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Additionally, the decayed\/missing\/filled teeth (DMFT) index was quantified. 3D\u2010FLAIR and 3D\u2010T1\u2010weighted images were used for white matter hyperintensity (WMH) segmentation. Diffusion\u2010weighted MRI was used to quantify peak width of skeletonized mean diffusivity (PSMD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 2030 participants were included in the analysis. Median age was 65\u2009years, with 43% female participants. After adjusting for age and sex, an increase in WMH load was significantly associated with more CAL, higher plaque index and higher DMFT index. PSMD was significantly associated with the plaque index and DMFT. Additional adjustment for education and cardiovascular risk factors revealed a significant association of PSMD with plaque index (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and DMFT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01), whereas effects of WMH load were attenuated (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest an adverse effect of periodontal health on CSVD and white matter integrity. Further research is necessary to examine whether early treatment of periodontal disease can prevent microstructural brain damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.13828","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T20:31:51Z","timestamp":1685651511000},"page":"1598-1609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Association between periodontal disease and microstructural brain alterations in the Hamburg City Health Study"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8065-8683","authenticated-orcid":false,"given":"Carola","family":"Mayer","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg 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