ΑSSOCIATION MECHANISMS BETWEEN PERIODONTAL DISEASE AND STROKE: A REVIEW OF THE LITERATURE

Authors

O. Schoinohoriti
M. Ioakeimidis
M. Chondrogianni
C. Zompola
C. Liantinioti
A. Roussopoulou
S. Triantafyllou
R. Antonelou
L. Palaiodimou
K. Voumvourakis
G. Tsivgoulis

Keywords:

periodontal disease, atherosclerotic vascular disease, stroke, ischemic, periodontal pathogens, inflammation, atherosclerosis

Abstract

Periodontal disease is a chronic progressive infectious disease of the periodontal tissues, caused by Gram-negative bacteria that are called ‘periodontal pathogens’ and induce local and systemic inflammation. Recently, periodontal disease has been identified as a risk factor for atherosclerotic vascular disease, including acute coronary syndromes and ischemic stroke.
The present narrative reviews aims to highlight the current literature regarding the pathophysiological mechanisms that may be involved in the association between periodontal disease and cerebrovascular diseases attempting to provide observational evidence for a causal relationship linking periodontal disease with cerebral ischemia. This association may be attributed to the following potential mechanisms: a) presence of common risk factors for both diseases, b) presence of a common genetic predisposition to both diseases and c) presence of pathophysiological pathways, connecting the periodontal-related systemic inflammation with atherogenesis and atherothrombosis.
In conclusion, this review will outline whether and to what extent the direct effects of periodontal pathogen may promote the atherosclerotic process and plaque rupture which in turn may lead to thromboemobolism and ischemic stroke.