Kvarnvik Christine, Ahonen Hanna, Jansson Henrik, Broström Anders, Stensson Malin, Sayardoust Shariel
School of Health and Welfare, Center for Oral Health, Jönköping University, Jönköping, Sweden.
Department of Periodontology, Postgraduate Dental Education, The Institute of Odontology, Region Jönköping County, Jönköping, Sweden.
Clin Exp Dent Res. 2024 Apr;10(2):e859. doi: 10.1002/cre2.859.
Through 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).
In 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.
The 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.
Hypertensive 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.
通过炎症和唾液分泌减少，阻塞性睡眠呼吸暂停（OSA）被认为会随着时间影响牙周状况。我们的目的是比较有或没有长期存在OSA的高血压患者的临床和影像学牙周状况，这些患者接受或未接受持续气道正压通气治疗（CPAP）。
在2007 - 2009年期间，对394例高血压初级保健患者进行了OSA筛查。根据呼吸暂停低通气指数（AHI），使用多导睡眠图将患者分为三组：无OSA组、非CPAP组或依从CPAP组。10年后，进行了一项横断面睡眠和牙周检查，包括临床和影像学检查、问卷调查以及基质金属蛋白酶-8（MMP-8）床边检测。根据牙槽骨水平、探诊出血（BoP）和探诊袋深度（PPD），将患者分为四个牙周阶段：牙周健康/牙龈炎以及三个牙周疾病阶段。比较了OSA组（n = 49）、非CPAP组（n = 38）或依从CPAP组（n = 34）之间的牙周状况和牙周阶段。
121例患者（53%为女性）的中位年龄为71岁。在牙齿中位数（p = 0.061）、牙齿/种植体（p = 0.107）、菌斑指数（p = 0.245）、BoP（p = 0.848）、PPD≥4mm（p = 0.561）、PPD≥6mm（p = 0.630）、MMP-8存在情况（p = 0.693）方面，OSA组之间未见差异，但骨质流失方面存在差异（p = 0.011）。在牙周健康/牙龈炎阶段的患者中观察到显著差异，其中70%被归类为无OSA，20%为非CPAP，10%为依从CPAP（p = 0.029）。在牙周疾病阶段未见差异。
与无OSA的患者相比，患有阻塞性睡眠呼吸暂停（OSA）的高血压患者没有不良的临床牙周状况。然而，当将影像学和临床状况合并为牙周阶段时，无论是否接受CPAP治疗，无OSA的患者比有OSA的患者更频繁地表现为牙周健康或牙龈炎。
