Lin Ju-Ying, Schneiderman Emet, Hui Jason, Parra Carrasquer Carlos, Stenberg William, German Zohre, Harvey Jason Adam, Schramm Preetam
Department of Periodontology, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
Dent J (Basel). 2025 Jun 27;13(7):292. doi: 10.3390/dj13070292.
: Periodontitis is linked to sleep-disordered breathing (SDB), including snoring, with 50-75% of cases involving mouth breathing (MB). Standard treatment includes scaling and root planing (SRP). Oral appliance therapy (OAT) is used to treat snoring and SDB. OAT plus a mouth shield (OAT+) worn during sleep may reduce MB to enhance periodontal health. This study evaluated whether OAT+, as an adjunct to SRP, improves periodontal health by reducing periodontal pathogens and facilitating upper airway patency. : Fourteen participants with mild-moderate periodontitis were randomized to receive SRP on one side of the mouth at baseline (T0). Pocket depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded, and bacterial DNA from periodontal pockets were analyzed via PCR at baseline (T0) and 12 weeks (T3). At 4 weeks (T1), all participants received a self-titrated myTAP OA, followed by a mouth shield at 8 weeks (T2). Sleep metrics, including respiratory disturbance index (RDI), were recorded using the NOX T3 at T0-T3. : BOP and deep PD levels exhibited slight improvements from the baseline for both SRP and non-SRP (OAT+ only) treated sites but did not achieve significance. BOP decreased significantly more from the baseline in the SRP than in the non-SRP group at T3 ( = 0.028); presence declined on both sides ( = 0.0135). Other periodontal and bacterial parameters showed no significant differences between or within groups. Snoring ( = 0.011), MB ( = 0.025), and RDI ( = 0.019) significantly decreased with OAT+ at T3. : In mild-moderate periodontitis patients who snore, OAT+ reduces snoring, MB, and obstructive events, serving as an adjunct to SRP with no negative clinical effects over the short term. The combined therapy yielded similar results to OAT+ alone, likely due to minimization of MB. Its capacity to improve the oral environment is worthy of further investigation.
牙周炎与睡眠呼吸紊乱（SDB）有关，包括打鼾，50%-75%的病例涉及口呼吸（MB）。标准治疗包括龈下刮治和根面平整（SRP）。口腔矫治器疗法（OAT）用于治疗打鼾和睡眠呼吸紊乱。睡眠期间佩戴OAT加口盾（OAT+）可能会减少口呼吸，以促进牙周健康。本研究评估了作为SRP辅助手段的OAT+是否通过减少牙周病原体和促进上呼吸道通畅来改善牙周健康。14名轻度至中度牙周炎患者在基线时（T0）被随机分配在口腔一侧接受SRP治疗。记录牙周袋深度（PD）、探诊出血（BOP）和菌斑指数（PI），并在基线时（T0）和12周时（T3）通过PCR分析牙周袋中的细菌DNA。在4周时（T1），所有参与者都接受了自我滴定的myTAP口腔矫治器，随后在8周时（T2）佩戴口盾。在T0-T3期间，使用NOX T3记录包括呼吸紊乱指数（RDI）在内的睡眠指标。对于SRP治疗部位和仅接受OAT+（非SRP）治疗的部位，BOP和深PD水平较基线均有轻微改善，但未达到显著水平。在T3时，SRP组的BOP较基线下降幅度显著大于非SRP组（P = 0.028）；两侧的牙龈卟啉单胞菌（P.gingivalis）检出率均下降（P = 0.0135）。其他牙周和细菌参数在组间或组内均无显著差异。在T3时，使用OAT+后打鼾（P = 0.011）、口呼吸（P = 0.025）和RDI（P = 0.019）均显著降低。在打鼾的轻度至中度牙周炎患者中，OAT+可减少打鼾、口呼吸和阻塞性事件，作为SRP的辅助手段，短期内无负面临床影响。联合治疗与单独使用OAT+产生的结果相似，可能是由于口呼吸减少。其改善口腔环境方面的能力值得进一步研究。
