Is an Oral Health Status a Predictor of Functional Improvement in Ischemic Stroke Patients Undergoing Comprehensive Rehabilitation Treatment?

Gerreth, Piotr; Gerreth, Karolina; Maciejczyk, Mateusz; Hojan, Katarzyna

doi:10.3390/brainsci11030338

Cited by 13 publications

(9 citation statements)

References 59 publications

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“…The oral examination was performed in a separate room, subsequently after sampling of saliva. The dentition was assessed in artificial light, using a plain mouth mirror and a dental probe, following the World Health Organization (WHO) criteria (61,62). All accessible tooth surfaces were evaluated, and finally, they were scored as healthy, decayed (DT), extracted due to caries (MT), or filled because of caries (FT).…”

Section: Examination Of Oral Cavitymentioning

confidence: 99%

Salivary Xanthine Oxidase as a Potential Biomarker in Stroke Diagnostics

et al. 2022

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Stroke is one of the most common cerebrovascular diseases. Despite significant progress in understanding stroke pathogenesis, cases are still increasing. Thus, laboratory biomarkers of stroke are sought to allow rapid and non-invasive diagnostics. Ischemia-reperfusion injury is an inflammatory process with characteristic cellular changes leading to microvascular disruption. Several studies have shown that hyperactivation of xanthine oxidase (XO) is a major pathogenic factor contributing to brain dysfunction. Given the critical role of XO in stroke complications, this study aimed to evaluate the activity of the enzyme and its metabolic products in the saliva of stroke subjects. Thirty patients in the subacute phase of stroke were included in the study: 15 with hemorrhagic stroke and 15 with ischemic stroke. The control group consisted of 30 healthy subjects similar to the cerebral stroke patients regarding age, gender, and status of the periodontium, dentition, and oral hygiene. The number of individuals was determined a priori based on our previous experiment (power of the test = 0.8; α = 0.05). The study material was mixed non‐stimulated whole saliva (NWS) and stimulated saliva (SWS). We showed that activity, specific activity, and XO output were significantly higher in NWS of ischemic stroke patients than in hemorrhagic stroke and healthy controls. Hydrogen peroxide and uric acid levels were also considerably higher in NWS of ischemic stroke patients. Using receiver operating curve (ROC) analysis, we demonstrated that XO-specific activity in NWS distinguishes ischemic stroke from hemorrhagic stroke (AUC: 0.764) and controls (AUC: 0.973) with very high sensitivity and specificity. Saliva collection is stress-free, requires no specialized medical personnel, and allows continuous monitoring of the patient’s condition through non-invasive sampling multiple times per day. Salivary XO also differentiates with high accuracy (100%) and specificity (93.75%) between stroke patients with mild to moderate cognitive decline (AUC = 0.988). Thus, salivary XO assessment may be a potential screening tool for a comprehensive neuropsychological evaluation. To summarize, our study demonstrates the potential utility of salivary XO in the differential diagnosis of stroke.

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Section: Examination Of Oral Cavitymentioning

confidence: 99%

Salivary Xanthine Oxidase as a Potential Biomarker in Stroke Diagnostics

et al. 2022

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“…Patients are considered to be at high risk of a stroke based on their specific comorbidities, type of postoperative treatment, and older age. Functional improvement in patients undergoing rehabilitation can be influenced by oral health among hospitalized patients [ 161 ].…”

Section: Effect Of Orodental Treatmentmentioning

confidence: 99%

The Link between Stroke Risk and Orodental Status—A Comprehensive Review

Shahi

Farhoudi

Dizaj

et al. 2022

JCM

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One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person’s general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors’ best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists.

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“…The dentition was evaluated in a separate room shortly after saliva sampling. According to the World Health Organization criteria, the individual's check-up was carried out using a plain mouth mirror and a dental probe in arti cial lighting 49,50 . The dentist performed the dental examination in front of the chair where the patient was seated and with the individual's head resting against the wall.…”

Section: Oral Examinationmentioning

confidence: 99%

Salivary Cytokine Profile in Patients with Ischemic Stroke. Can Salivary TNF-α be a Non-invasive Biomarker of Cognitive Impairment in Stroke Cases?

Maciejczyk

Mil

Gerreth

et al. 2021

Preprint

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Inflammation plays a crucial role in stroke pathogenesis. Thus, it is not surprising that cytokines, chemokines, and growth factors have been advocated in stroke diagnostics. Our study is the first to evaluate the salivary cytokine profile in patients with ischemic stroke. Twenty-five patients with subacute ischemic stroke and an age-, sex-, and oral hygiene status-matched control group were enrolled in the study. The number of patients was set a priori based on our previous experiment (α = 0.05, test power = 0.9). Salivary concentrations of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 10 (IL-10) were assessed using an ELISA method. We showed that salivary TNF-α and IL-6 were significantly higher, whereas IL-10 content was statistically lower in both non-stimulated (NWS) and stimulated (SWS) whole saliva of ischemic stroke patients. However, evaluation of cytokines in NWS rather than in SWS may be of greater diagnostic value. Of particular note is salivary TNF-α, which may indicate cognitive/physical impairment in post-stroke individuals. This parameter distinguishes stroke patients from healthy controls and correlates with cognitive dysfunction and severity of functional impairment. It also differentiates (with high sensitivity and specificity) stroke patients with normal cognition from mild to moderate dementia patients. Saliva may be an alternative to blood for assessing cytokines in stroke patients, although further studies on a larger patient population are needed.

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Is an Oral Health Status a Predictor of Functional Improvement in Ischemic Stroke Patients Undergoing Comprehensive Rehabilitation Treatment?

Cited by 13 publications

References 59 publications

Salivary Xanthine Oxidase as a Potential Biomarker in Stroke Diagnostics

Salivary Xanthine Oxidase as a Potential Biomarker in Stroke Diagnostics

The Link between Stroke Risk and Orodental Status—A Comprehensive Review

Salivary Cytokine Profile in Patients with Ischemic Stroke. Can Salivary TNF-α be a Non-invasive Biomarker of Cognitive Impairment in Stroke Cases?

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