Research progress on the association between periodontal disease and cerebral infarction_West China Medical Journal

Authors：

TAN Xiaofeng ¹ , WANG Changyi ² ,  LIU Fan ³

1. Jin Jiang Outpatient Department, West China Hospital of Stomotology, Sichuan University, Chengdu, Sichuan 610066, P. R. China;
2. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Nursing Department, West China Hospital of Stomotology, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Fan, Email: samotj@163.com

Keywords：

Periodontal disease; Cerebral infarction; Association

DOI：

10.7507/1002-0179.202105047

Video：

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Periodontal disease is a common chronic infectious disease targeting the connective tissue supporting the dentition. In recent years, the research on periodontal disease and cerebral infarction has been increasing. However, the causal relationship between periodontal disease and cerebral infarction remains unclear. Periodontal disease may be associated with atherosclerosis, which is one of the major causes of cerebral infarction. Regular dental care can reduce the risk of cardiovascular disease. Therefore, investigating the above association and its underlying mechanisms is of great clinical significance, which may help clinicians to make appropriate treatment and prevention measures. In this paper, the research progress and possible mechanism of the relationship between periodontal disease and cerebral infarction were reviewed.

Citation： TAN Xiaofeng, WANG Changyi, LIU Fan. Research progress on the association between periodontal disease and cerebral infarction. West China Medical Journal, 2021, 36(6): 812-815. doi: 10.7507/1002-0179.202105047 Copy

1.	Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet, 2005, 366(9499): 1809-1820.
2.	Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
3.	Sen S, Giamberardino LD, Moss K, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke, 2018, 49(2): 355-362.
4.	Lin HW, Chen CM, Yeh YC, et al. Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: a retrospective population-based cohort study. J Clin Periodontol, 2019, 46(6): 642-649.
5.	Leira Y, Seoane J, Blanco M, et al. Association between periodontitis and ischemic stroke: a systematic review and meta-analysis. Eur J Epidemiol, 2017, 32(1): 43-53.
6.	Sen S, Sumner R, Hardin J, et al. Periodontal disease and recurrent vascular events in stroke/transient ischemic attack patients. J Stroke Cerebrovasc Dis, 2013, 22(8): 1420-1427.
7.	Sen S, Mascari R. Exploring the periodontal disease-ischemic stroke link. J Periodontol, 2020, 91(Suppl 1): S35-S39.
8.	Bell S, Gibson JT, Harshfield EL, et al. Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A mendelian randomization study. Atherosclerosis, 2020, 313: 111-117.
9.	Palm F, Pussinen PJ, Aigner A, et al. Association between infectious burden, socioeconomic status, and ischemic stroke. Atherosclerosis, 2016, 254: 117-123.
10.	Haraszthy VI, Zambon JJ, Trevisan M, et al. Identification of periodontal pathogens in atheromatous plaques. J Periodontol, 2000, 71(10): 1554-1560.
11.	Desvarieux M, Demmer RT, Rundek T, et al. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the oral infections and vascular disease epidemiology study (INVEST). Stroke, 2003, 34(9): 2120-2125.
12.	Brun A, Nuzzo A, Prouvost B, et al. Oral microbiota and atherothrombotic carotid plaque vulnerability in periodontitis patients. A cross-sectional study. J Periodontal Res, 2021, 56(2): 339-350.
13.	Li L, Messas E, Batista EL Jr, et al. Porphyromonas gingivalis infection accelerates the progression of atherosclerosis in a heterozygous apolipoprotein E-deficient murine model. Circulation, 2002, 105(7): 861-867.
14.	Schenkein HA, Papapanou PN, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000, 2020, 83(1): 90-106.
15.	Sen S, Redd K, Trivedi T, et al. Periodontal disease, atrial fibrillation and stroke. Am Heart J, 2021, 235: 36-43.
16.	Lee JB, Yi HY, Bae KH. The association between periodontitis and dyslipidemia based on the Fourth Korea National Health and Nutrition Examination Survey. J Clin Periodontol, 2013, 40(5): 437-442.
17.	Lee S, Im A, Burm E, et al. Association between periodontitis and blood lipid levels in a Korean population. J Periodontol, 2018, 89(1): 28-35.
18.	Kim HJ, Cha GS, Kim HJ, et al. Porphyromonas gingivalis accelerates atherosclerosis through oxidation of high-density lipoprotein. J Periodontal Implant Sci, 2018, 48(1): 60-68.
19.	Lönn J, Ljunggren S, Klarström-Engström K, et al. Lipoprotein modifications by gingipains of Porphyromonas gingivalis. J Periodontal Res, 2018, 53(3): 403-413.
20.	Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol, 2013, 40(Suppl 14): S51-S69.
21.	Eberhard J, Jepsen S, Jervøe-Storm PM, et al. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev, 2015(4): CD004622.
22.	Santuchi CC, Cortelli JR, Cortelli SC, et al. Scaling and root planing per quadrant versus one-stage full-mouth disinfection: assessment of the impact of chronic periodontitis treatment on quality of life--a clinical randomized, controlled trial. J Periodontol, 2016, 87(2): 114-123.
23.	Orlandi M, Graziani F, D’Aiuto F. Periodontal therapy and cardiovascular risk, Periodontol 2000, 2020, 83(1): 107-124.
24.	Lee YL, Hu HY, Huang N, et al. Dental prophylaxis and periodontal treatment are protective factors to ischemic stroke. Stroke, 2013, 44(4): 1026-1030.
25.	Park SY, Kim SH, Kang SH, et al. Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea. Eur Heart J, 2019, 40(14): 1138-1145.
26.	Popescu D, Gheorghe D, Puiu I, et al. Odontal-periodontal changes in patients with type 1 diabetes. Curr Health Sci J, 2017, 43(4): 330-334.

1. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet, 2005, 366(9499): 1809-1820.
2. Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
3. Sen S, Giamberardino LD, Moss K, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke, 2018, 49(2): 355-362.
4. Lin HW, Chen CM, Yeh YC, et al. Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: a retrospective population-based cohort study. J Clin Periodontol, 2019, 46(6): 642-649.
5. Leira Y, Seoane J, Blanco M, et al. Association between periodontitis and ischemic stroke: a systematic review and meta-analysis. Eur J Epidemiol, 2017, 32(1): 43-53.
6. Sen S, Sumner R, Hardin J, et al. Periodontal disease and recurrent vascular events in stroke/transient ischemic attack patients. J Stroke Cerebrovasc Dis, 2013, 22(8): 1420-1427.
7. Sen S, Mascari R. Exploring the periodontal disease-ischemic stroke link. J Periodontol, 2020, 91(Suppl 1): S35-S39.
8. Bell S, Gibson JT, Harshfield EL, et al. Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A mendelian randomization study. Atherosclerosis, 2020, 313: 111-117.
9. Palm F, Pussinen PJ, Aigner A, et al. Association between infectious burden, socioeconomic status, and ischemic stroke. Atherosclerosis, 2016, 254: 117-123.
10. Haraszthy VI, Zambon JJ, Trevisan M, et al. Identification of periodontal pathogens in atheromatous plaques. J Periodontol, 2000, 71(10): 1554-1560.
11. Desvarieux M, Demmer RT, Rundek T, et al. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the oral infections and vascular disease epidemiology study (INVEST). Stroke, 2003, 34(9): 2120-2125.
12. Brun A, Nuzzo A, Prouvost B, et al. Oral microbiota and atherothrombotic carotid plaque vulnerability in periodontitis patients. A cross-sectional study. J Periodontal Res, 2021, 56(2): 339-350.
13. Li L, Messas E, Batista EL Jr, et al. Porphyromonas gingivalis infection accelerates the progression of atherosclerosis in a heterozygous apolipoprotein E-deficient murine model. Circulation, 2002, 105(7): 861-867.
14. Schenkein HA, Papapanou PN, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000, 2020, 83(1): 90-106.
15. Sen S, Redd K, Trivedi T, et al. Periodontal disease, atrial fibrillation and stroke. Am Heart J, 2021, 235: 36-43.
16. Lee JB, Yi HY, Bae KH. The association between periodontitis and dyslipidemia based on the Fourth Korea National Health and Nutrition Examination Survey. J Clin Periodontol, 2013, 40(5): 437-442.
17. Lee S, Im A, Burm E, et al. Association between periodontitis and blood lipid levels in a Korean population. J Periodontol, 2018, 89(1): 28-35.
18. Kim HJ, Cha GS, Kim HJ, et al. Porphyromonas gingivalis accelerates atherosclerosis through oxidation of high-density lipoprotein. J Periodontal Implant Sci, 2018, 48(1): 60-68.
19. Lönn J, Ljunggren S, Klarström-Engström K, et al. Lipoprotein modifications by gingipains of Porphyromonas gingivalis. J Periodontal Res, 2018, 53(3): 403-413.
20. Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol, 2013, 40(Suppl 14): S51-S69.
21. Eberhard J, Jepsen S, Jervøe-Storm PM, et al. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev, 2015(4): CD004622.
22. Santuchi CC, Cortelli JR, Cortelli SC, et al. Scaling and root planing per quadrant versus one-stage full-mouth disinfection: assessment of the impact of chronic periodontitis treatment on quality of life--a clinical randomized, controlled trial. J Periodontol, 2016, 87(2): 114-123.
23. Orlandi M, Graziani F, D’Aiuto F. Periodontal therapy and cardiovascular risk, Periodontol 2000, 2020, 83(1): 107-124.
24. Lee YL, Hu HY, Huang N, et al. Dental prophylaxis and periodontal treatment are protective factors to ischemic stroke. Stroke, 2013, 44(4): 1026-1030.
25. Park SY, Kim SH, Kang SH, et al. Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea. Eur Heart J, 2019, 40(14): 1138-1145.
26. Popescu D, Gheorghe D, Puiu I, et al. Odontal-periodontal changes in patients with type 1 diabetes. Curr Health Sci J, 2017, 43(4): 330-334.

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