The Role of Periodontal Diseases and Stimulation of Saliva Secretion in the Acute Phase of Ischemic Stroke
Study Details
Study Description
Brief Summary
Methods: 100 consecutive patients with their first ever ischemic stroke were enrolled in the study. 56 randomly selected patients were subjected to stimulation of salivation, the remaining patients were not stimulated. The severity of the neurological condition was assessed using the NIHSS scale on days 1, 3 and 7 of stroke. The incidence of periodontal diseases was classified using the Hall's scale in the 1st day of stroke. On days 1 and 7 of stroke, the concentration of IL-1beta, MMP8, OPG and RANKL in the patients' saliva was assessed using the Elisa technique. At the same time, the level of CRP and the number of leukocytes in the peripheral blood were tested on days 1, 3 and 7 of the stroke, and the incidence of upper respiratory and urinary tract infections was assessed.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The course of an ischemic stroke varies by many factors. The influence of periodontal diseases and the stimulation of salivation on the course and difficulty of stroke remains unresolved.
Methods: 100 consecutive patients with their first ever ischemic stroke were enrolled in the study. 56 randomly selected patients were subjected to stimulation of salivation, the remaining patients were not stimulated. The severity of the neurological condition was assessed using the NIHSS scale on days 1, 3 and 7 of stroke. The incidence of periodontal diseases was classified using the Hall's scale in the 1st day of stroke. On days 1 and 7 of stroke, the concentration of IL-1beta, MMP8, OPG and RANKL in the patients' saliva was assessed using the Elisa technique. At the same time, the level of CRP and the number of leukocytes in the peripheral blood were tested on days 1, 3 and 7 of the stroke, and the incidence of upper respiratory and urinary tract infections was assessed.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: saliva-stimulated group In approximately 50 randomly selected patients (group 1), from the second day of admission until the end of hospitalization, a 15-minute manual stimulation of the submandibular and sublingual bib was performed internally and externally. In addition, oral hygiene was performed in patients, taking into account the tongue and cheeks. |
Diagnostic Test: saliva stimulation
In 50 patients with ischemic stroke, saliva was the option of a neurologopedic massage of choice
|
| No Intervention: the group in which the saliva was not stimulated There was no saliva in the group of 50 patients |
Outcome Measures
Primary Outcome Measures
- evaluation of saliva parameters od day 1 [day 1 of stroke]
On the first day of admission, saliva (2 ml) is collected and the parameters are MMP8 (ng/mL), OPG ( (ng/mL) and RANKL (ng/mL)
- evaluation of saliva parameters od day 1 [day 1 of stroke]
On the first day of admission, saliva (2 ml) is collected and the parameter IL-1Beta(pg/mL)
- assessment of blood parameters from day 1 [day 1 of stroke]
Assessment of CRP(mg/L) in blood on the first day of hospitalization
- assessment of blood parameters from day 1 [day 1 of stroke]
Assessment of WBC( G/µL)in blood on the first day of hospitalization
Secondary Outcome Measures
- evaluation of saliva parameters- second measurement [day 7 of stroke]
On the seventh day of admission, saliva (2 ml) is collected with the parameters MMP8MMP8 (ng/mL), OPG ( (ng/mL) and RANKL (ng/mL)
- evaluation of saliva parameters- second measurement [day 7 of stroke]
On the seven day of admission, saliva (2 ml) is collected and the parameter IL-1Beta(pg/mL)
- assessment of blood parameters from day 7 [day 7 of stroke]
Assessment of CRP(mg/L) in blood on the seven day of hospitalization
- assessment of blood parameters from day 7 [day 7 of stroke]
Assessment of WBC( G/µL)in blood on the seven day of hospitalization
Other Outcome Measures
- Neurological assessment using the NIHSS scale [day 1 of stroke]
On admission, the patient's neurological status is assessed using the NIHSS scale
- Neurological assessment using the NIHSS scale [day 3 of stroke]
On the third, the patient's neurological status is assessed using the NIHSS scale
- Neurological assessment using the NIHSS scale [day 7 of stroke]
On the seventh day, the patient's neurological status is assessed using the NIHSS scale
Eligibility Criteria
Criteria
Inclusion Criteria:
-
men and women,
-
at the age of 48-80,
-
first-ever stroke,
-
with symptoms from the anterior cerebral vascularity (basin of the internal carotid artery),
-
with a significant neurological deficit (minimum 3 points according to the NIH scale)
-
capable of giving informed consent;
Exclusion Criteria:
-
aphasia, disturbance of consciousness, mental disorders - making it impossible to express informed consent
-
surgery of the salivary glands - disrupting the secretion of saliva
-
diseases of the salivary glands that disrupt the secretion of saliva (diabetes, Sjögren's syndrome, state after radiotherapy in the area of the salivary glands)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Departmen of Neurology | Szczecin | Unii Lubelskiej | Poland | 71-228 |
Sponsors and Collaborators
- Pomeranian Medical University Szczecin
Investigators
- Study Chair: Wioletta W Pawlukowska, dr hab., Department of Neurology, Pomeranian Medical University, Szczecin, Poland
Study Documents (Full-Text)
None provided.More Information
Publications
- Blaizot A, Vergnes JN, Nuwwareh S, Amar J, Sixou M. Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int Dent J. 2009 Aug;59(4):197-209. Review.
- Carallo C, Fortunato L, de Franceschi MS, Irace C, Tripolino C, Cristofaro MG, Giudice M, Gnasso A. Periodontal disease and carotid atherosclerosis: are hemodynamic forces a link? Atherosclerosis. 2010 Nov;213(1):263-7. doi: 10.1016/j.atherosclerosis.2010.07.025. Epub 2010 Jul 29.
- Grau AJ, Becher H, Ziegler CM, Lichy C, Buggle F, Kaiser C, Lutz R, Bültmann S, Preusch M, Dörfer CE. Periodontal disease as a risk factor for ischemic stroke. Stroke. 2004 Feb;35(2):496-501. Epub 2004 Jan 5.
- Hashemipour MA, Afshar AJ, Borna R, Seddighi B, Motamedi A. Gingivitis and periodontitis as a risk factor for stroke: A case-control study in the Iranian population. Dent Res J (Isfahan). 2013 Sep;10(5):613-9.
- Mattila KJ, Asikainen S, Wolf J, Jousimies-Somer H, Valtonen V, Nieminen M. Age, dental infections, and coronary heart disease. J Dent Res. 2000 Feb;79(2):756-60.
- Orlandi M, Suvan J, Petrie A, Donos N, Masi S, Hingorani A, Deanfield J, D'Aiuto F. Association between periodontal disease and its treatment, flow-mediated dilatation and carotid intima-media thickness: a systematic review and meta-analysis. Atherosclerosis. 2014 Sep;236(1):39-46. doi: 10.1016/j.atherosclerosis.2014.06.002. Epub 2014 Jun 17. Review.
- Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008 Apr;35(4):277-90. doi: 10.1111/j.1600-051X.2007.01173.x. Epub 2008 Feb 20. Review.
- Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005 Nov 19;366(9499):1809-20. Review.
- Pinho MM, Faria-Almeida R, Azevedo E, Manso MC, Martins L. Periodontitis and atherosclerosis: an observational study. J Periodontal Res. 2013 Aug;48(4):452-7. doi: 10.1111/jre.12026. Epub 2012 Dec 30.
- Pomeranian Medical University