Is there an association between obstructive sleep apnea syndrome and periodontal inflammation?

Abstract

Objectives: To assess salivary, serum biomarkers, and subgingival bacteria as putative candidates in the potential association between obstructive sleep apnea syndrome (OSAS) and periodontal disease. Materials and methods:Fifty-two patients were grouped according to the severity of OSAS: 13 participants served as controls, 17 patients had mild-to-moderate OSAS, and 22 severe OSAS. Serum, saliva, and subgingival plaque samples were collected, clinical periodontal parameters recorded. Salivary, serum concentrations of interleukin-6 (IL-6), tumour necrosis factor (TNF-α), osteoprotegerin, sRANKL, and apelin were analysed by enzyme-linked immunosorbent assay. Bacterial counts were determined by real-time QPCR on plaque microbial DNA preparations.Results: There was a significant change in the composition of microbes in plaque particularly in severe OSAS samples (p<0.01). Statistical analyses indicated significantly higher salivary IL-6 levels in both OSAS groups compared to controls (p<0.05). Salivary apelin levels were significantly higher in Serum levels of these biomarkers and salivary osteoprotegerin, sRANKL levels were similar in the study groups. The incidence and duration of apnea positively correlated with clinical periodontal parameters (p<0.05). Conclusion:OSAS appeared to alter the tested bacteria in plaque, correlate with increasing periodontal disease severity, have additive effect on salivary IL-6.Clinical relevance: OSAS is likely to interact with periodontal disease.

Does Obstructive Sleep Apnea Increase the Risk for Periodontal Disease? A Case‐Control Study

“…Furthermore, all clinical periodontal parameters, including PI, GI, BOP, PD, and CAL, were significantly higher in the OSA group than in the controls. Other studies have also reported higher, but not statistically significant, periodontal indices in patients with OSA 10,18‐20 . Reported prevalence of periodontitis ranged between 17.5% and 77% to 79% in patients with OSA 8–12 .…”

“…Different prevalence results between these two studies may be explained by differences in the distribution of OSA groups. Other studies did not clearly define periodontitis or they used clinical parameters, such as PD or CAL, instead of the AAP/CDC classification 10,18‐20 …”

“…Levels of salivary and serum cytokines in patients with OSA have been investigated as well 18 , 19 . Nizam et al 18–20 found that salivary IL‐6 and IL‐33 concentrations were significantly higher in the OSA group than in controls, whereas salivary IL‐1β concentrations and salivary and serum TNF‐α levels were similar between the groups. However, there is not enough evidence to prove that cytokine levels in saliva are related to periodontal disease status.…”

“…In those studies, the severe OSA group had higher BMI and a higher number of males than the controls. Furthermore, prevalence of periodontal disease severity was not evaluated 18–20 …”

“…However, in these studies, only the periodontal status of patients was examined. Furthermore, only one group of investigators evaluated salivary‐serum cytokine concentrations and subgingival bacteria in patients with OSA in the same patient population 18–20 . It was demonstrated that OSA appeared to alter the tested bacteria in plaque and was correlated with increasing periodontal disease severity and higher salivary IL‐6 levels 19 , 20 …”