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Abstract：
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.
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.
摘要：
目的：通过炎症和唾液分泌减少，建议阻塞性睡眠呼吸暂停（OSA）随着时间的推移会影响牙周状态。我们的目的是比较长期存在或不存在OSA的高血压患者的临床和影像学牙周状况，持续气道正压通气治疗（CPAP）治疗或未治疗。
方法：在2007-2009年，对394名高血压初级保健患者进行了OSA筛查。测谎被用来创建三组：没有OSA，非CPAP,或基于呼吸暂停低通气指数（AHI）的粘附性CPAP。十年后,横断面睡眠和牙周检查，包括临床和影像学检查，一份问卷，并进行基质金属蛋白酶-8(MMP-8)椅侧试验。根据牙槽骨的水平，探查出血（BoP），和探测袋深度(PPD)，患者分为4个牙周阶段:牙周健康/牙龈炎和3个牙周疾病阶段.比较牙周状态和牙周分期(n=49),非CPAP（n=38），或粘附CPAP组(n=34)。
结果：121例患者（53%为女性）的中位年龄为71岁。OSA组之间的牙齿中位数没有差异（p=.061），牙齿/植入物，（p=.107），菌斑指数（p=.245），BOP（p=.848），PPD≥4mm(p=.561),PPD≥6mm（p=.630），存在MMP-8（p=.693），骨丢失（p=.011）除外。在患有牙周健康/牙龈炎的患者中，观察到显着差异，其中70%被归类为无OSA，20%为非CPAP，10%为粘附性CPAP(p=0.029)。在牙周病阶段未见差异。
结论：患有阻塞性睡眠呼吸暂停（OSA）的高血压患者与没有OSA的患者相比，没有不良的临床牙周状况。然而,当将放射学和临床状态结合到牙周阶段时，与没有OSA的患者相比，没有OSA的患者更频繁地表现出牙周健康或牙龈炎，无论CPAP治疗。
方法：在2007-2009年，对394名高血压初级保健患者进行了OSA筛查。测谎被用来创建三组：没有OSA，非CPAP,或基于呼吸暂停低通气指数（AHI）的粘附性CPAP。十年后,横断面睡眠和牙周检查，包括临床和影像学检查，一份问卷，并进行基质金属蛋白酶-8(MMP-8)椅侧试验。根据牙槽骨的水平，探查出血（BoP），和探测袋深度(PPD)，患者分为4个牙周阶段:牙周健康/牙龈炎和3个牙周疾病阶段.比较牙周状态和牙周分期(n=49),非CPAP（n=38），或粘附CPAP组(n=34)。
结果：121例患者（53%为女性）的中位年龄为71岁。OSA组之间的牙齿中位数没有差异（p=.061），牙齿/植入物，（p=.107），菌斑指数（p=.245），BOP（p=.848），PPD≥4mm(p=.561),PPD≥6mm（p=.630），存在MMP-8（p=.693），骨丢失（p=.011）除外。在患有牙周健康/牙龈炎的患者中，观察到显着差异，其中70%被归类为无OSA，20%为非CPAP，10%为粘附性CPAP(p=0.029)。在牙周病阶段未见差异。
结论：患有阻塞性睡眠呼吸暂停（OSA）的高血压患者与没有OSA的患者相比，没有不良的临床牙周状况。然而,当将放射学和临床状态结合到牙周阶段时，与没有OSA的患者相比，没有OSA的患者更频繁地表现出牙周健康或牙龈炎，无论CPAP治疗。
