芝加哥—— 一项发表在《牙周病学杂志》（JOP）10月刊的最新研究显示，如果一个人部分或全部牙缺失，或存在着牙槽骨严重吸收、牙周组织萎缩的牙周病症状，那么他得中风的危险性大大提高。
波士顿大学的研究员通过调查分析第三届全国健康和营养测试调查（NHANES III）的数据，研究牙周病与60岁及以上中风病人之间的关系。
波士顿大学Goldman牙科学院的Martha E. Nunn博士认为，全口无牙、局部缺牙和/或有严重的临床附着丧失的牙周病患者比牙齿完整、无附着丧失的成人更容易出现中风，但是，根据这个研究的结果，仍未能确定牙周病是中风的独立危险因素还是仅仅反映牙周病和中风共同危险因素负面作用的标志。
该研究还分析了包括年龄、吸烟、高血压、糖尿病、血糖、C反应蛋白（CRP）水平及酒精摄入在内的一些中风危险因素。这些混杂因素都是心血管疾病的独立危险因素，如果牙周炎未得到有效治疗，则不利于糖尿病和血糖水平的控制，还会使CRP水平升高。
越来越多证据显示，严重的牙周炎可促进形成动脉粥样硬化斑块。动脉粥样硬化斑块的形成是心肌梗塞和缺血性中风的成因。过去JOP的研究认为，由于慢性牙周病患者的CRP水平升高，从而使动脉粥样硬化斑块加速形成。
有必要进行进一步研究以证明牙周病的干预治疗是控制全身炎症反应的手段之一。本期JOP的另一研究显示，对患有严重牙周病的患者采用刮牙术和根面平整术等牙周病治疗可降低CRP水平。
Preston D. Miller认为，需要对如反复洁治和根面平整或手术治疗等其他治疗方法进行评估，才能证明牙周治疗可改善CRP水平，“只有科学研究指出正确的方向，牙周病学家才能使病人最终得到健康，我们现在知道的是要消除牙周感染，保护牙齿。”
New evidence finds an association between periodontal disease and stroke
Researchers from Boston University investigate the relationship between periodontal disease and ischemic stroke
CHICAGO -- People missing some or all of their teeth or who have significant loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke, according to a new study that appeared in the October issue of the Journal of Periodontology (JOP).
Researchers from Boston University investigated the relationship between periodontal disease and history of stroke in patients 60 years of age and older by examining the data of the Third National Health and Nutrition Examination Survey (NHANES III).
"We found that patients 60 years and older who were edentulous, partially edentulous and/or had significant clinical attachment loss were more likely to have a history of stroke compared to dentate adults without significant clinical attachment loss," said Dr. Martha E. Nunn, Goldman School of Dental Medicine, Boston University. "However, based on the results of this study, it is unclear whether periodontal disease is an independent risk factor for stroke or simply a risk marker that reflects negative effects of risk factors common to both periodontal disease and stroke."
Age, tobacco use, hypertension, diabetes, serum glucose, C-Reactive protein (CRP) and alcohol intake were also included as additional risk factors in this study. These confounders are independent risk factors for cardiovascular disease and if left untreated, periodontitis has been shown to have harmful effects on the control of diabetes, serum glucose levels and increases CRP levels.
Evidence continues to accumulate associating severe periodontitis with an increased risk of forming atherosclerotic plaques, which are responsible for myocardial infarction and ischemic stroke. According to past JOP studies, this relationship could be due to elevated CRP levels in patients with chronic periodontal disease.
Further investigation is needed to support periodontal treatment intervention as a means of controlling systemic inflammation. Based on findings from another study in this JOP issue, CRP levels may now be reduced by periodontal treatment such as scaling and root planing in patients with severe periodontal disease.
"Studies evaluating additional treatment methods such as repeated scaling and root planing or surgical treatment are needed to conclusively demonstrate that CRP can be improved by periodontal treatment," said Preston D. Miller, DDS and AAP president. "Until science presents a definitive direction, the periodontists ultimate goal is to lead patients to the right side of health. What we do know is that eliminating periodontal infection saves teeth."
编辑：蓝色幻想
