bjective:
the purpose of this narrative review is
to examine evidence in research of chronic periodontal
inflammation and cerebrovascular disease (stroke) and to
identify biologic plausibility, strength of evidence and results
of the best evidence.
Methods:
a search for systematic
reviews (sr) related to stroke and periodontal disease (PD)
was conducted through Pub Med using MesH terms of stroke,
cardiovascular disease, periodontal disease, oral–systemic
relationship. recent high level evidence not included in sr was
examined for additional evidence.
results and discussion:
there are few srs and primary studies investigating the topic
but epidemiologic studies reveal a moderate association
between PD and stroke. However, several studies do not show
associations. specificity is not established for any associations
as there are multiple risk factors for atherosclerotic disease.
atheroma in carotid arteries was found to be significantly
associated with oral disease burden and radiographic evidence
of PD.
Conclusion:
a direct causal relationship between PD and
atherosclerotic cerebrovascular disease has not been established
and no prospective rCt
s are available to evaluate reduced
vascular events of intervention trials. given the significant cost
for an adequately powered rCt and the modest strength of
epidemiologic evidence, rigorous trials to establish if causality
exists between PD and stroke are unlik