title: Periodontitis and the risk for non-fatal stroke in Korean adults.
abstract: BACKGROUND
  The association between periodontal inflammation and non-fatal stroke is still controversial and limited to evidence in Western countries. The aim of this study was to investigate whether periodontitis is independently associated with non-fatal stroke in Korean adults.
  
  
  METHODS
  A case-control study was conducted on 265 non-fatal chronic stroke cases at the National Rehabilitation Center, Seoul, Korea, and 214 non-stroke population controls. Medical specialists diagnosed stroke by using brain imaging from magnetic resonance imaging and/or computerized tomography. A dentist recorded the clinical attachment level (CAL), the distance between the cemento-enamel junction and the probed base of the periodontal pocket, using a University of North Carolina-15 manual probe. An interview assessed 17 sociodemographic, behavioral, systemic/oral health-related possible confounders. Multiple logistic regression analysis was used to evaluate the association between periodontitis and stroke while controlling for age, gender, income, education, smoking, drinking, history of systemic disease, body mass index, familial cardiovascular risk factors, and oral health behaviors. Subgroup analyses were also performed.
  
  
  RESULTS
  Stroke was strongly associated with periodontitis (presence of CAL > or =6 mm): the odds ratio was 4.0 (95% confidence interval: 2.3 to 7.0) after controlling for all possible confounders. The association with periodontitis (tertiary percentage of CAL > or =5 mm) had a dose-response effect. The association between periodontitis and stroke was higher among adults younger than age 60 (6.0 versus 2.6) and normotensives (4.8 versus 3.2).
  
  
  CONCLUSIONS
  Our data suggested that periodontitis is independently associated with non-fatal stroke, and its impact seems to be greater among younger or normotensive Korean adults.
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Seon-Ju
authors.initials: SJ
authors.lastname: Sim
authors.forename: Hyun-Duck
authors.initials: HD
authors.lastname: Kim
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Moon
authors.forename: Athanasio I
authors.initials: AI
authors.lastname: Zavras
authors.forename: John
authors.initials: J
authors.lastname: Zdanowicz
authors.forename: Sun-Ja
authors.initials: SJ
authors.lastname: Jang
authors.forename: Bo-Hyoung
authors.initials: BH
authors.lastname: Jin
authors.forename: Kwang-Hak
authors.initials: KH
authors.lastname: Bae
authors.forename: Dai-Il
authors.initials: DI
authors.lastname: Paik
authors.forename: Chester W
authors.initials: CW
authors.lastname: Douglass
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D003920:Diabetes Mellitus / Q000235:genetics; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006331:Heart Diseases / Q000235:genetics; D006801:Humans; D006973:Hypertension / Q000235:genetics; D007182:Income; D007723:Korea; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D017622:Periodontal Attachment Loss / Q000150:complications; D010514:Periodontal Pocket / Q000150:complications; D010518:Periodontitis / Q000150:complications*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D020521:Stroke / Q000209:etiology*