title: The association of gingivitis and periodontitis with ischemic stroke.
abstract: OBJECTIVE
  The aim of this study was to assess the associations of different periodontal parameters with cerebral ischemia.
  
  
  METHODS
  In a case-control study, 303 consecutive patients with ischemic stroke or transient ischemic attack, and 300 representative population controls received a complete clinical and radiographic dental examination. Patients were examined on average 3 days after ischemia. The individual mean clinical attachment loss measured at four sites per tooth was used as indicator variable for periodontitis.
  
  
  RESULTS
  Patients had higher clinical attachment loss than population (p<0.001). After adjustment for age, gender, number of teeth, vascular risk factors and diseases, childhood and adult socioeconomic conditions and lifestyle factors, a mean clinical attachment loss >6 mm had a 7.4 times (95% confidence interval 1.55-15.3) a gingival index >1.2 a 18.3 times (5.84-57.26) and a radiographic bone loss a 3.6 times (1.58-8.28) higher risk of cerebral ischemia than subjects without periodontitis or gingivitis, respectively.
  
  
  CONCLUSIONS
  Periodontitis is an independent risk factor for cerebral ischemia and acute exacerbation of inflammatory processes in the periodontium might be a trigger for the event of cerebral ischemia.
authors.affiliation: Policlinic for Conservative Dentistry and Periodontology, University of Heidelberg Dental School, Germany. christof_doerfer@med.uni-heidelberg.de
authors.forename: Christof E
authors.initials: CE
authors.lastname: Dörfer
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Ziegler
authors.forename: Claudia
authors.initials: C
authors.lastname: Kaiser
authors.forename: Rainer
authors.initials: R
authors.lastname: Lutz
authors.forename: Daniela
authors.initials: D
authors.lastname: Jörss
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichy
authors.forename: Florian
authors.initials: F
authors.lastname: Buggle
authors.forename: Stefan
authors.initials: S
authors.lastname: Bültmann
authors.forename: Michael
authors.initials: M
authors.lastname: Preusch
authors.forename: Armin J
authors.initials: AJ
authors.lastname: Grau
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005891:Gingivitis / Q000150:complications*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000150:complications; D010514:Periodontal Pocket / Q000150:complications; D010518:Periodontitis / Q000150:complications*; D012737:Sex Factors; D012923:Social Class; D020521:Stroke / Q000150:complications*