RESUMO
BACKGROUND: Several studies have reported an association between periodontal disease and obstructive sleep apnea (OSA). However, heterogeneity of results suggests that there is insufficient evidence to support this association. AIMS: The objective of this study was to identify the association between periodontal disease and OSA in adults with different comorbidities. SETTINGS AND DESIGN: One hundred and ninety-nine individuals (107 women and 92 men) underwent polysomnography with a mean age of 49.9 years were recruited. MATERIALS AND METHODS: The presence of OSA, comorbidities, and periodontal disease was evaluated in each individual. Student's t-tests or Chi-square and ANOVA tests were used to determine the differences between groups. RESULTS: The prevalence of periodontal disease was 62.3% and 34.1% for gingivitis. The results showed no statistically significant association between all groups of patients with OSA and non-OSA patients for gingivitis (P = 0.27) and for periodontitis (P = 0.312). However, statistically significant association was shown between periodontitis and mild OSA compared with the periodontitis and non-OSA referent (P = 0.041; odds ratio: 1.37 and 95% confidence interval 1.11-2.68). The analysis between OSA and comorbidities showed a statistically significant difference for patients with OSA and hypertension (P < 0.001) and for patients with OSA and hypertensive cardiomyopathy (P < 0.001) compared with healthy individuals. Periodontitis was more likely in men with severe OSA and with any of two comorbidities such as hypertension or hypertensive cardiomyopathy. Women with hypertension or hypertensive cardiomyopathy were more likely to have mild OSA, and these associations were statistically significant (P < 0.05). CONCLUSIONS: This study identified association between periodontitis and mild OSA and this association was more frequent in women with hypertension or hypertensive cardiomyopathy. Periodontitis was associated with severe OSA in men who showed any of two comorbidities such as hypertension or hypertensive cardiomyopathy.
RESUMO
Objetivo: evaluar la disfunción endotelial a través de la vasodilatación mediada por flujo (VMF) en la arteria braquial en pacientes fumadores con periodontitis crónica avanzada y compararla con pacientes fumadores sin enfermedad periodontal, para determinar si hay diferencias en cuando a disfunción endotelial entre quienes presentan o no periodontitis crónica avanzada. Métodos: se incluyeron 30 pacientes con hábito de tabaquismo, 15 con periodontitis crónica avanzada y 15 sin periodontitis. Se realizó historia clínica completa, exámenes de laboratorio y prueba de vasodilatación mediada por flujo de la arteria braquial. Resultados: el estudio mostró que había diferencias significativas en los diámetros finales, resultantes de vasodilatación mediada por flujo (p=0,0328), con menores valores finales para quienes tenían enfermedad periodontal. Las diferencias en las respuestas porcentuales y en el número de personas con disfunción determinada dicotómicamente, no alcanzaron significación estadística. Conclusión: se observó que el grupo de pacientes con periodontitis crónica avanzada tuvo diámetros resultantes luego de la prueba que fueron significativamente menores que los del grupo de controles. Aunque al evaluar las diferencias en porcentajes no se alcanzó significación estadística, el estudio mostró una respuesta claramente menor en vasodilatación en el grupo con enfermedad periodontal.
Objective: To evaluate endothelial dysfunction through flow-mediated vasodilation (FMD) in the brachial artery in smokers with advanced chronic periodontitis and compare it with smokers without periodontal disease, to determine whether there are differences in endothelial dysfunction among those with or without advanced chronic periodontitis. Methods: We included 30 patients with smoking habit, 15 with advanced chronic periodontitis and 15 without periodontal disease. We performed a complete medical history, laboratory tests and flow-mediated vasodilation test of the brachial artery. Results: The study showed that there were significant differences in the final diameters, resulting from flow-mediated dilation (p = 0.0328), with lower final values for those with periodontal disease. The differences in the percentage responses and the number of people with specific dysfunction determined dichotomously did not reach statistical significance. Conclusion: We observed that the group of patients with advanced chronic periodontitis had after the test resulting diameters that were significantly lower than those in the control group. Although when evaluating differences in percentages no statistical significance was found, the study showed a clearly lower response in vasodilation in the group with periodontal disease.
