Obstructive Sleep Apnea and Periodontal Disease: A Systematic Review

Lembo, Daniela; Caroccia, Francesco; Lopes, Chiara; Moscagiuri, Francesco; Sinjari, Bruna; D’Attilio, Michele

doi:10.3390/medicina57060640

Cited by 17 publications

(14 citation statements)

References 34 publications

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“…However, longitudinal studies linking OSA to periodontitis have found little evidence, and population sizes are often too small to detect clinically relevant associations. In current studies, there are systematic reviews or meta-analyses on the relationship between OSA and periodontitis [ 25 , 26 ], but so far only one meta-analyses has been published in 2015, focusing on the correlation [ 25 ], and no studies on the incidence of periodontitis in OSA patients. In addition, most reliable and new trial results have been published since 2016.…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk of periodontitis in obstructive sleep apnea: A meta-analysis

Zhang

Zhai

et al. 2022

PLoS ONE

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Introduction At present, the possible relationship between obstructive sleep apnea and periodontitis has been reported. The link remains ambiguous and unclear. The objective of this study is to assess the association between OSA and periodontitis. Methods Three databases, including Pubmed, Embase, and the Web of Science, were systematically searched to identify eligible studies that from their establishment to February 2022 for relevant studies. Subsequently, a meta-analysis was conducted to determine the relationship of pooled-effects more accurately. Results A summary analysis of the 9 results from the studies covering 43,414 individuals showed a statistical association results of the between OSA and the incidence rate of periodontitis(OR = 0.52; 95% CI: 0.49–0.55; I2 = 98.43%; P = 0.000). In addition, OSA patients and the risk of the population were statistically significantly associated with an increased risk of periodontitis.(OR = 1.56; 95% CI: 1.06–2.06; P = 0.00). Conclusions Our results indicated that OSA may be associated with an increased risk of periodontitis. Further studies are required to confirm the link and explore the underlying mechanism of the link.

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Section: Introductionmentioning

confidence: 99%

Incidence and risk of periodontitis in obstructive sleep apnea: A meta-analysis

Zhang

Zhai

et al. 2022

PLoS ONE

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“…Nizam et al suggest that OSAS has a key role in the development of periodontal inflammation, with bacterial population changes in the subgingival plaque and an increase in salivary concentration of IL-6 and apeline [ 19 ]. Consequently, a possible link between periodontitis and OSAS has been hypothesized, although the pathophysiological mechanism and cause–effect still remain unclear [ 20 ]. For several years, the dentist has represented an important figure as a diagnostic sentinel, and—along with sleep medicine specialists—had a key role in its therapeutical treatment.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

Santilli

Manciocchi

D’Addazio

et al. 2021

IJERPH

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Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder that often remains undiagnosed and untreated. OSAS prevalence is increasing exponentially. Starting on the dentist’s role as an epidemiological and diagnostic “sentinel”, the purpose of this study was to assess the prevalence of OSAS. The clinical diaries of 4659 patients were reviewed through a single-center retrospective analytic study. Descriptive statistical analysis was performed. Only 0.26% of patients reported to suffer from sleep apnea and were then diagnosed with OSAS. It was found that, out of 4487 patients, 678 suffered from hypertension (14.80%), 188 from gastro-esophageal-reflux-disease (GERD = 4.10%) and 484 from gastritis (10.78%). These results could be related to a difficult diagnosis of OSAS and to the absence of a dedicated section on sleep disorders in medical records. Therefore, the introduction of a question dedicated to sleep disorders, the administration of questionnaires (such as the STOP-BANG questionnaire) for early diagnosis, a multidisciplinary approach and pneumological examination could support the dentist in identifying patients at risk of OSAS.

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“…Current studies have shown that there appears to be low evidence for the association between OSAHS and periodontitis [ 23 ], and the pathophysiological mechanisms underlying the association between the two conditions remain unclear. We hypothesized that there is a possible correlation between OSAHS and periodontal disease.…”

Section: Introductionmentioning

confidence: 99%

Effects of Hypoxic Environment on Periodontal Tissue through the ROS/TXNIP/NLRP3 Inflammasome Pathway

Zhu

2022

BioMed Research International

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There is low evidence for the possible association between obstructive sleep apnea-hypopnea syndrome (OSAHS) and periodontitis, necessitating further research. This study was aimed at investigating this association. For the in vitro study, 8-day-old Wistar rats were divided into the unilateral nasal obstruction group (UNO) and the sham surgery group (SHAM). Rats in the former group were subjected to UNO by cauterization of the external nostril at the age of 8 days. Immunofluorescence analysis, quantitative real-time polymerase chain reaction, and western blot were performed to assess the expression of thioredoxin-interacting protein (TXNIP), NLR family pyrin domain-containing 3 (NLRP3) inflammasome-associated factors, and interleukin-1β (IL-1β). Throughout the experimental period, the weights of rats in the two groups were similar. The mRNA and protein expression of TXNIP and IL-1β was significantly higher in the UNO than in the SHAM groups. Compared with SHAM, NLRP3 inflammasome-associated factors were activated in the UNO group. For the in vitro study, a cellular hypoxia model was established by treating human periodontal ligament cells (HPDLCs) with cobalt chloride. The studies showed that hypoxia can induce an excessive production and accumulation of reactive oxygen species (ROS) in HPDLCs and induce abnormal expression of TNXIP, NLRP3 inflammasome-related factors, and IL-1β. More importantly, N-acetylcysteine induced reduction of ROS in HPDLCs, downregulated TXNIP expression, inhibited the expression and aggregation of NLRP3 inflammasome-related factors, and abrogated the inflammatory response to hypoxia. In conclusion, hypoxia-induced ROS can activate the TXNIP/NLRP3 inflammasome signaling pathway in response to oxidative stress, resulting in the increased expression of inflammatory factors in HPDLCs. Our findings provide evidence for the mechanism underlying the possible association between OSAHS and periodontal disease.

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Obstructive Sleep Apnea and Periodontal Disease: A Systematic Review

Cited by 17 publications

References 34 publications

Incidence and risk of periodontitis in obstructive sleep apnea: A meta-analysis

Incidence and risk of periodontitis in obstructive sleep apnea: A meta-analysis

Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

Effects of Hypoxic Environment on Periodontal Tissue through the ROS/TXNIP/NLRP3 Inflammasome Pathway

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