Clinical Oral Investigations

, Volume 20, Issue 4, pp 659–668 | Cite as

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

  • N. Nizam
  • O. K. Basoglu
  • M. S. Tasbakan
  • D. F. Lappin
  • N. Buduneli
Original Article



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.

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, 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.


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).


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 associate with periodontal disease.


Apelin Interleukin-6 Osteoprotegerin Plaque Obstructive sleep apnea Periodontal disease 



The authors appreciate the help of the sleep technicians Bahar Yörük, Yakup Coşkun, and Mustafa Kurt in the Sleep Disorders Laboratory, Department of Chest Diseases, School of Medicine, Ege University, in gathering the data related with systemic health and to Şefika Aysoy and to Esin Şahin for their assistance in the preparation of serum samples of the patients.

Conflict of interest

The authors declare that they have no competing interests.

Source of funding

The study has been funded solely by the institutions of the authors.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • N. Nizam
    • 1
  • O. K. Basoglu
    • 2
  • M. S. Tasbakan
    • 2
  • D. F. Lappin
    • 3
  • N. Buduneli
    • 1
  1. 1.School of Dentistry, Department of PeriodontologyEge UniversityBornovaTurkey
  2. 2.School of Medicine, Department of Chest DiseasesEge UniversityBornovaTurkey
  3. 3.Infection and Immunity Group, Dental Hospital and School, School of Medicine, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK

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