Association of Dental Infections with Intracranial Atherosclerotic Stenosis.
Association of Dental Infections with Intracranial Atherosclerotic Stenosis.
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牙齿感染与颅内动脉粥样硬化性狭窄的关联。
DOI：
10.1159/000530829
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Gottesman,RebeccaF
中科院分区：
文献类型：
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作者：
Sen,Souvik;Meyer,Jaclyn;Mascari,Rachel;Trivedi,Tushar;Suri,Fareed;Wasserman,Bruce;Rosamond,Wayne;Moss,Kevin;Beck,James;Gottesman,RebeccaF
牙周病和龋齿是导致牙齿脱落的口腔感染，与动脉粥样硬化和脑血管疾病有关。我们在社区动脉粥样硬化风险（ARIC）研究中评估了PD和龋齿与无症状颅内动脉粥样硬化（ICAS）相关的假设。（7项指标）从6，155名来自社区牙科动脉粥样硬化风险研究（DARIC）的既往无卒中的受试者被用于区分7个PD阶段（牙周膜轮廓分类[PPC]-I至-VII）和冠状面（DS）和牙根面（DRS）上的龋齿。一个分层的子集进行了3D飞行时间MR血管造影和3D高各向同性分辨率黑血MRI。根据华法林-阿司匹林症状性颅内疾病（WASID）试验建立的标准对ICAS进行分级。我们评估了PD阶段和龋齿与无症状ICAS之间的关系，分级为无ICAS，<50%ICAS，和≥ 50%ICAS.ResultsAmong牙齿受试者进行血管成像，801（70%）没有ICAS，232（20%）有<50%ICAS，和112（10%）有≥ 50%ICAS。与没有牙龈疾病的参与者（PPC-I）相比，轻度-中度牙齿脱落（PPC-VI），重度牙齿脱落（PPC-VII）和重度PD（PPC-IV）的参与者患有< 50% ICAS的几率更高。患有广泛牙龈炎（PPC-V）的参与者发生≥ 50% ICAS的几率显著更高。在调整混杂变量（年龄、性别、种族、高血压、糖尿病、血脂异常、三级教育和吸烟状况）后，这种关联仍然显著。ICAS< 50%和≥ 50%与龋齿（DS和DRS）无相关性。结论ICAS < 50%与轻中度牙缺失、重度牙缺失和重度PD有显著相关性，而ICAS ≥ 50%与广泛性牙龈炎有显著相关性。我们没有发现龋齿和ICAS之间的关联。
IntroductionPeriodontal disease (PD) and dental caries are oral infections leading to tooth loss that are associated with atherosclerosis and cerebrovascular disease. We assessed the hypothesis that PD and caries are associated with asymptomatic intracranial atherosclerosis (ICAS) in the Atherosclerosis Risk in Communities (ARIC) study.MethodsFull-mouth clinical periodontal measurements (7 indices) collected at 6 sites per tooth from 6,155 subjects from the Dental Atherosclerosis Risk in Communities Study (DARIC) without prior stroke were used to differentiate seven PD stages (Periodontal Profile Class [PPC]-I to-VII) and dental caries on coronal dental surface (DS) and dental root surface (DRS). A stratified subset underwent 3D time-of-flight MR angiogram and 3D high isotropic-resolution black blood MRI. ICAS was graded according to the criteria established by the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial. We evaluated the relationship between PD stage and dental caries with asymptomatic ICAS, graded as no ICAS,< 50% ICAS, and≥ 50% ICAS.ResultsAmong dentate subjects who underwent vascular imaging, 801 (70%) had no ICAS, 232 (20%) had< 50% ICAS, and 112 (10%) had≥ 50% ICAS. Compared to participants without gum disease (PPC-I), participants with mild-moderate tooth loss (PPC-VI), severe tooth loss (PPC-VII), and severe PD (PPC-IV) had higher odds of having< 50% ICAS. Participants with extensive gingivitis (PPC-V) had significantly higher odds of having≥ 50% ICAS. This association remained significant after adjusting for confounding variables: age, gender, race, hypertension, diabetes, dyslipidemia, 3-level education, and smoking status. There was no association between dental caries (DS and DRS) and ICAS< 50% and≥ 50%.ConclusionWe report significant associations between mild-moderate tooth loss, severe tooth loss, and severe PD with< 50% ICAS as well as an association between extensive gingivitis and≥ 50% ICAS. We did not find an association between dental caries and ICAS.