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CC BY 4.0 · Eur J Dent 2025; 19(02): 265-274
DOI: 10.1055/s-0044-1793844
Review Article

Association of Chronic Periodontitis with Hemorrhagic Stroke: A Systematic Review and Meta-Analysis

Athanasios Tsimpiris
1   Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
,
Ioannis Tsolianos
2   Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Andreas Grigoriadis 
1   Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
3   Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Zoi Tsimtsiou
4   Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Dimitrios G. Goulis 
5   Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Nikolaos Grigoriadis
6   2nd Department of Neurology, AHEPA Hospital, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Abstract

Periodontitis is a chronic, multifactorial inflammatory condition linked to dysbiotic plaque biofilms and characterized by the gradual destruction of the structures supporting the teeth owing to compromised immune system function. Hemorrhagic stroke, which primarily occurs within the brain tissue or in the subarachnoid space as a blood leak of ruptured vessels, is a sudden neurological impairment caused by vascular damage in the central nervous system, resulting in focal neurological deficits. Chronic periodontitis (CP) and hemorrhagic stroke may share common pathogenic features involving inflammation and immune system activation, prompting researchers to investigate their potential connection. The aim of the study is to systematically review the literature on the epidemiological association between CP and hemorrhagic stroke in adults. The study protocol adhered to the PRISMA 2020 guidelines, and the design followed the Cochrane methodology. A thorough literature search encompassing PubMed, Scopus, and Web of Science databases and a manual search and evaluation of gray literature was conducted. Meta-analysis was performed using Review Manager (RevMan) 5.4, with the effect size represented by the odds ratio (OR) and a 95% confidence interval (CI). Heterogeneity was assessed using the chi-squared and I 2 statistics. The selected articles, written in English without time constraints, focused on observational studies involving patients and controls and included disease diagnostic criteria. Duplicate entries were eliminated. The reliability of each study's results was evaluated using the Newcastle-Ottawa Scale and GRADE tools. Two reviewers conducted the assessments, and a third reviewer resolved any disagreements. The meta-analysis comprised four observational studies involving 1,882 individuals. It revealed that individuals diagnosed with hemorrhagic stroke were notably more likely to have concurrent CP (OR: 6.32; 95% CI: 1.35–29.49; p = 0.02) or severe CP (OR: 3.08; 95% CI: 1.56–6.06; p = 0.001) compared with healthy controls. A notable occurrence of CP was detected in patients with hemorrhagic stroke compared with controls. Health care professionals need to acknowledge the connection between the two conditions, as it allows them to provide optimal holistic care through a thorough approach to diagnosis and treatment.

Keywords

systematic review - meta-analysis - chronic periodontitis - severe chronic periodontitis - hemorrhagic stroke

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Artikel online veröffentlicht:
10. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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