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Periodontitis severity in obstructive sleep apnea patients

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Abstract

Objectives

This cross-sectional study investigated the stages of periodontitis in obstructive sleep apnea (OSA) patients and risk factors associated with periodontitis severity among them.

Materials and methods

A total of 194 patients underwent a polysomnography/polygraphy and were referred to periodontal examination. According to apnea–hypopnea index (AHI), patients were classified as mild OSA (AHI < 15) and moderate to severe OSA (AHI ≥ 15), whereas periodontitis severity was determined by the clinical attachment level (CAL) according to the recent Classification of Periodontal Diseases and Conditions. Patients were grouped into two categories: stages 1 and 2, and stages 3 and 4.

Results

Higher AHI values were reported in OSA patients exhibiting periodontitis stages 3 and 4 compared to OSA patients with periodontitis stages 1 and 2 (p = 0.043) and the non-periodontitis group (p = 0.044). A positive correlation was found between AHI and mean CAL (r = 0.215; p = 0.004), and between AHI and plaque scores (r = 0.292; p < 0.001). Following a multivariable regression analysis, AHI was a significant predictor of mean CAL (β = 0.169; p = 0.031), explaining 16.4% of variability in mean CAL (adjusted R2 = 0.164; p < 0.001). Older patients had higher odds for an increased mean CAL (β = 0.266; p = 0.001), as well as patients smoking or formerly smoking (β = 0.305; p < 0.001) whereas visiting a dental medicine doctor once a year or more often was associated with a decreased mean CAL (β =  − 0.182; p = 0.02).

Conclusions

OSA was associated with severe stages of periodontitis along with increased age, smoking, low frequency of dental visits, and poor oral hygiene.

Clinical relevance

Screening for periodontitis is recommended for patients with more severe forms of OSA.

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Acknowledgements

The authors would like to thank prof. Ana Marušić and assist. prof. Darko Kero for their valuable suggestions and support and Nika Veček dr. med. dent. and Ružica Dragun dr. med. dent. for their help in data acquisition.

Funding

This study was supported by the Croatian Science Foundation project “Translational research on neuroplasticity of breathing and effect of intermittent hypoxia in anesthesia and sleep—TIHO2_SLEEP_BREATH” (grant number IP-11–2013-5935).

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Authors and Affiliations

  1. Study Programme of Dental Medicine, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia

    Petra Stazić

  2. Study Programme of Dental Medicine, Department of Oral Medicine and Periodontology, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia

    Marija Roguljić

  3. Department of Neuroscience, Split Sleep Medicine Center, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia

    Zoran Đogaš, Linda Lušić Kalcina, Ivana Pavlinac Dodig, Maja Valić & Renata Pecotić

  4. Department of Periodontology, University of Zagreb School of Dental Medicine, Gundulićeva 5, 10000, Zagreb, Croatia

    Darko Božić

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  1. Petra Stazić
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Contributions

Petra Stazić contributed to conception, design, data acquisition, analysis, and interpretation, and drafted and critically revised the manuscript. Marija Roguljić contributed to conception, design, data acquisition, analysis, and interpretation and critically revised the manuscript. Zoran Đogaš contributed to conception, design, and data interpretation and critically revised the manuscript. Linda Lušić Kalcina contributed to design, data analysis, and interpretation, and critically revised the manuscript. Ivana Pavlinac Dodig contributed to design, data analysis, and interpretation, and critically revised the manuscript. Maja Valić contributed to design, data analysis, and interpretation, and critically revised the manuscript. Darko Božić contributed to data interpretation, and critically revised the manuscript. Renata Pecotić contributed to conception, design, and data interpretation and critically revised the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Marija Roguljić.

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Ethics approval

The study was approved by the Ethics Committee of the University of Split School of Medicine (USSM). All procedures performed in this study were in accordance with the standards of the institutional ethics committee and with the Helsinki declaration [25].

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Informed consent was obtained from all individual participants included in this study.

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The authors declare no competing interests.

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Stazić, P., Roguljić, M., Đogaš, Z. et al. Periodontitis severity in obstructive sleep apnea patients. Clin Oral Invest 26, 407–415 (2022). https://doi.org/10.1007/s00784-021-04012-5

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