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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic oral infections (gingivitis/periodontitis) have been associated with age-related diseases such as diabetes, coronary heart disease, and acute ischemic stroke. In addition, imaging surrogates of cerebrovascular ischemia beyond acute ischemic stroke (i.e., silent strokes and brain white matter hyperintensities) may also be associated with chronic oral infections. The pathology underlying lacunar strokes and brain white matter hyperintensities (WMH) relates to small vessel disease in the brain. In this review, we highlight recent progress in exploring potential associations of oral infections with cerebral small vessel disease and its surrogates (silent strokes, white matter hyperintensities) and clinical sequelae (i.e., vascular dementia). Recent evidence suggests that periodontitis aggravates cerebral small vessel disease and increases lacunar stroke risk. Moreover, periodontitis interacts with Alzheimer's disease to increase the severity of clinical dementia and to accelerate its manifestations. The results suggest that periodontitis may be an emerging risk factor of small vessel disease-associated cerebrovascular disorders and that the risk increase may be mediated by the systemic inflammation resulting from chronic oral infections. Large cohort studies employing state-of-the-art magnetic resonance techniques to identify specific cerebral pathologies as a function of time, oral health status, and systemic inflammation are needed to further substantiate the hypothesis.
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PMID:Chronic oral infection: An emerging risk factor of cerebral small vessel disease. 2987 87

The goal of this review is to summarize the results of randomized trials reported since 2010 that assessed the effect of periodontal interventions on at least one systemic outcome in human subjects of any age, gender or ethnicity. Oral outcome measures included gingivitis, pocket depth, clinical attachment loss and/or radiographic bone loss and oral hygiene indices. Studies were excluded if the trial was not completed or if treatment was not randomized. The results suggest that nonsurgical periodontal intervention provided to pregnant women is safe and improves periodontal status without preventing adverse pregnancy outcomes. Nonsurgical periodontal intervention was also found to provide modest improvement in glycemic control in individuals with type 2 diabetes mellitus and periodontitis. Also, improving oral care through mechanical or chemical control of dental-plaque biofilm formation can contribute to the prevention of respiratory infections in differing clinical settings, including hospitals and nursing homes, and in patients with chronic obstructive pulmonary disease. No clinical trials were reported that tested the effect of periodontal interventions on medical outcomes of atherosclerosis, cardiovascular diseases, stroke, rheumatoid arthritis, Alzheimer's disease, chronic kidney disease or malignant neoplasia.
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PMID:Role of periodontal therapy in management of common complex systemic diseases and conditions: An update. 3019 28


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