Features of periodontal diseases in patients with obstructive sleep apnea

Systemic diseases of the body, including obstructive sleep apnea (OSA), play an essential role in the pathogenesis of chronic generalized periodontitis. The main dental symptom of OSA is dry mouth due to oral breathing, which is a significant risk factor for periodontal disease. Purpose. Сlinical and laboratory assessment of periodontal tissues in patients with obstructive sleep apnea. Material and methods. The subjects of our study were patients from 35 to 65 years old. In total, 40 patients with obstructive sleep apnea syndrome and 30 patients who made up the comparison group were examined. Patients with obstructive sleep apnea syndrome were divided into three groups according to the severity of apnea. The first group included patients of women and men with mild apnea, the second group of men and women with moderate apnea, and the third with severe obstructive sleep apnea. Gum bleeding was assessed by the Mulleman-Cowell index, the degree of inflammation in the gum using the papillary-marginal-alveolar index (PMA). The hygiene index was evaluated by Quigle-Hein as modified by Tureski. Results. The hygienic condition of the oral cavity in patients with obstructive sleep apnea was rated as “unsatisfactory”. In the structure of the distribution of periodontal diseases in patients with obstructive sleep apnea, periodontitis of moderate severity prevails, while in the comparison group - periodontitis of mild severity. We also observed a correlation between the severity of apnea and the values of periodontal indices. Index data for mild severity and the data of the comparison group practically did not differ. While in severe apnea, the indices were much higher (average Muhlemann-Cowell index — 1.59±0.3, РМА — 57.49±0.87%) than the comparison group (average Muhlemann-Cowell index — 1.25±0.1, РМА — 38.84±0.93%). When assessing the qualitative composition of the oral microflora by PCR of patients with apnea, a higher number of P. gingivalis and A. Actinomycetemcomitans was revealed compared with the comparison group (p <0.02). Conclusions. According to the results of the dental examination, the prevalence of inflammatory periodontal diseases in patients with obstructive sleep apnea is higher than in the comparison group. The data obtained indicate a more severe periodontal disease in patients with obstructive sleep apnea compared with the comparison group.