Abstract 170: A Correlation Between Intracranial Aneurysm and Immunoinflammatory Status with the Imaging Characteristics of Periodontitis
Authors: Girao V. , Ortega D. , Chan V. , Liu E. , Cancelliere N. , Jerkic M. , Spears J. , Marotta T. , Tenenbaum H. , Goldberg M. , McGlennen R. , Frösen J. , Glogauer M. , Pereira V. M. 
Published: January 2025

IIntroduction/Purpose
Intracranial aneurysms (IAs) are abnormal vascular dilations that often result in severe intracranial bleeding, contributing to morbidity and mortality worldwide. It is believed that IA development, growth, and rupture originate from endothelial dysfunction. A high prevalence of periodontal diseases (PDs) has been linked to both unruptured and ruptured IAs, suggesting that PDs‐associated bacterial invasion, followed by a local immunoinflammatory response, may play a role in IA formation. However, the pathophysiological link between PDs and IAs remains unclear. While some studies have explored the association between PDs and IAs, the relationship between imaging findings suggestive of periodontitis and the status of IAs has not been adequately examined. This study aims to correlate imaging manifestations suggestive of periodontitis with the immunoinflammatory status and aneurysm characteristics in patients with both ruptured and unruptured IAs.

Materials and Methods
A cross‐sectional study was conducted, classifying patients with IAs and controls (no aneurysms) into six subgroups: 1) Control group, 2) Stable aneurysms, 3) Previously unruptured, currently unruptured treated aneurysms, 4) Previously ruptured, currently unruptured treated aneurysms, 5) Previously unruptured, currently ruptured aneurysms, and 6) Previously ruptured, currently ruptured aneurysms. Computerized Tomography (CT) scans were acquired to evaluate teeth and adjacent alveolar bone for signs of PD. All CT scans were evaluated by a trained dentist. Saliva samples were collected and analyzed for inflammatory markers (e.g., IL‐1β, IL‐6, TNF‐α) and periodontopathic microorganisms. Peripheral blood samples from all groups, and intra‐aneurysmal blood from Groups 3‐6, were collected and analyzed for inflammatory biomarkers and microorganisms.

Results

This study is a subanalysis of the DentIA study, focusing on periodontal imaging findings in patients with and without IAs. The prevalence and severity of PD markers, such as alveolar bone loss and periodontal pocket, will be analyzed across different patient subgroups. The correlation between the quantity and severity of alveolar bone loss, suggestive of periodontitis, detected on CT and elevated immunoinflammatory biomarkers in saliva, peripheral blood, and intra‐aneurysmal blood will be examined. The levels of IL‐1β, IL‐6, and TNF‐α will be compared amongst patients, stratifying by degree of alveolar bone loss. Additionally, the presence of periodontopathic microorganisms, particularly
Porphyromonas gingivalis
and
Treponema denticola
, will be analyzed in patients with and without identifiable aneurysms. Furthermore, extensive alveolar bone loss on imaging will be compared among patients with IAs, evaluating the prevalence and association in patients with advanced aneurysm status, whether in terms of growth, previous rupture, or post‐treatment recurrence. These results may further clarify the potential connection between oral health and the immunoinflammatory environment conducive to aneurysm development and progression.

Conclusion
This study will provide a detailed analysis of the relationship between IA status, immunoinflammatory biomarkers, and CT imaging characteristics of periodontitis. These preliminary results will indicate how the CT images suggestive of periodontitis are correlated with immunoinflammatory biomarkers in patients with IAs, discussing the potential association between periodontitis imaging characteristics and the presence of IAs, in addition to an elevated immunoinflammatory and periodontopathogenic profile.