Petra Stazić1, Marija Roguljić2, Zoran Đogaš3, Linda Lušić Kalcina3, Ivana Pavlinac Dodig3, Maja Valić3, Darko Božić4, Renata Pecotić3. 1. Study Programme of Dental Medicine, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia. 2. Study Programme of Dental Medicine, Department of Oral Medicine and Periodontology, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia. marija.roguljic@mefst.hr. 3. Department of Neuroscience, Split Sleep Medicine Center, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia. 4. Department of Periodontology, University of Zagreb School of Dental Medicine, Gundulićeva 5, 10000, Zagreb, Croatia.
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.
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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