Introduction
Material and methods
Study population for the case series of IA patients
Case-control comparison of IA patients with matched controls
Prospective follow-up of Health 2000 Survey participants for aSAH
Clinical examination for periodontitis
Statistical analyses
Results
High frequency of periodontitis in a case series of intracranial aneurysm patients
Variable | aSAH (n = 33) | No aSAH (n = 41) | p value | Matched controls (n = 70) | p value |
---|---|---|---|---|---|
Age | 50.0 (27.0–76.0) | 60.0 (22.0–77.0) | 0.004 | 57.0 (31.0–76.0) | NS |
Gender (number of females) | 23/33 (69.7%, 95%CI 51.1–83.8) | 25/41 (61.0%, 95%CI 44.6–75.4) | NS | 45/70 (64.3%, 95%CI 51.9–75.1) | NS |
IA family history | 5/33 (15.2%, 95%CI 5.7–32.7) | 6/41 (14.6%, 95%CI 6.1–29.9) | NS | ||
Multiple IAs | 17/33 (51.5%, 95%CI 33.9–68.8) | 17/41 (41.5%, 95%CI 26.7–57.8) | NS | ||
Hypertension (treated with medication) | 16/33 (48.5%, 95%CI 31.2–66.1) | 23/41 (56.1%, 95%CI 39.9–71.2) | NS | 40/70 (57.1%, 95%CI 44.8–68.7) | NS |
Untreated or inadequately treated hypertension | 3/33 (9.1%, 95%CI 2.4–25.5) | 0/41 | NS | ||
Diabetes (type I or II) | 0/33 | 3/41 (7.3%, 95%CI 1.9–21.0) | NS | ||
Heavy alcohol consumption (defined by treating physician) | 1/33 (3.0%, 95%CI 0.2–17.5) | 3/41 (7.3%, 95%CI 1.9–21.0) | NS | ||
Current smoking | 16/33 (48.5%, 95%CI 31.2–66.1) | 10/41 (24.4%, 95%CI 12.9–40.6) | 0.047 | 26/70 (37.1%, 95%CI 26.1–49.6) | NS |
No smoking history | 16/33 (48.5%, 95%CI 31.2–66.1) | 23/41 (56.1%, 95%CI 39.9–71.2) | 0.047 | ||
Periodontitis (≥ 4 mm periodontal pocket) | 31/33 (93.9%, 95%CI 78.4–98.9) | 37/41 (90.2%, 95%CI 75.9–96.8) | NS | 47/70 (67.1%, 95%CI) | < 0.001 |
Periodontitis (periodontal pocket 4–5 mm) | 15/33 (45.5%, 95%CI 28.5–63.4) | 17/41 (41.5%, 95%CI 26.7–57.8) | NS NS | 29/70 (41.4%, 95%CI 30.0–53.8) | < 0.001 |
Severe periodontitis (≥ 6 mm periodontal pocket) | 16/33 (48.5%, 95%CI 31.2–66.1) | 20/41 (48.8%, 95%CI 33.2–64.6) | 18/70 (25.7%, 95%CI 16.3–37.8) | < 0.001 | |
Mean BOP % | 40.1% | 37.9% | NS | ||
Number of bleeding sextants | |||||
0–1 | 1/33 (3.0%, 95%CI 0.2–17.5) | 2/41 (4.9%, 95%CI 0.9–17.8) | NS | 39/70 (55.7%, 95%CI 43.4–67.4) | < 0.001 |
2–3 | 6/33 (18.2%, 95%CI 7.6–36.1) | 11/41 (26.8%, 95%CI 14.8–43.2) | NS | 18/70 (25.7%, 95%CI 16.3–37.8) | < 0.001 |
4–6 | 26/33 (78.8%, 95%CI 60.6–90.4) | 28/41 (68.3%, 95%CI 51.8–81.4) | NS | 13/70 (18.6%, 95%CI 10.6–30.0) | < 0.001 |
Gingival bleeding from teeth sextants (mean sextants affected) | 4.8 | 4.3 | NS | 1.0 | < 0.001 |
Periodontitis and gingival inflammation associate with intracranial aneurysms in case-controlled multivariate comparison
Variable | Cases | Odds ratio | 95%CI | p value |
---|---|---|---|---|
Model 1 | ||||
Age | 144 | 0.950 | 0.912–0.989 | 0.013* |
Gender | ||||
Male | 51/144 | 1 | ||
Female | 93/144 | 1.869 | 0.690–5.063 | 0.219 |
Hypertension | ||||
No confirmed hypertension | 62/144 | 1 | ||
Confirmed hypertension | 82/144 | 1.172 | 0.469–2.925 | 0.734 |
Smoking status | ||||
Non-smoking | 74/144 | 1 | ||
Intermittent smoking | 18/144 | 0.180 | 0.020–1.621 | 0.126 |
Daily smoking | 52/144 | 1.717 | 0.654–4.504 | 0.272 |
Periodontitis* | ||||
No periodontitis | 29/144 | 1 | ||
Periodontitis | 61/144 | 5.315 | 1.089–25.935 | 0.039* |
Severe periodontitis | 54/144 | 6.312 | 1.270–31.372 | 0.024* |
Model 2 | ||||
Age | 144 | 0.959 | 0.920–1.000 | 0.048* |
Gender | ||||
Male | 51/144 | 1 | ||
Female | 93/144 | 2.377 | 0.777–7.268 | 0.129 |
Hypertension | ||||
No confirmed hypertension | 62/144 | 1 | ||
Confirmed hypertension | 82/144 | 1.088 | 0.434–2.728 | 0.858 |
Smoking status | ||||
Non-smoking | 74/144 | 1 | ||
Intermittent smoking | 18/144 | 0.228 | 0.024–2.138 | 0.195 |
Daily smoking | 52/144 | 3.045 | 0.995–9.318 | 0.051 |
Gingival bleeding** | ||||
0–1 sextants | 42/144 | 1 | ||
2–3 sextants | 35/144 | 12.475 | 1.331–116.905 | 0.027* |
4–6 sextants | 67/144 | 34.356 | 4.196–281.305 | < 0.001* |
Periodontitis and gingival inflammation at baseline associate with risk of aSAH during follow-up
Variable | Cases in each group/number of followed subjects in the model | Hazard ratio | 95%CI | p value |
---|---|---|---|---|
Model 1 | ||||
Age | 2792 | 1.0 | 0.9–1.1 | 0.600 |
Gender | ||||
Male | 1602/2792 | 1 | ||
Female | 1194/2792 | 4.5 | 0.8–25.5 | 0.090 |
Hypertension | ||||
No confirmed hypertension | 1673/2792 | 1 | ||
Confirmed hypertension | 1123/2792 | 0.6 | 0.1–3.7 | 0.575 |
Smoking status | ||||
Non-smoking | 1345/2792 | 1 | ||
Daily or intermittent smoking | 1451/2792 | 3.6 | 0.4–32.1 | 0.256 |
Severe periodontitis# (≥ 6 mm periodontal pocket) | ||||
0–2 teeth affected | 2522/2792 | 1 | ||
≥ 3 teeth affected | 274/2792 | 22.5 | 3.6–139.5 | 0.001* |
Model 2 | ||||
Age | 2786 | 1.1 | 1.0–1.1 | 0.172 |
Gender | ||||
Male | 1598/2786 | 1 | ||
Female | 1189/2786 | 3.5 | 0.6–19.6 | 0.157 |
Hypertension | ||||
No confirmed hypertension | 1668/2786 | 1 | ||
Confirmed hypertension | 1119/2786 | 0.8 | 0.1–4.7 | 0.786 |
Smoking status | ||||
Non-smoking | 1340/2786 | 1 | ||
Daily or intermittent smoking | 1447/2786 | 5.4 | 0.6–48.7 | 0.130 |
Gingival bleeding¤ | ||||
0–4 sextants affected | 2170/2786 | 1 | ||
5–6 sextants affected | 617/2786 | 8.3 | 1.5–46.1 | 0.015* |