Affiliation:
1. School of Health and Welfare, Center for Oral Health Jönköping University Jönköping Sweden
2. Department of Periodontology Postgraduate Dental Education, The Institute of Odontology, Region Jönköping County Jönköping Sweden
3. Department of Odontology and Oral Health Sciences Jönköping University Jönköping Sweden
4. Folktandvården Skåne Lund Sweden
5. School of Health and Welfare Jönköping University Jönköping Sweden
6. Department of Clinical Neurophysiology Linköping University Hospital Linköping Sweden
7. Department of Health and Caring Sciences, Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
8. Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
9. Center for Oral Rehabilitation Linköping Sweden
Abstract
AbstractObjectivesThrough inflammation and hyposalivation, obstructive sleep apnea (OSA) is suggested to affect periodontal status over time. Our aim was to compare the clinical and radiographic periodontal status of hypertensive patients with or without long‐term presence of OSA, treated or untreated with continuous positive airway pressure treatment (CPAP).Materials and MethodsIn 2007–2009, a screening for OSA was conducted among 394 hypertensive primary care patients. Polygraphy was used to create three groups: no OSA, non‐CPAP, or adherent CPAP based on the apnea hypopnea index (AHI). After 10 years, a cross‐sectional sleep and periodontal examination including a clinical and radiographic examination, a questionnaire, and a matrix metalloproteinase‐8 (MMP‐8) chair‐side test was conducted. Based on levels of alveolar bone, bleeding on probing (BoP), and probing pocket depth (PPD), patients were categorized into four periodontal stages: periodontal health/gingivitis and three periodontal disease stages. Periodontal status and periodontal stages were compared between the OSA (n = 49), non‐CPAP (n = 38), or adherent CPAP (n = 34) groups.ResultsThe 121 patients (53% women) had a median age of 71 years. No differences were seen between the OSA groups regarding median number of teeth (p = .061), teeth/implants, (p = .107), plaque index (p = .245), BoP (p = .848), PPD ≥ 4 mm (p = .561), PPD ≥ 6 mm (p = .630), presence of MMP‐8 (p = .693) except for bone loss (p = .011). Among patients with stage periodontal health/gingivitis a significant difference was seen, as 70% of those were categorized as no OSA, 20% as non‐CPAP, and 10% as adherent CPAP (p = .029). Differences were not seen in periodontal disease stages.ConclusionsHypertensive patients with obstructive sleep apnea (OSA) did not have an adverse clinical periodontal status compared to patients without OSA. However, when combining radiographic and clinical status into periodontal stages, patients without OSA more frequently exhibited periodontal health or gingivitis compared to patients without OSA, regardless of CPAP treatment.