title: Investigating the association between obstructive sleep apnea and periodontitis.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is a sleep disorder characterized by disruptions of normal sleep architecture. Chronic periodontitis is a chronic disease of the periodontium that elicits a general inflammatory response to local dental plaque. It has been suggested that periodontal disease may increase in severity with increasingly severe OSA because both disease entities share common inflammatory pathways, acting synergistically to alter the host response. The aim of this study is to analyze the association between severity of OSA and the prevalence/severity of periodontitis.
  
  
  METHODS
  One hundred patients from a large veterans administration sleep study center (n = 26 normal, n = 21 mild, n = 19 moderate, n = 34 severe) diagnosed with an overnight polysomnogram underwent a comprehensive periodontal examination. Periodontal parameters measured included the following: 1) mean periodontal probing depth (PD); 2) clinical attachment level (CAL); 3) gingival recession; and 4) percentage of sites with bleeding on probing, plaque, PD ≥5 mm, and CAL ≥3 mm.
  
  
  RESULTS
  Seventy-three percent of the sampled population had moderate/severe periodontal disease. χ(2) analyses revealed no significant differences in the prevalence of periodontal disease between the apnea-hypopnea index (AHI) groups, with a negligible Spearman correlation coefficient of 0.246 between AHI severity and periodontal disease severity categories. Analysis of covariance indicated a significant association between AHI severity categories and percentage of sites with plaque, after adjusting for age. Multivariable logistic regression analysis predicting moderate/severe periodontitis with AHI score, age, and smoking status indicated a significant association with age (P = 0.028) but no significant association with the other two predictors.
  
  
  CONCLUSIONS
  OSA was not significantly associated with the prevalence of moderate/severe periodontitis and the periodontal parameters examined, except percentage plaque.
authors.affiliation: Department of Periodontics, University of Texas Health Science Center at San Antonio Dental School, San Antonio, TX.
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Loke
authors.forename: Thomas
authors.initials: T
authors.lastname: Girvan
authors.forename: Paul
authors.initials: P
authors.lastname: Ingmundson
authors.forename: Ronald
authors.initials: R
authors.lastname: Verrett
authors.forename: John
authors.initials: J
authors.lastname: Schoolfield
authors.forename: Brian L
authors.initials: BL
authors.lastname: Mealey
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D055113:Chronic Periodontitis / Q000145:classification / Q000150:complications*; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D048909:Diabetes Complications; D005260:Female; D005889:Gingival Recession / Q000145:classification; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D017286:Polysomnography / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000150:complications*; D012907:Smoking
keywords: Chronic periodontitis; sleep apnea, obstructive