gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Artikel

Artikel empfehlen

Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid haemorrhage

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Joona Hallikainen - University of Eastern Finland, Department of Dentistry, Kuopio, Finland; Kuopio University Hospital, Hemorrhagic Brain Pathology Research Group, Kuopio, Finland
  • Antti Lindgren - Kuopio University Hospital, Hemorrhagic Brain Pathology Research Group, Kuopio, Finland; Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland
  • Jarno Savolainen - University of Eastern Finland, Department of Dentistry, Kuopio, Finland; Kuopio University Hospital, Department of Oral and Maxillofacial Diseases, Kuopio, Finland
  • Tuomas Selander - Kuopio University Hospital, Science Service Center, Kuopio, Finland
  • Antti Jula - National Institute for Health and Welfare, Helsinki, Finland
  • Matti Närhi - University of Eastern Finland, Department of Dentistry, Kuopio, Finland; University of Eastern Finland, Department of Biomedicine, Kuopio, Finland
  • Timo Koivisto - Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland
  • Jari Kellokoski - University of Eastern Finland, Department of Dentistry, Kuopio, Finland; Kuopio University Hospital, Department of Oral and Maxillofacial Diseases, Kuopio, Finland
  • Pekka Ylöstalo - University of Oulu, Unit of Oral Health Sciences, Oulu, Finland; Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland
  • Anna Liisa Suominen - University of Eastern Finland, Department of Dentistry, Kuopio, Finland; Kuopio University Hospital, Department of Oral and Maxillofacial Diseases, Kuopio, Finland; National Institute for Health and Welfare, Finland
  • Juhana Frösen - Kuopio University Hospital, Hemorrhagic Brain Pathology Research Group, Kuopio, Finland; Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocJM-SNS08

doi: 10.3205/19dgnc246, urn:nbn:de:0183-19dgnc2461

Veröffentlicht: 8. Mai 2019

© 2019 Hallikainen et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Oral bacteria DNA has been found in intracranial aneurysms (IA) and high prevalence of periodontitis reported in case series of IA patients. Since periodontitis predisposes to the development and progression of other aneurysms, we investigated whether periodontitis or gingival inflammation associates with the development of intracranial aneurysms (IA) and subsequent progression to aneurysmal subarachnoid hemorrhage (aSAH) caused by IA rupture.

Methods: First, we collected a case series of 76 IA patients (42 unruptured IA, 34 ruptured IA) that underwent oral examination. Second, we compared these 76 IA patients in a casecontrol setting with 70 age and gender matched controls from the same geographical area, obtained from participants of a prior Health 2000 Survey (BRIF8901). Third, we investigated in a prospective follow-up setting of 5170 Health 2000 Survey participants whether periodontitis or gingival inflammation at baseline associated with aSAH during a 13-year follow-up period, for which follow-up data was obtained from national registries for hospital discharge diagnoses and for causes of death. Univariate analysis, logistic regression, and Cox-regression were used.

Results: Periodontitis (≥4mm gingival pocket) and severe periodontitis (≥6mm gingival pocket) were found in 92% and 49% of IA patients respectively. In case-control comparison, periodontitis and especially severe periodontitis associated with IAs (OR 5.3, 95%CI 1.1–25.9, p<0.000 and OR 6.3, 95%CI 1.3–31.4, p<0.001, respectively). Gingival bleeding had an even stronger association, especially if detected in 4–6 teeth sextants (OR 34.4, 95%CI 4.2–281.3). In the prospective follow-up, severe periodontitis in ≥3 teeth or gingival bleeding in 4–6 teeth sextants increased the risk of aSAH (HR 22.5, 95%CI 3.6–139.5, p=0.001 and HR 8.3, 95%CI 1.5–46.1, p=0.015 respectively).

Association of periodontitis and gingival bleeding with risk of IA development and aSAH was independent of gender, smoking status, hypertension, or alcohol abuse in both study settings.

Conclusion: We report that poor periodontal condition and gingival bleeding associate with increased risk for IA formation and eventual aSAH. Further epidemiological and mechanistic studies are indicated.