Periodontitis and stroke

There are various forms of periodontitis characterised as an inflammatory disease with more or less expressed alteration of genetic immunological components and associated with local as well as psycho-social factors. Presence of chronic destructive inflammation in the mouth - a region with rich blood supply, contributes to escape of bacteria, their virulent factors and various pro-inflammatory cells, cytokines and immunologically active substances into the blood stream and their subsequent penetration into different organs and tissues, where they continue in their harmful destruction. Atherosclerosis of cerebral vessels and its consequences resulting in ischaemic stroke are the most frequents cause of acute strokes. Today's knowledge and studies of etiopathogenesis of vascular atherosclerosis present the atherosclerotic process of vascular walls as metabolic, infectious and immunological process, which progressively obliterates vascular lumen and creates conditions for acute and chronic vascular events in various regions. Inflammation is a source of chronic and acute infections in often distal organs and tissues as a risk factor of a atherosclerotic vascular process. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and a stroke. A special emphasis is put on explanation of possible relations between an oral infection and stimulation of pro-atherogenetic mechanisms. The second part of the paper deals with principles of treatment in patients after stroke.