Chronic periodontitis is associated with lacunar infarct: a case–control study

Leira, Yago; López‐Dequidt, Iria; Arias, Susana; Rodríguez‐Yáñez, Manuel; Leira, Rogelio; Sobrino, Tomás; Campos, Francisco; Blanco, Miguel; Blanco, Juan; Castillo, José

doi:10.1111/ene.13080

Cited by 28 publications

(49 citation statements)

References 43 publications

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“…The periodontal examination was performed by a single calibrated periodontist (YL). The calibration was recently reported . Each case (20 to 30 days after LI) and control (maximum 1 month after CT/MRI) underwent a full‐mouth periodontal examination, including probing depth (PD), clinical attachment level (CAL), gingival recession (GR), full‐mouth plaque score (FMPS), and full‐mouth bleeding score (FMBS) as well as the number of missing teeth (excluding three° molars).…”

Section: Methodsmentioning

confidence: 99%

“…Neuroimaging and ultrasonographic evaluation was done at admission. A detailed description of the neurological examination protocol was published elsewhere . In summary, LI was diagnosed when the patient had one of the clinical lacunar syndromes lasting > 24 hours, no evidence of cortical dysfunction, and a normal or deep focal infarction with a diameter ≤15 mm in an appropriate location visualized by CT/MRI.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, our group found a significant association between periodontitis and LI . However, the mechanisms underlying this relationship have not been yet elucidated.…”

Section: Introductionmentioning

confidence: 95%

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Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct

Leira

Rodríguez‐Yáñez

Arias

et al. 2018

Journal of Periodontology

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Background Periodontitis has been associated with lacunar infarct (LI), a type of cerebral small vessel disease. The objective of this study was to ascertain whether periodontitis is associated with increased circulating levels of systemic inflammation and endothelial dysfunction biomarkers in patients with LI. Methods One hundred twenty patients with LI and 120 healthy controls underwent a full‐mouth periodontal examination. The periodontal inflamed surface area (PISA) was calculated for each participant. Demographic, medical, and neurological information were recorded from all of them. In addition, blood samples were collected in order to investigate differences in terms of interleukin (IL)‐6, IL‐10, pentraxin (PTX) 3, soluble fragment of tumor necrosis factor‐like weak inducer of apoptosis (sTWEAK) and amyloid‐beta (Aβ) peptides (i.e., Aβ1‐40, and Aβ1‐42) measured in serum. Results Periodontitis was independently associated with increased levels of IL‐6 (R2 = 0.656, P < 0.001), PTX3 (R2 = 0.115, P < 0.001), sTWEAK (R2 = 0.527, P < 0.001), and Aβ1‐40 (R2 = 0.467, P < 0.001) in patients with LI. Within patients with poor outcome, PISA positively correlated with IL‐6 (r = 0.738, P < 0.001), PTX3 (r = 0.468, P = 0.008), sTWEAK (r = 0.771, P < 0.001), and Aβ1‐40 (r = 0.745, P < 0.001). Conclusions Our data suggest a link between periodontitis, systemic inflammatory response, and disruption of the vascular endothelial function in patients with LI. Experimental studies are needed to elucidate possible pathways through which periodontitis could lead to this systemic inflammatory state with impairment of the endothelial function in LI. Further longitudinal studies with large samples are warranted to confirm our findings.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct

Leira

Rodríguez‐Yáñez

Arias

et al. 2018

Journal of Periodontology

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“…It has been proposed that PD could be a risk factor for systemic conditions such as cardiovascular disease [28] , diabetes [29] , respiratory diseases [30] , and both cerebral large [31], and small vessel disease [32] . In this sense, chronic periodontal infections may also be involved in the onset of dementia through several pathways.…”

Section: Discussionmentioning

confidence: 99%

Is Periodontal Disease Associated with Alzheimer's Disease? A Systematic Review with Meta-Analysis

et al. 2017

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Background: In the last decade, several observational studies have suggested that there exists an association between periodontal disease (PD) and Alzheimer's disease (AD). The aim of this systematic review was to investigate whether or not this link exists. Summary: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline for systematic review was used and registered at PROSPERO (CRD42016035377). The search strategy included using electronic databases and by hand searching articles published up to January 2016. MEDLINE via PubMed, EMBASE and Web of Science were searched by 2 independent reviewers. Observational studies including patients meeting criteria for both AD and PD were eligible to be included in the analysis. Quality assessment of selected studies was performed by the Newcastle-Ottawa Scale. From a total of 550 titles and abstracts, 5 studies were included (2 cross-sectional, 2 case-control and one cohort study) in the review. A fixed effects meta-analysis showed that the presence of PD is associated with the presence of AD (OR 1.69, 95% CI 1.21-2.35). When only severe forms of PD were evaluated, a significant association was also observed (OR 2.98, 95% CI 1.58-5.62). Key Messages: In the present review, a significant association was observed between PD and AD. Further studies should be carried out in order to investigate the direction of the association and factors that may confound it.

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“…Stroke represents the largest proportion of papers published, including those on pathophysiology , acute stroke management and the outcome of patients who have suffered stroke . Stroke is a worldwide problem, but its prevalence varies and may reflect both the genetic and environmental contributions to stroke, both in turn reflecting the known risk factors for stroke.…”

mentioning

confidence: 99%

Advances and insights into neurological practice 2016−17

Schapira¹

2017

Euro J of Neurology

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Chronic periodontitis is associated with lacunar infarct: a case–control study

Abstract: Chronic periodontitis was independently associated with the presence of LI after adjusting for well-known vascular risk factors for lacunar stroke. Further observational studies are necessary to investigate the pathophysiological mechanisms that can explain this relationship.

Cited by 28 publications

References 43 publications

Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct

Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct

Is Periodontal Disease Associated with Alzheimer's Disease? A Systematic Review with Meta-Analysis

Advances and insights into neurological practice 2016−17

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