Does Obstructive Sleep Apnea Increase the Risk for Periodontal Disease? A Case-Control Study.

BACKGROUND: A possible association between periodontitis and obstructive sleep apnea (OSA) has been suggested. The aim of this study is to compare periodontitis prevalence between controls and patients with OSA by assessing clinical periodontal parameters and gingival crevicular fluid (GCF) levels of interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha, and high-sensitive C-reactive protein (hs-CRP); serum hs-CRP was also sampled. METHODS: A case-control study was performed that included 163 individuals: 83 individuals (18 females and 65 males) with OSA and 80 non-OSA individuals (23 females and 57 males) as controls. The test group was classified according to OSA severity. Clinical periodontal measurements were recorded, and GCF samples were collected. GCF hs-CRP, IL-lbeta, and TNF-alpha levels were analyzed using an enzyme-linked immunosorbent assay method. Serum hs-CRP was measured by latex-enhanced immunoturbidimetric assay. RESULTS: Prevalence of periodontitis in the OSA group (96.4%) was significantly higher than in the control group (75% [P <0.001]). Severe periodontitis prevalence was higher in the OSA group than control group. All periodontal clinical parameters and GCF IL-lbeta concentrations were significantly higher in patients with OSA than in controls (P = 0.001). No significant differences were found between the mild OSA and moderate-to-severe OSA groups. Additionally, there was no significant difference in GCF TNF-alpha and hs-CRP levels between the groups (P >0.05). Serum hs-CRP levels were significantly higher in patients with OSA. A significant correlation was found between GCF IL-1beta and all clinical parameters. CONCLUSIONS: Results demonstrated higher prevalence of periodontitis and higher levels of GCF IL-1beta and serum hs-CRP in patients with OSA. However, there is still a need for randomized clinical trials testing oral care interventions.