{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:46:34Z","timestamp":1792017994819,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Cerebrovascular diseases (CVAs) have several risk factors that are categorized as modifiable and nonmodifiable. Periodontal diseases (PD) have a modifiable role in causing CVA, where several studies suggested direct or indirect correlations with systemic diseases. This study aims to summarize, evaluate and analyze all the evidence available in literature, to reach a better understanding of the relation between periodontitis, gingivitis, tooth loss and CVA. Methods: PubMed, Cochrane, Scopus and Web of Science databases were searched for all meta-analyses assessing the effect of PD on CVA in accordance with Joanna Briggs Institute guidance for umbrella reviews in March 2024. Assessment of Multiple Systematic Reviews (AMSTAR) was used for quality assessment. Pooled analysis was performed to assess the effect of periodontitis, gingivitis and tooth loss on CVA, depending on the availability of data using Review Manager Version 5.2.11. Results: Seven of the identified meta-analyses were of high quality, and they were distributed in different countries. Periodontitis was generally associated with a significant increase in CVA risk (OR = 2.32, 95% CI: 1.70, 3.17, p &lt; 0.00001 and RR = 1.22, 95% CI: 1.15\u20131.29, p &lt; 0.00001), same as tooth loss, but to a lower degree (0.78). However, the effect of gingivitis was insignificant in terms of CVA (RR = 1.32, 95% CI: 1.12\u20131.56, p = 0.0008). Conclusions: This study confirms the effect of periodontitis and tooth loss on CVA, disregarding any significant role for gingivitis. The relation reached favors the suggested role of some inflammatory changes in the pathogenic pathway leading to atherosclerotic changes.<\/jats:p>","DOI":"10.3390\/brainsci15010010","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T19:33:07Z","timestamp":1735241587000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Association Between Periodontitis, Gingivitis, Tooth Loss and Stroke: An Umbrella Study with Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Jad","family":"El Masri","sequence":"first","affiliation":[{"name":"INSERM U955-E01, Institut Mondor de Recherche Biom\u00e9dicale (IMRB), Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"\u00c9cole Doctorale Sciences de la Vie et de la Sant\u00e9, Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"Neuroscience Research Center (NRC), Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"INSPECT-LB (Institut National de Sant e Publique, d\u2019\u00c9pidemiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Al Malak","sequence":"additional","affiliation":[{"name":"Faculty of Dental Sciences, Lebanese University, Beirut 1153, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diala","family":"El Masri","sequence":"additional","affiliation":[{"name":"Neuroscience Research Center (NRC), Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"Faculty of Medical Sciences, University of Balamand, Koura 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silva","family":"Al Boussi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"El Masri","sequence":"additional","affiliation":[{"name":"Faculty of Dental Sciences, Lebanese University, Beirut 1153, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Hassoun","sequence":"additional","affiliation":[{"name":"Faculty of Dental Sciences, Lebanese University, Beirut 1153, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Tlayss","sequence":"additional","affiliation":[{"name":"Faculty of Arts and Sciences, University of Balamand, Koura 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-0772","authenticated-orcid":false,"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"INSPECT-LB (Institut National de Sant e Publique, d\u2019\u00c9pidemiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon"},{"name":"Faculty of Pharmacy, Lebanese University, Beirut 1153, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos 1102, Lebanon"},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2417, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Hosseini","sequence":"additional","affiliation":[{"name":"INSERM U955-E01, Institut Mondor de Recherche Biom\u00e9dicale (IMRB), Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"Department of Neurology, Henri Mondor Hospital, AP-HP, 94010 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"ref_1","first-page":"3238165","article-title":"Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life","volume":"2018","author":"Donkor","year":"2018","journal-title":"Stroke Res. 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