IADR Abstract Archives
Clinical Signs of Periodontitis are Associated With Cryptogenic Ischemic Stroke
Objectives:
Etiology of ischemic stroke can be identified in most patients in general, but in young adults even up to half are labeled as cryptogenic, i.e. no cause is found after complete and timely diagnostic evaluation. We investigated the association between oral health and early-onset cryptogenic stroke in a prospective case-control study.
Methods:
Cryptogenic ischemic stroke patients (n=48) aged 18 to 49 were enrolled and treated at Helsinki University Hospital between November 2013 and March 2016. Control subjects were matched for age and sex. All participants filled in a structured questionnaire and underwent a clinical oral examination by a senior periodontologist. Statistical analysis used McNemar and Wilcoxon Signed Rank tests.
Results:
Patients and controls were of age (median, years) 41.6 (interquartile range [IQR] 33.27-46.22) and 42.9 (34.31-47.41), respectively, and 58.3% of the subjects were male. Between patients and controls, frequencies of current smoking (14.6% vs 10.6%, p=0.774), never smoking (52.1% vs 64.6%, p=0.327), diabetes (2.1% vs 4.2%, p=1.000), antibiotic use during the previous 6 months (37.5% vs 18.8%, p=0.078), and regular dentist visits (54.2% vs 58.3%, p=0.839) did not differ. There was no significant difference between patients and controls on bleeding on probing (33.30 [IQR 24.40-47.20] vs 36.75 [30.00-43.65], p=0.926), occurrence of oral mucosal finding (18.8% vs 18.8%, p=1.000), or ≥6 mm pocket(s) (16.7% vs 14.6%, p=1.000). However, patients had significantly higher number of deepened periodontal pockets (7.0 [IQR 4.00-14.00] vs 2.0 [1.00-7.50], p=0.002), especially 4-5 mm pockets (7.0 [4.00-13.00] vs 2.0 [1.00-7.50], p<0.001), leading to a greater Periodontal Inflammatory Burden Index (7.0 [4.00-14.00] vs 2.0 [1.00-7.50], p=0.002).
Conclusions:
Our results suggest that clinical signs of periodontitis are associated with young-onset cryptogenic ischemic stroke. Use of antibiotics seemed to be more common in patients than in controls, which may indicate recent infections prior to stroke.
Etiology of ischemic stroke can be identified in most patients in general, but in young adults even up to half are labeled as cryptogenic, i.e. no cause is found after complete and timely diagnostic evaluation. We investigated the association between oral health and early-onset cryptogenic stroke in a prospective case-control study.
Methods:
Cryptogenic ischemic stroke patients (n=48) aged 18 to 49 were enrolled and treated at Helsinki University Hospital between November 2013 and March 2016. Control subjects were matched for age and sex. All participants filled in a structured questionnaire and underwent a clinical oral examination by a senior periodontologist. Statistical analysis used McNemar and Wilcoxon Signed Rank tests.
Results:
Patients and controls were of age (median, years) 41.6 (interquartile range [IQR] 33.27-46.22) and 42.9 (34.31-47.41), respectively, and 58.3% of the subjects were male. Between patients and controls, frequencies of current smoking (14.6% vs 10.6%, p=0.774), never smoking (52.1% vs 64.6%, p=0.327), diabetes (2.1% vs 4.2%, p=1.000), antibiotic use during the previous 6 months (37.5% vs 18.8%, p=0.078), and regular dentist visits (54.2% vs 58.3%, p=0.839) did not differ. There was no significant difference between patients and controls on bleeding on probing (33.30 [IQR 24.40-47.20] vs 36.75 [30.00-43.65], p=0.926), occurrence of oral mucosal finding (18.8% vs 18.8%, p=1.000), or ≥6 mm pocket(s) (16.7% vs 14.6%, p=1.000). However, patients had significantly higher number of deepened periodontal pockets (7.0 [IQR 4.00-14.00] vs 2.0 [1.00-7.50], p=0.002), especially 4-5 mm pockets (7.0 [4.00-13.00] vs 2.0 [1.00-7.50], p<0.001), leading to a greater Periodontal Inflammatory Burden Index (7.0 [4.00-14.00] vs 2.0 [1.00-7.50], p=0.002).
Conclusions:
Our results suggest that clinical signs of periodontitis are associated with young-onset cryptogenic ischemic stroke. Use of antibiotics seemed to be more common in patients than in controls, which may indicate recent infections prior to stroke.