title: Is there an association between obstructive sleep apnea syndrome and periodontal inflammation?
abstract: OBJECTIVE
  The aim of this study is to assess salivary, serum biomarkers, and subgingival bacteria as putative candidates in the potential association between obstructive sleep apnea syndrome (OSAS) and periodontal disease.
  
  
  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, and clinical periodontal parameters were recorded. Salivary, serum concentrations of interleukin-6 (IL-6), tumour necrosis factor (TNF-α), osteoprotegerin, soluble Receptor activator of nuclear factor kappa B ligand (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 the severe OSAS group compared to the control group. 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).
  
  
  CONCLUSIONS
  OSAS appeared to alter the tested bacteria in plaque, correlate with increasing periodontal disease severity, have additive effect on salivary IL-6.
  
  
  CONCLUSIONS
  OSAS is likely to associate with periodontal disease.
authors.affiliation: School of Dentistry, Department of Periodontology, Ege University, 35100, Bornova, İzmir, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Nizam
authors.affiliation: School of Medicine, Department of Chest Diseases, Ege University, 35100, Bornova, İzmir, Turkey.
authors.forename: O K
authors.initials: OK
authors.lastname: Basoglu
authors.affiliation: School of Medicine, Department of Chest Diseases, Ege University, 35100, Bornova, İzmir, Turkey.
authors.forename: M S
authors.initials: MS
authors.lastname: Tasbakan
authors.affiliation: Infection and Immunity Group, Dental Hospital and School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
authors.forename: D F
authors.initials: DF
authors.lastname: Lappin
authors.affiliation: School of Dentistry, Department of Periodontology, Ege University, 35100, Bornova, İzmir, Turkey. nurcan.buduneli@ege.edu.tr.
authors.forename: N
authors.initials: N
authors.lastname: Buduneli
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000032:analysis*; D010510:Periodontal Diseases / Q000150:complications* / Q000276:immunology; D012463:Saliva / Q000737:chemistry; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D014409:Tumor Necrosis Factor-alpha
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha
keywords: Apelin; Interleukin-6; Obstructive sleep apnea; Osteoprotegerin; Periodontal disease; Plaque