shannon and Simpson diversity index. On the basis of permutational multivariate analysis of variance, the data indicate a great variation in the saliva microbiota composition between HC and HRIS (F = 2.40, P < 0.001), HC and IS (F = 5.07, P < 0.001), and HRIS and IS (F = 2.79, P < 0.001). The relative abundance of g_Streptococcus, g_Prevotella, g_Veillonella, g_Fusobacterium, and g_Treponema was higher in HRIS and IS compared with that in HC. Furthermore, we constructed the predictive model by differential genera to effectively distinguish patients with IS with poor 90-day prognoses from those with good (area under the curve = 79.7%; 95% CI, 64.41%–94.97%; p < 0.01).DiscussionIn summary, the oral salivary microbiome of HRIS and IS subjects have a higher diversity, and the differential bacteria have some predictive value for the severity and prognosis of IS. Oral microbiota may be used as potential biomarkers in patients with IS.

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“…A contribuição da periodontite para a ocorrência do acidente vascular cerebral isquêmico pode ser indiretamente mediante mecanismos inflamatórios (Sen et al, 2018;O'Boyle et al, 2020). Doenças inflamatórias crônicas, incluindo gengivite e periodontite, vêm sendo demonstradas como fatores envolvidos no desenvolvimento de doenças cardiovasculares e risco de acidentes vasculares cerebrais (Beck et al, 1996;Beck, & Offenbacher, 2001;Scannapieco, Bush, & Paju, 2003;Chi et al, 2019;Lin et al, 2019;O'Boyle et al, 2020;Sen, & Mascari, 2020). Estudos ressaltam que a periodontite e a perda dentária estão associados com os índices de ocorrência de AVC isquêmicos (Söder, Meurman, & Söder, 2015;Sen, & Mascari, 2020).…”

Section: Introductionunclassified

“…Doenças inflamatórias crônicas, incluindo gengivite e periodontite, vêm sendo demonstradas como fatores envolvidos no desenvolvimento de doenças cardiovasculares e risco de acidentes vasculares cerebrais (Beck et al, 1996;Beck, & Offenbacher, 2001;Scannapieco, Bush, & Paju, 2003;Chi et al, 2019;Lin et al, 2019;O'Boyle et al, 2020;Sen, & Mascari, 2020). Estudos ressaltam que a periodontite e a perda dentária estão associados com os índices de ocorrência de AVC isquêmicos (Söder, Meurman, & Söder, 2015;Sen, & Mascari, 2020). Devido a essa intima relação se devem estabelecer os grupos populacionais de risco para a doença periodontal, e que esta inflamação crônica possa aumentar a probabilidade de ocorrência do Acidente Vascular Cerebral (AVC) (Díaz, & Aguiar, 2016;Sen et al, 2018).…”

Section: Introductionunclassified

Estudo da prevalência de alterações periodontais em pacientes acometidos por acidente vascular cerebral isquêmico

Cardoso

Couto

et al. 2021

RSD

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A doença periodontal é uma doença inflamatória crônica causada por colonização de patógenos que afeta os tecidos de sustentação e suporte dos dentes. A contribuição da periodontite para a ocorrência do acidente vascular cerebral isquêmico pode ser indiretamente relacionada mediante mecanismos inflamatórios. O objetivo deste estudo foi verificar a prevalência de alterações periodontais em pacientes acometidos por Acidente Vascular Cerebral Isquêmico (AVC). Trata-se de um estudo transversal, observacional em que foram avaliados a doença periodontal por meio de sondagem periodontal e do diagnóstico da doença periodontal em 20 voluntários que ingressaram na Fundação de Beneficência Hospital de Cirurgia no ano de 2020. Como resultados tem-se que dos avaliados 10 eram do gênero feminino, com idade média de 68,2 (± 10,2). Destes, 95% tinham o AVC a menos de 1 ano, 60% era o primeiro histórico da doença, 90% eram hipertensos e 60% diabéticos, 95% não tomavam medicamentos hiperplasiantes, 45% tinham o primeiro grau de estudo e 70% tinham ido ao dentista a mais de 1 ano. Sobre a doença periodontal 80% tinham diagnóstico de doença periodontal generalizada, 35% no estágio IV e 65% no grau B. Conclui-se que a doença periodontal se mostrou prevalente entre os avaliados, podendo ser características de processos associados ao AVC.

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Exploring the periodontal disease—ischemic stroke link

Cited by 4 publications

References 14 publications

Association of Dental Infections with Intracranial Atherosclerotic Stenosis

Association of Dental Infections with Intracranial Atherosclerotic Stenosis

The oral microbiome of patients with ischemic stroke predicts their severity and prognosis

Estudo da prevalência de alterações periodontais em pacientes acometidos por acidente vascular cerebral isquêmico

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