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Periodontitis and obstructive sleep apnea’s bidirectional relationship: a systematic review and meta-analysis

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Abstract

Purpose

The aim of this study is to evaluate the association between periodontal disease and obstructive sleep apnea (OSA).

Methods

Electronic search using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Central Trial Registry, Cochrane Database of Systematic Reviews, Scopus, and Embase was carried out for randomized controlled trials, longitudinal, cohort, case-control, and epidemiological studies on humans, published until October 2014. Manual searches were also performed. The participants considered were adult subjects with OSA and chronic periodontitis. The authors reviewed all articles and extracted data using a customized data abstraction sheet. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale.

Results

Six studies met the inclusion criteria set for this review. They evaluated the association between periodontal disease and OSA and the efficacy of periodontal interventions on OSA occurrence and severity. The periodontal disease outcome measures included clinical attachment loss, periodontal pocket depth, oral hygiene indices, radiographic alveolar bone loss, and salivary cytokines. Meta-analysis of four studies revealed a statistically significant association between periodontal disease and OSA (pooled odds ratio = 1.65, 95 % confidence interval (CI) = 1.11, 2.46, P = 0.01). There is insufficient evidence on the efficacy of periodontal disease interventions.

Conclusions

There is some evidence to a plausible association between periodontal disease and OSA. Evidence on the efficacy of periodontal disease interventions is insufficient. The causal-effect relationship of periodontal disease and OSA is debatable. Further research with case-control studies is warranted.

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Conflict of interest

The authors declare that they have no conflict of interest.

Review registration number

Center for Reviews and Dissemination, University of York, United Kingdom, registration number CRD42014010124.

Author information

Authors and Affiliations

  1. Division of Dental Public Health, Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia

    Thikriat S. Al-Jewair

  2. Department of Periodontics, State University of New York at Buffalo, Buffalo, NY, USA

    Reham Al-Jasser

  3. Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia

    Khalid Almas

Authors
  1. Thikriat S. Al-Jewair
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  2. Reham Al-Jasser
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  3. Khalid Almas
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Corresponding author

Correspondence to Thikriat S. Al-Jewair.

Additional information

Thikriat Al-Jewair is an assistant professor in the Division of Dental Public Health, Department of Preventive Dental Sciences, College of Dentistry, University of Dammam and holds BDS, MBA, MSc, and MS and is a fellow of Royal College of Dentists of Canada.

Reham Al-Jasser is a postgraduate specialty resident in the Department of Periodontics, State University of New York.

Khalid Almas is a Professor in the Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Dammam.

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Al-Jewair, T.S., Al-Jasser, R. & Almas, K. Periodontitis and obstructive sleep apnea’s bidirectional relationship: a systematic review and meta-analysis. Sleep Breath 19, 1111–1120 (2015). https://doi.org/10.1007/s11325-015-1160-8

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  • DOI: https://doi.org/10.1007/s11325-015-1160-8

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