Association between Periodontal Disease, Occlusal Patterns and Ischemic Stroke

Abstract

 Purpose: This cross-sectional study aimed to investigate the association between dental conditions, clinical markers of periodontal disease and ischemic stroke or coronary heart disease and to assess the potential influence of occlusal condition or inflammatory response on the observed associations.

 Methods: Ninety-three subjects, including a series of 8 cases with ischemic stroke and 16 with coronary heart disease, were recruited in the study at the Health Sciences University of Hokkaido Hospital. The results of clinical dental examination (number of remaining teeth, number of teeth with probing pocket depth ≥4 mm and 6 mm, percentage and number of teeth with bleeding on probing sites, mean probing pocket depth, periodontal inflamed surface area, Eichner’s classification) and medical or biological parameters (sex, age, alcohol intake, smoking, diabetes mellitus, hypertension, dyslipidemia, pharmacotherapy of these three diseases, hs-CRP, fasting blood glucose, BMI, blood pressure, total cholesterol, HDL, non HDL, LDL, VLDL, triglycerides) were collected. Pearson’s chi-square test, Fisher’s exact test or Mann-Whitney test and multivariable analyses were performed to identify factors associated with ischemic stroke and coronary heart disease.

 Results: The prevalence of Eichner’s C was significantly higher, and that of Eichner’s A, total cholesterol and HDL were significantly lower in ischemic stroke patients. In the results of binary logistic regression analysis, the odds ratios for ischemic stroke were higher in the group of patients with Eichner’s C (OR=17.381, p=0.013, 95% CI=1.848-163.489) and with lower HDL cholesterol (OR=0.894, p=0.020, 95% CI=0.813-0.982). However, total cholesterol (OR=0.968, p=0.083, 95% CI=0.934-1.004) and hs-CRP (OR=1.604, p=0.090, 95% CI=0.929-2.771) were not statistically significantly different. Every possible predictor that was taken into account was not associated with coronary heart disease.

 Conclusion: This study demonstrates that Eichner’s C is independently associated with ischemic stroke.