Association between periodontal disease and non-fatal ischemic stroke: a case-control study.

OBJECTIVE: This study aimed to investigate the association between clinical and radiological markers of periodontal disease and ischemic stroke and to assess the potential influence of inflammatory response on the observed associations. METHODS: A prospective case-control study including a series of 48 cases with a minor ischemic stroke and 47 controls was conducted at the University Hospital of Dijon. Vascular risk factors, clinical dental examination (plaque index, gingival index, percentage of pockets >5 mm, percentage of bleeding on probing (BOP) sites), dental panoramic (bone loss) and biological parameters (CRP, total cholesterol, HDL, LDL, fasting glucose) were collected. Conditional regression analyses were performed to identify factors associated with ischemic stroke. RESULTS: The prevalence of hypertension, high CRP and glucose levels and overall odontological variables was higher in stroke patients. In multivariable analyses, hypertension (OR = 12.56; 95% CI = 2.29-69.96, p = 0.004), CRP levels >5 mg/L (OR = 18.54; 95% CI = 2.01-171.17, p = 0.010), BOP (OR = 1.049; 95% CI = 1.012-1.88, p = 0.009) and bone loss >20% (OR = 1.053; 95% CI = 1.017-1.091, p = 0.004) were associated with ischemic stroke. Among stroke patients, there was a non-significant trend towards higher CRP levels in patients with bone loss >20% compared with those with bone loss <20% (8.1 ± 1.27 mg/L vs 3.12 ± 3.14 mg/L, p = 0.25), whereas other biological parameters were very similar between the two groups. CONCLUSION: This case-control study demonstrates that periodontal disease, especially markers such as BOP and bone loss, is independently associated with ischemic stroke.

Sinonasal undifferentiated carcinoma, or schneiderian carcinoma arising from an aspergillosis: a case history.

The sinonasal undifferentiated carcinoma or schneiderian carcinoma is a rare, malignant, aggressive tumour of the maxillary sinuses with an unknown aetiology. Its site and clinical symptoms can simulate chronic sinusitis, and radiographs suggest severe osteonecrotic-type destruction. Only histological and cellular investigations can confirm the diagnosis. We describe a 62-year-old woman with no previous medical or surgical history who presented with unilateral dental pain and chronic sinusitis. She was diagnosed with sinonasal carcinoma and had a hemimaxillectomy and radiotherapy.